Removal of antiacetylcholine receptor antibodies by protein-A immunoadsorption in myasthenia gravis

E. Berta, P. Confalonieri, O. Simoncini, G. Bernardi, G. Busnach, R. Mantegazza, F. Cornelio, C. Antozzi

Research output: Contribution to journalArticlepeer-review


Myasthenia Gravis is an autoimmune disease in which autoantibodies to the acetylcholine receptor interfere with neuromuscular transmission. Plasma exchange is effective in temporarily relieving the symptoms of the disease, but for repeated use the lack of selectivity and need for replacement fluids (which increases the risk of contracting viral diseases) are important drawbacks. Staphylococcal protein A, a potent ligand for immunoglobulins, that interacts negligibly with other plasma proteins, appears to be an optimal candidate for removing antiacetylcholine receptor antibodies, which are mostly IgG. We treated three patients with severe immunosuppression-resistant myasthenia gravis with protein A immunoadsorption. Neurological impairment significantly improved in all patients. After immunoadsorption of 1.5-2 plasma volumes per session, the mean percentage reductions for serum IgG and specific autoantibodies were 71% and 82% respectively. No major side effects occurred. Protein A immunoadsorption appears to be a safe, efficient and effective alternative to plasma exchange for selected myasthenic patients requiring prolonged apheresis.

Original languageEnglish
Pages (from-to)603-608
Number of pages6
JournalInternational Journal of Artificial Organs
Issue number11
Publication statusPublished - 1994


  • Antiacetylcholine receptor antibodies
  • Immunoadsorption
  • Immunoglobulins
  • Myasthenia gravis
  • Plasmapheresis
  • Protein A

ASJC Scopus subject areas

  • Biophysics


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