Myasthenia Gravis

Myasthenia gravis is an autoimmune disorder, characterized by the formation of antibodies against the acetylcholine receptors (Ach-R) situated in the neuromuscular junction. The anti-AchR antibodies block the signals from the nerves to the muscles which are manifested by muscle weakness that worsens at the end of the day.

Symptoms

The weakness of the eye muscles causes double vision and drooping, the involvement of the facial muscles is represented by a difficulty to hold the head straight and the mouth closed.

Problems with chewing and swallowing as well as voice changes may be the first symptoms. Other muscle groups are less commonly affected, but the involvement of the diaphragms during a myasthenic crisis is potentially life-threatening.


The role of Chinese medicine

Conventional medications such as acetylcholinesterase inhibitors and corticosteroids are used in the management of Myasthenia gravis. In addition, various researches have demonstrated improved treatment results if standard drugs are being combined with acupuncture or traditional Chinese medicine herbs.

The beneficial results from both these alternative medicine methods are due to:

1
The increase of the acetylcholine receptors in the neuromuscular junction, along with the reduction of the antibodies against the Ach-R, leading to a better transmission of the nerve signals and decreased muscle weakness.
2
Regulation of the immune system- acupuncture is proved to regulate the secretion of various pro-inflammatory substances such as Interleukin-4 (IL-4) as well as Il-12, IL-18. In that way, acupuncture suppresses the abnormal immune response, seen in Myasthenia gravis.
The use of Chinese herbal medicine as an adjunct or supportive therapy for the management of the patients suffering from myasthenia gravis has been in question for a while.

Acupuncture

Another study has demonstrated the beneficial effects of electroacupuncture warming therapy as a combination treatment for myasthenia gravis by evaluating the levels of interleukin-4 (IL-4) in patients. IL-4 belongs to a group of proteins that the body produce in order to execute many regulating immunity and inflammation and wound repair.

In case of myasthenia gravis, lower levels of IL-4 indicate that the body will produce a decreased number of those cells which are responsible for the initiation of the autoimmune reaction that causes the symptoms associated with this disease. The study comprised of sixty patients which were divided into a group of two. The observation group received oral administration of Pyridostigmine and Prednisone along with electroacupuncture warming therapy while the control group was treated with the medicines alone.

Clinical symptoms and the levels of serum IL-4 were then assessed before and after the treatment. The serum levels of IL-4 were markedly decreased in the patients receiving combination treatment which means that they were showing a reduced immune response. Clinical symptoms were also improved in the observation group which indicates that electroacupuncture therapy can be used as an adjunct treatment in the patients with myasthenia gravis. The above-mentioned findings are further supported by another study in which sixty cases of the patients with ocular myasthenia gravis were treated with acupuncture and moxibustion. Findings demonstrated the total efficacy rate to be 91.7% which proves the therapeutic efficacy of this treatment.

Acupuncture along with the application of different Chinese medicine herb mixtures alleviates the symptoms and prevents relapses. One of their greatest advantages is that there are minimal side effects associated.

References

1. Huang H, Pan H, Wang HF, Warming yang and invigorating qi” acupuncture alters acetylcholine receptor expression in the neuromuscular junction of rats with experimental autoimmune myasthenia gravis, Neural Regen Res. 2016 Mar; 11(3): 465–468. doi: 10.4103/1673-5374.179060

2. Qi G, Gu Sh, Liu P, Effects of combined traditional Chinese medicine with immunosuppressive agents for patients with myasthenia gravis, Int J Clin Exp Med. 2015; 8(10): 19044–19050

Qi GY, Liu P, Gao BL, Shenqi Fuzheng Injection Alleviates the Transient Worsening Caused by Steroids Pulse Therapy in Treating Myasthenia Gravis, Evidence-Based Complementary and Alternative Medicine, Volume 2013 (2013)

Wang JK, Zhang XF, Yang MS, A Prospective Study of Tablet Fuzhengqiangjin Therapy in Patients with Myasthenia Gravis, Chinese Journal of Neuroimmunology and Neurology, 2007-02

Xi-qian Yang et al. Efficacy and Safety of the TCM Qi-Supplementing Therapy in Patients with Myasthenia Gravis: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine.Volume 2017, Article ID 6512572

CHEN, C.PAN, Y. LIU Sixty cases of ocular myasthenia gravis treated with acupuncture and moxibustion at extra-meridian and collateral. World Journal of Acupuncture – Moxibustion, Volume 22, Issue 4, December 2012, Pages 56-59

Wang SH, Cui X, Feng J. Electroacupuncture warming therapy combined with western medicine for the treatment of myasthenia gravis and effect on IL-4 level in the patients. Zhongguo Zhen Jiu. 2007 Dec;27(12):901-3

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