Adipokines Could Help Assess Course of Myasthenia Gravis, Study Suggests

Adipokines Could Help Assess Course of Myasthenia Gravis, Study Suggests

Hormones produced by adipose (fat) tissue, called adipokines, can help assess the progression and status of myasthenia gravis, researchers suggest.

A team at Medical University of Silesia in Poland assessed the association between the levels of different adipokines and clinical factors that characterize myasthenia gravis.

The study, “What is the role of adipokines in myasthenia gravis?,” was published in the journal Therapeutics and Clinical Risk Management.

“The identification of the causative agent or a factor affecting the course of the disease and the effectiveness of treatment would be crucial elements in improving the diagnosis and therapy of patients with myasthenia gravis,” the researchers said.

For decades, adipose tissue was perceived as a simple reservoir of fat. But more recently, it was discovered that adipocytes are very active cells.

Adipocytes are responsible for the production of several signaling molecules and hormones (adipokines) essential for the regulation of critical mechanisms in the body, including appetite and the digestive process, and broader processes such as inflammation and autoimmunity.

Given adipokines’ role in the regulation of immune cells, and consequent modulation of the inflammatory status, it is possible that these hormones might influence the course of myasthenia gravis.

The study enrolled 50 patients with a mean age of 60.7 years and a mean disease duration of about 9.5 years. It also enrolled 30 age-matched healthy volunteers. Among the patients, 82% were AChR antibody positive and 18% were negative.

Blood analysis showed that levels of several key adipokines — in particular adiponectin, omentin, visfatin, lectin, and resistin — were similar among patients with early- and late-onset disease.  Adiponectin and resistin levels were 2.5 and 1.4 times higher in myasthenia gravis patients than in the healthy control group, respectively.

Additional analyses revealed several associations between adipokines’ levels and clinical factors that characterize the common disease course.

Adiponectin levels were elevated in patients who were taking a higher dose of acetylcholinesterase inhibitors and who had moderate class IIIb disease, according to the Myasthenia Gravis Foundation of America (MGFA) clinical classification. Also, higher adiponectin levels were associated with poorer quality of life and more severe disease manifestation.

“Adiponectin has mainly an anti-inflammatory effect; hence, according to our observations, high levels of adiponectin in patients with severe symptoms of the disease may be indicative of the body’s response to exacerbation of the disease,” the researchers said.

Levels of the pro-inflammatory visfatin were found to be highly correlated with higher levels of the inflammatory protein CRP. Leptin, a pro-inflammatory hormone that also controls appetite, correlated with with disease duration and treatment duration.

The researchers did not find any association between changes in adipokine levels and the use of Imuran (azathioprine).

These findings suggest that changes in the levels of different adipokines might contribute broadly to the development and progression of myasthenia gravis.

“The current study is a pilot trial, and our observations should be continued and further investigated,” the researchers stated.

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