Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 29;16(2):973-978.
doi: 10.21037/jtd-23-94. Epub 2024 Feb 26.

Anti-titin antibodies in a cohort of myasthenia gravis patients

João Moura  1 , Ana Paula Sousa  2 , Raquel Samões  1   3   4 , Paula Carneiro  5 , Esmeralda Neves  5 , Ana Martins Silva  1   3   4 , Ernestina Santos  1   3   4
Affiliations

Anti-titin antibodies in a cohort of myasthenia gravis patients

João Moura et al. J Thorac Dis. .

Abstract

Background: Anti-titin antibodies have been previously associated with thymoma-associated myasthenia gravis (MG) and a more clinically severe form of MG. While currently only serving as a disease biomarker, its possible utility as an indicator of underlying thymus malignancy may be of value in clinical practice.

Methods: Data was retrospectively collected and analyzed from 2013 to 2022 using an institutional record of MG patients. Anti-titin antibodies were assessed using Line Blot immunoassay.

Results: From 130 MG cases, 32 (24.6%) were anti-titin positive. Anti-titin positive cases were associated with older age of disease onset [median (IQR): 63.0 (44.3-70.8) vs. 35.5 (24.8-60.8) years] (P<0.01). Thymectomy was performed in 46 (35.4%) MG patients, 12 of which anti-titin positive (26.1%). Thymectomy samples from anti-titin positive patients comprised 10 (83.3%) cases of thymoma and 2 (16.7%) cases of thymus hyperplasia. There was a tendency towards anti-titin positive patients having more thymoma while anti-titin negative displayed more hyperplasia (P<0.01). Anti-titin positivity correlated with thymoma in patients with age of onset bellow 50 years (P=0.028). Anti-titin positivity was significantly associated with generalized MG in the late-onset group (P=0.005).

Conclusions: The presence of anti-titin antibodies appears to correlate with underlying thymoma in early-onset MG cases and with generalized MG in late-onset cases. Prospective studies are needed to further study this association.

Keywords: Myasthenia gravis (MG); anti-titin; neuroimmunology; thymoma.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-94/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Distribution of MGFA classification grades according to the anti-titin serostatus for the whole cohort (A) and for patients with age of disease onset below (B) and above 50 years (C). MGFA, Myasthenia Gravis Foundation of America.
Figure 2
Figure 2
Distribution of histological patterns of thymectomy specimens according to the anti-titin serostatus.
See this image and copyright information in PMC

References

    1. Gilhus NE. Myasthenia Gravis. N Engl J Med 2016;375:2570-81. 10.1056/NEJMra1602678 - DOI - PubMed
    1. Gilhus NE, Verschuuren JJ. Myasthenia gravis: subgroup classification and therapeutic strategies. Lancet Neurol 2015;14:1023-36. 10.1016/S1474-4422(15)00145-3 - DOI - PubMed
    1. Santos E, Coutinho E, Moreira I, et al. Epidemiology of myasthenia gravis in Northern Portugal: Frequency estimates and clinical epidemiological distribution of cases. Muscle Nerve 2016;54:413-21. 10.1002/mus.25068 - DOI - PubMed
    1. Romi F, Hong Y, Gilhus NE. Pathophysiology and immunological profile of myasthenia gravis and its subgroups. Curr Opin Immunol 2017;49:9-13. 10.1016/j.coi.2017.07.006 - DOI - PubMed
    1. Tskhovrebova L, Trinick J. Roles of titin in the structure and elasticity of the sarcomere. J Biomed Biotechnol 2010;2010:612482 .10.1155/2010/612482 - DOI - PMC - PubMed