• Akiyuki Uzawa, Naoki Kawaguchi, Tetsuya Kanai, Keiichi Himuro, and Satoshi Kuwabara.
• Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
• J. Neurol. Neurosurg. Psychiatr.. 2015 Jun 1;86(6):695-7.

ObjectiveHigh mobility group box 1 (HMGB1) functions as an inflammatory mediator and is implicated in the pathogenesis of various autoimmune diseases. Our primary aim is to determine whether HMGB1 is involved in the pathogenesis of myasthenia gravis (MG).MethodsSerum HMGB1 levels of 60 patients with anti-acetylcholine receptor (AChR) antibody-positive MG without immunosuppressive treatment and of 10 patients with anti-muscle-specific receptor tyrosine kinase (MuSK) antibody-positive MG were compared with those in 40 controls. We also investigated the potential correlation between serum HMGB1 levels and the clinical variables in patients with MG.ResultsSerum HMGB1 levels in patients with anti-AChR antibody-positive MG were higher than those in controls (7.80 ± 7.47 vs 4.13 ± 2.55 ng/mL, p=0.004) and were decreased after treatment (p=0.051). Although not significant, patients with anti-MuSK antibody-positive MG showed higher serum HMGB1 levels than the controls (p=0.178). There were correlations between serum HMGB1 levels and phenotypes of anti-AChR antibody-positive MG: patients with generalised MG showed higher HMGB1 levels than those of patients with ocular MG (p=0.059) and controls (p=0.002); patients with thymoma showed higher HMGB1 levels than those without thymoma (p=0.094) and controls (p=0.001).ConclusionsSerum HMGB1 is elevated in patients with MG and may play a key role in the inflammation of the neuromuscular junction.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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