Significance in neonatal myasthenia gravis of inhibitory effect of amniotic fluid on binding of antibodies to acetylcholine receptor.

The effect of amniotic fluid on the binding of anti-acetylcholine receptor (anti-AChR) antibodies from myasthenia gravis (MG) patients to AChR preparations was examined by radioimmunoassay using 125I-labelled alpha-bungarotoxin. Human amniotic fluid from healthy women in their second trimester inhibited the in-vitro interaction between antibody and antigen. This finding suggests that during pregnancy there is a similar inhibitory effect in MG on the in-vivo binding of maternal anti-AChR antibodies, transferred through the placenta, to AChR at the fetal neuromuscular junction. The presence of feto-placental inhibitory factors may explain the development of transitory muscular weakness only after birth and only in the minority of the babies born to myasthenic mothers.