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- Fundamental aspects
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1. Inflammation and tissue homeostasis
- Prof. Herman Waldmann
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2. Introduction to the immune system
- Prof. Herman Waldmann
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3. Hematopoiesis: the making of an immune system
- Prof. Paul J. Fairchild
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4. Inflammation: purposes, mechanisms and development
- Prof. Pietro Ghezzi
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5. Phagocytosis
- Dr. Eileen Uribe-Querol
-
6. Regulated cell death mechanisms and their crosstalk with the immune system 1
- Dr. Luis Alberto Baena-Lopez
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7. Regulated cell death mechanisms and their crosstalk with the immune system 2
- Dr. Luis Alberto Baena-Lopez
- Innate immunity
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11. Cells of the innate immune system
- Prof. Kevin Maloy
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12. Microbial recognition and the immune response
- Dr. Dana Philpott
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13. Toll-like receptor signalling during infection and inflammation
- Prof. Luke O'Neill
- Intercellular mediators
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14. Chemokines
- Dr. James E. Pease
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15. Cytokines
- Prof. Iain McInnes
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16. IL-1 family cytokines as the canonical DAMPs of the immune system
- Prof. Seamus Martin
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17. Glycans at the frontiers of inflammation, autoimmunity and cancer
- Prof. Salomé S. Pinho
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18. Glycoimmunology
- Prof. Paula Videira
- Adaptive immunity B cells
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21. Antigen recognition in the immune system
- Prof. Herman Waldmann
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22. B cell biology
- Prof. Richard Cornall
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23. Antibody structure and function: antibody structure
- Dr. Mike Clark
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24. Antibody structure and function: antibody function
- Dr. Mike Clark
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25. Antibody genes and diversity
- Dr. Mike Clark
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26. In vivo antibody discovery and hybridoma technology
- Prof. Dr. Katja Hanack
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27. Antibody engineering: beginnings to bispecifics and beyond
- Dr. Ian Wilkinson
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29. The immunobiology of Fc receptors
- Prof. Mark Cragg
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30. Immunoreceptors
- Prof. Anton van der Merwe
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31. Affinity, avidity and kinetics in immune recognition
- Prof. Anton van der Merwe
- Adaptive immunity T cells
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32. The thymus and T cell development: a primer
- Prof. Georg Holländer
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33. Lineage decisions in the thymus: T cell lineage commitment
- Prof. Bruno Silva-Santos
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34. Lineage decisions in the thymus: αβ and γδ T cell lineages
- Prof. Bruno Silva-Santos
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35. CD4 T cell subsets
- Dr. Brigitta Stockinger
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36. Cytotoxic T lymphocytes
- Prof. Gillian M. Griffiths
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37. Gamma delta T-cells
- Prof. Bruno Silva-Santos
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38. Tfh and Tfr cells
- Prof. Luis Graca
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39. Tissue resident memory T cells (TRM)
- Dr. Marc Veldhoen
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40. Mathematical modeling in immunology
- Prof. Ruy M. Ribeiro
- The importance of the MHC in immunity
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41. The MHC and MHC molecules 1
- Prof. Jim Kaufman
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42. The MHC and MHC molecules 2
- Prof. Jim Kaufman
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43. Natural killer cells
- Dr. Philippa Kennedy
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44. Human NK cells
- Prof. Lorenzo Moretta
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46. NK cells in viral immunity
- Prof. Lewis Lanier
- Lymphocyte activation
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47. Signal transduction by leukocyte receptors
- Dr. Omer Dushek
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48. Immunological memory 1
- Prof. David Gray
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49. Immunological memory 2
- Prof. David Gray
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50. Studying immune responses “one cell at a time”
- Dr. Mir-Farzin Mashreghi
- Major cellular partners in immunity
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51. The mononuclear phagocyte system - tissue resident macrophages: distribution and functions
- Prof. Emeritus Siamon Gordon
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52. The mononuclear phagocyte system: tissue resident macrophages - activation and regulation
