Pro-Inflammatory Cytokines in Myasthenia Gravis: A Systematic Review and Meta-Analysis Publisher



Shushtari A^{1, 2} ; Ashayeri H^{1, 3} ; Salmannezhad A^{1, 4} ; Seyedmirzaei H^{1, 5} ; Rezaei N^{1, 6, 7} Show Affiliations
Source: Neurological Sciences Published:2025

Abstract

Background: Myasthenia gravis (MG) is an autoimmune neuromuscular disorder impacting muscle endplate components. Pro-inflammatory cytokines, particularly, might play pivotal roles in MG pathogenesis, influencing regulatory T cells and contributing to chronic inflammation. We did this systematic review and meta-analysis to address the conflicting results about pro-inflammatory cytokine profiles in MG. Methods: A thorough search was conducted in PubMed, Scopus, and Embase to find studies measuring interleukin (IL)-1 family (IL-1β, IL-18, IL-33, IL-36, IL-37), IL-6, and tumor necrosis factor-alpha (TNF-α) levels in MG patients’ serum and controls. Selection criteria encompassed various MG types, including ocular and generalized, with and without thymoma, and acetylcholine receptor (AChR) antibody-positive and negative. Results: Of the 1843 identified studies, 16 met the inclusion criteria. The meta-analysis revealed a significant increase in serum TNF-α, IL-1β, and IL-33 level in MG patients compared to controls. The included studies also implied elevated levels of IL-18 in people with MG compared to controls and elevated levels of IL-18 and IL-33 in generalized MG compared to ocular MG. Conclusion: Our study highlights the altered profiles of pro-inflammatory cytokines in MG. © Fondazione Societa Italiana di Neurologia 2025.