The effect of immunosuppression or thymectomy on the response to tetanus revaccination in myasthenia gravis

Objective: To determine the effect of tetanus toxoid (TT) revaccination on circulating B-, T-and NK-cell com-partments in myasthenia gravis (MG) patients.Methods: Lymphocyte (sub)populations and differentiation stages were assessed by flow cytometry in 50 TT revaccinated MG patients. TT-specific proliferative responses were explored in PBMC cultures. Results: In patients treated with azathioprine B-and NK cell numbers were strongly decreased. Lymphocyte (sub) populations remained unaffected upon TT revaccination. t All patients showed a significant TT-induced prolif-erative response.Conclusion: TT revaccination is effective in MG patients with stable disease irrespective of their thymectomy status and medication and does not alter the composition of the lymphocyte compartment.

Automated summary

This study demonstrates that tetanus toxoid (TT) revaccination does not alter the composition of lymphocyte compartments in myasthenia gravis (MG) patients with stable disease. It also effectively stimulates TT-specific proliferative responses.