- Prof. Emeritus Siamon Gordon
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53. Dendritic cells: professional antigen presenting cells
- Prof. Paul J. Fairchild
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54. Mucosal immunology
- Prof. Daniel Mucida
- Immunological tolerance and regulation
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55. Self-tolerance
- Prof. Herman Waldmann
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56. Tolerance and autoimmunity
- Prof. Emerita Anne Cooke
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57. The balance between intestinal immune homeostasis and inflammation
- Prof. Dr. Janneke Samsom
- Translational immunology - immune deficiency
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58. Primary immunodeficiency disorders
- Dr. Smita Y. Patel
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59. Changes in innate and adaptive immunity during human ageing 1
- Dr. Roel De Maeyer
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60. Changes in innate and adaptive immunity during human ageing 2
- Dr. Roel De Maeyer
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61. The aging immune system
- Prof. Ana Caetano
- Translational immunology - protection against pathogenic microbes
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62. Immune responses to viruses
- Prof. Paul Klenerman
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63. HIV and the immune system
- Prof. Quentin Sattentau
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64. COVID-19: the anti-viral immune response
- Prof. Danny Altmann
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65. Bacterial immune evasion
- Prof. Christoph Tang
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66. The immunology underlying tuberculosis
- Prof. Thomas R. Hawn
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67. Innate immunity to fungi
- Prof. Gordon D. Brown
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68. Parasite immunity: introduction and Plasmodium
- Dr. Catarina Gadelha
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69. Parasite immunity: Leishmania and Schistosoma
- Dr. Catarina Gadelha
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70. Vaccination
- Dr. Anita Milicic
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71. The history of vaccines 1
- Prof. Emeritus Anthony R. Rees
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72. The history of vaccines 2
- Prof. Emeritus Anthony R. Rees
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73. The history of vaccines 3
- Prof. Emeritus Anthony R. Rees
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74. The science of vaccine adjuvants
- Dr. Derek O'Hagan
- Translational immunology - hypersensitivity, autoimmune disease and their management
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75. Hypersensitivity diseases: type 1 hypersensitivity
- Prof. Herman Waldmann
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76. Innate lymphoid cells in allergy
- Prof. Emeritus Shigeo Koyasu
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77. Hypersensitivity diseases: type II-IV hypersensitivity
- Prof. Sara Marshall
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78. Immune memory underlying lifelong peanut allergy
- Dr. Kelly Bruton
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79. Memory B cells in allergy: B cell activation and response
- Dr. Kelly Bruton
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80. Memory B cells in allergy: ontogeny, phenotype and plasticity
- Dr. Kelly Bruton
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81. B cells at the crossroads of autoimmune diseases
- Dr. Xiang Lin
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82. Interleukin-17: from clone to clinic
- Prof. Leonie Taams
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83. Autoimmunity and type 1 diabetes
- Prof. Emerita Anne Cooke
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84. What is new in type 1 diabetes?
- Prof. Åke Lernmark
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85. Antibodies to control or prevent type 1 diabetes
- Dr. Robert Hilbrands
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86. Monoclonal antibodies in haemato-oncology
- Prof. Mark Cragg
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87. Therapeutic antibodies
- Dr. Geoffrey Hale
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88. Endothelial cells: regulators of autoimmune-neuroinflammation
- Dr. Laure Garnier
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89. Neuroimmunometabolism
- Prof. Ana Domingos
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90. The immunology of multiple sclerosis
- Dr. Joanne Jones
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91. Immunology of the peripheral nervous system: the inflammatory neuropathies
- Dr. Simon Rinaldi
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92. Ocular immunology: an overview of immune mechanisms operating in the eye
- Dr. Eleftherios Agorogiannis
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93. Understanding myasthenia gravis and advances in its management
- Prof. Henry J. Kaminski
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94. The immunology underlying rheumatic diseases
- Dr. Hussein Al-Mossawi
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96. Complement and lupus
- Prof. Marina Botto
