[The effect of plasmapheresis with high-dose intravenous methylprednisolone therapy on cytokine synthesis of peripheral blood monocyte from patients with myasthenia gravis].

: We studied interleukin-1 beta (IL-1 beta) and interleukin-2 (IL-2) production by peripheral blood monocyte (PBM) from 7 patients with myasthenia gravis (MG) receiving plasmapheresis (PP) (PP therapy only, one patient; PP+high dose intravenous methylprednisolone therapy (pulse therapy: pu therapy), 6 patients) to evaluate the effects of PP therapy on cytokine synthesis of PBM from MG patients. Immediately after PP, PBM IL-2 production decreased and PBM IL-1 beta production increased. In a patient receiving PP only, PBM IL-2 production increased again and PBM IL-1 beta production maintained the high value through the next day. But in 6 patients receiving PP+pu therapy, PBM IL-2 production maintained significantly (p < 0.01) through the next day compared with a patient receiving PP only. In four patients receiving repeated PP+pu therapy, as PBM IL-2 production gradually reduced, the severity of MG improved. These findings suggest that PP in MG had the effects of down-regulation of PBM IL-2 production and up-regulation of PBM IL-1 beta production, and that PP+pu therapy combined with PP suppresses the enhanced PBM IL-1 beta synthesis in MG patients.