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The Journal of Neuroscience, November 4, 2009, 29(44):13898-13908; doi:10.1523/JNEUROSCI.2833-09.2009

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*Myasthenia Gravis

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Neurobiology of Disease
Main Immunogenic Region Structure Promotes Binding of Conformation-Dependent Myasthenia Gravis Autoantibodies, Nicotinic Acetylcholine Receptor Conformation Maturation, and Agonist Sensitivity

Jie Luo,1 Palmer Taylor,2 Mario Losen,3 Marc H. de Baets,3 G. Diane Shelton,4 and Jon Lindstrom1

1Department of Neuroscience, University of Pennsylvania Medical School, Philadelphia, Pennsylvania 19104-6074, 2Department of Pharmacology, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, California 92093-0650, 3Neuroimmunology Group, Department of Neuroscience, School of Mental Health and Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands, and 4Department of Pathology, School of Medicine, University of California, San Diego, La Jolla, California 92093-0709

Correspondence should be addressed to Dr. Jon M. Lindstrom, Department of Neuroscience, University of Pennsylvania Medical School, 217 Stemmler Hall, 36th and Hamilton Walk, Philadelphia, PA 19104-6074. Email: jslkk{at}mail.med.upenn.edu

The main immunogenic region (MIR) is a conformation-dependent region at the extracellular apex of {alpha}1 subunits of muscle nicotinic acetylcholine receptor (AChR) that is the target of half or more of the autoantibodies to muscle AChRs in human myasthenia gravis and rat experimental autoimmune myasthenia gravis. By making chimeras of human {alpha}1 subunits with {alpha}7 subunits, both MIR epitopes recognized by rat mAbs and by the patient-derived human mAb 637 to the MIR were determined to consist of two discontiguous sequences, which are adjacent only in the native conformation. The MIR, including loop {alpha}1 67–76 in combination with the N-terminal {alpha} helix {alpha}1 1–14, conferred high-affinity binding for most rat mAbs to the MIR. However, an additional sequence corresponding to {alpha}1 15–32 was required for high-affinity binding of human mAb 637. A water soluble chimera of Aplysia acetylcholine binding protein with the same {alpha}1 MIR sequences substituted was recognized by a majority of human, feline, and canine myasthenia gravis sera. The presence of the {alpha}1 MIR sequences in {alpha}1/{alpha}7 chimeras greatly promoted AChR expression and significantly altered the sensitivity to activation. This reveals a structural and functional, as well as antigenic, significance of the MIR.


Received June 15, 2009; revised Sept. 3, 2009; accepted Sept. 7, 2009.

Correspondence should be addressed to Dr. Jon M. Lindstrom, Department of Neuroscience, University of Pennsylvania Medical School, 217 Stemmler Hall, 36th and Hamilton Walk, Philadelphia, PA 19104-6074. Email: jslkk{at}mail.med.upenn.edu






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