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97. Immune mechanisms in liver diseases
- Prof. Paul Klenerman
- Translational immunology - transplantation immunology
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98. Principles of transplantation: overview of the immune response
- Prof. Emerita Kathryn Wood
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99. Factors influencing outcomes in clinical transplantation 1
- Prof. Emerita Kathryn Wood
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100. Factors influencing outcomes in clinical transplantation 2
- Prof. Emerita Kathryn Wood
- Translational immunology - cancer immunology
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101. Cancer immunology
- Prof. Tim Elliott
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102. Cancer immunotherapy
- Prof. Tim Elliott
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103. Myeloid-derived suppressor cells in cancer
- Prof. Dmitry Gabrilovich
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104. IL-2 in the immunotherapy of autoimmunity and cancer
- Prof. Thomas Malek
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105. Latest advances in the development of CAR & TCR T-cell treatments for solid tumours
- Dr. Else Marit Inderberg
Printable Handouts
Navigable Slide Index
- Introduction
- Outline
- Myasthenia gravis (MG)
- Clinical presentation
- MG may mimic any eye movement abnormality
- Generalized weakness
- Diagnostic evaluation
- Pathophysiology of MG
- The site of pathology is the neuromuscular junction
- The neuromuscular junction
- Mechanisms of acetylcholine receptor antibody-mediated injury (1)
- Mechanisms of acetylcholine receptor antibody-mediated injury (2)
- Musk IgG4 antibodies
- Cellular mediators of MG
- Treatment of MG (1)
- Mortality of MG is low
- MG treatments and when they came into use
- Treatment of MG (2)
- Anticholinesterases
- Generalized MG corticosteroids
- The MGTX trial and MG treatment (1)
- The MGTX trial and MG treatment (2)
- Generalized MG immunosuppression
- Standard immunosuppressives
- Established acute therapies
- Recently FDA-approved
- Complement inhibition
- Complement system
- REGAIN study
- Eculizumab, FDA approved for use AChR-Ab
- Complement inhibition
- Most expensive US drugs
- Neonatal Fc receptor inhibitors
- Phase 3: multicenter, randomized, placebo-controlled of efgartigimod
- Better than placebo
- FcRN inhibition to be aware
- Economic analysis of eculizumab
- Comment
- B cell targeted therapy
- Randomized, blinded, placebo-controlled of rituximab for treatment resistant patients
- Phase 2: randomized, blinded, placebo-controlled of rituximab
- Efficacy and safety of rituximab for new-onset generalized AChR antibody positive MG
- Phase 3: randomized, blinded, placebo-controlled of rituximab
- Classification of evidences
- Conclusions
- Acknowledgements
Topics Covered
- Clinical presentation of myasthenia gravis
- Diagnosis of myasthenia gravis
- Pathophysiology of myasthenia gravis
- Standard and emerging therapies
- Clinical trials on the treatment of myasthenia gravis
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Kaminski, H.J. (2023, August 31). Understanding myasthenia gravis and advances in its management [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved February 5, 2025, from https://doi.org/10.69645/EAKQ4638.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Kaminski is principal investigator for the Rare Disease Network, MGNet supported by NIH grant U54NS115054 and a consultant for R43NS12432; is a consultant for Alnylam Pharmaceuticals, Roche, Takeda, argenix, Cabaletta Bio, UCB Pharmaceuticals, EMD Serono, Ono Pharmaceuticals, Gilde Healthcare and Admirix, Inc.
A selection of talks on Immunology
Transcript
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0:00
Hello. My name is
Henry Kaminski.
I'm a professor at George
Washington University,
and I've studied myasthenia gravis
for my entire medical career.
Today, I'll be talking to you about
understanding of myasthenia gravis
and recent advances
in its management.
0:19
A brief outline.
I'm going to discuss the
clinical presentation
and how myasthenia
gravis is diagnosed,
introduce the physiology
of myasthenia gravis,
and the standard of care
and emerging therapies,
which are very exciting
in our disease right now.
0:37
Let me first start with one of
the original descriptions of myasthenia
gravis by Sir Thomas Willis,
and allow me to read this.
"At this time I have under my
charge a prudent and honest woman,
who for many years
has been obnoxious to
this sort of spurious palsy.
Not only in her members,
but also in her tongue.
She for some time can speak
freely and readily enough,
but after she has spoke
long or hastily or eagerly,
she's not able to speak a word,
but becomes as mute as a fish.
Nor can she recover the use of
her voice under an hour or two."
This description has many key
features of myasthenia gravis.
The first one appreciates that
there are periods of normality.
She can speak
freely and readily,
but then she develops
fatigue to near muteness,
or entire muteness,
which I certainly have seen in
some patients during my career.
And then the weakness recovers.
A woman is described,
and so young women have a
propensity to develop this disease,
compared to men, in early years.
And Willis points out that
she's prudent and honest,
so there's a distinction
with psychiatric conditions.
Sadly, sometimes, myasthenia
gravis is confused with
and also delays the diagnosis
of actual myasthenia gravis.