Cross-reactivity of anti-acetylcholine receptor autoantibodies.

The heterogeneity of the specificities of anti-acetylcholine receptor (anti-AChR) antibodies of myasthenia gravis (MG) patients has been demonstrated by comparing reactions against a panel of xenogeneic AChR. For each patient there was a more or less unique cross-reactivity profile. Such heterogeneity emphasizes the need to use human AChR for the routine detection of anti-AChR. In vitro cross-reactivity was important in predicting the effect of anti-AChR after passive transfer to rats. Specificity may influence the outcome in human neonates receiving maternal anti-AChR via the placenta. In contrast to the extreme heterogeneity seen in spontaneous MG, the antibodies associated with D-penicillamine-induced MG were more homogeneous.