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In the past 10 years, research results in the field of myasthenia gravis (MG) in China have emerged, and the number of papers published has ranked among the top in the world
.
In order to further encourage China's original research in the MG field and build an open and equal scientific research exchange platform for young scholars, the first "Elite Club, MG Youth Original Scientific Research Forum 2022 Summit" was held in 2022 It was held
online on November 5.
This conference focuses on China's original research in the field of MG in recent years, and invites Professor Zhao Chongbo of Huashan Hospital affiliated to Fudan University to make an opening speech and summary of this conference, and Professor Yanchen Xie of Washington College of Clinical Research to share clinical research ideas Professor Yang Huan, Xiangya Hospital, Central South University, Professor Guan Universe, Peking Union Medical College Hospital, Professor Xiao Fei, First Affiliated Hospital of Chongqing Medical University, Professor Lu Jiahong, Huashan Hospital Affiliated to Fudan University, Professor Feng Huiyu of the First Affiliated Hospital of Sun Yat-sen University and Professor Yin Jian of Beijing Hospital made professional academic comments, and invited 12 young scholars focusing on MG in China to give original research keynote speeches
.
The collision of ideas is exciting, let's review the highlights together
.
Elite Club Online Launch Ceremony
Chapter 1:
Traveling with the Road
At the beginning of the conference, Professor Zhao Chongbo, chairman of the conference and Huashan Hospital affiliated to Fudan University, extended a warm welcome
to all experts, young scholars and guests.
Professor Zhao Chongbo praised the rapid development and outstanding achievements in the field of MG in China in the past ten years, encouraged and affirmed the original research of young Chinese scholars, and finally wished the conference a complete success
.
Professor Zhao Chongbo
Professor Yanchen Xie of the Washington College of Clinical Research in the United States took "Ideas for Selecting Clinical Research Topics" as the title, encouraging doctors and scientists to make scientific research and SCI papers become by-products of clinical work, starting from feasibility, interest, necessity and ethics, paying attention to literature retrieval, and clarifying PICOS (Participants, Intervention, Comparison, Outcome, Study
design) to explore and solve "important but unsolved clinical problems", and ultimately promote the common progress of
clinical and scientific research.
Professor Xie Yanchen
The second chapter:
scientific research is more powerful, starting with the end
In this session, Zhou Hao from Xiangya Hospital of Central South University reported on the "Retrospective Analysis of Possible Influencing Factors of Minimal Clinical Manifestations after MG Treatment", aiming to explore, analyze and verify the microstate of MG (MMS).
Influencing factors
of induction.
The ocular MG and low baseline QMG score (≤16 points) were found to be the result of MG achieving MG microscopic status ( MMS).
Subsequently, Wang Xu from the First Hospital of Jilin University and Yan Jingwen from Peking Union Medical College Hospital brought two MuSK antibody-positive MG (MuSK-MG) related studies
respectively 。 Wang Xu's team focused on the clinical features of MuSK-MG, and found that MuSK-MG was more common in women, with the first symptoms mostly extraocular muscle weakness and a high proportion of throat muscle involvement.
More likely to have thyroid antibody abnormalities and other autoimmune diseases; Yan Jingwen's team focused on verifying the long-term efficacy of non-hormonal immunosuppressants in Musk antibody-positive MG patients, and found that treatment with one or more non-hormonal IS for at least 6 months was associated with a longer duration of remission, and if the patient had a longer course of disease (≥ 12 months) and a heavier clinical manifestation (higher MGFA grade), it may be better
for non-hormonal immunosuppressants.
ZHOU Hao
Wang Xu
Yan Jingwen
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Scientific research is more powerful, and the subtle knowledge is known
In this session, Yue Yaoxian of Qilu Hospital of Shandong University, Chen Hongxi of West China Hospital of Sichuan University and Xiao Xinyi of the First Affiliated Hospital of Soochow University paid attention to the most urgent clinical needs, and reported three studies
close to the real life of MG patients, namely "Real-world reports on MG patients after new crown vaccination", "Myocardial injury in MG hospitalized patients" and "Study on cognitive level of patients receiving immunosuppressants in the treatment of myasthenia gravis".
Yue Yao first brought a definite answer to the safety issue of new crown vaccination that has plagued MG patients for a long time: for patients with mild disease and stable symptoms, it is generally safe to receive the new crown vaccine; Patients with unstable symptoms (new symptoms/exacerbations in the past six months) have an increased risk of worsening symptoms after vaccination; MG patients should avoid other common triggers
such as infection and fatigue before vaccination.
Dr.
Chen Hongxi suggested in his report that it is necessary to pay full attention to myocardial injury in MG patients, especially when patients have thymomas, infections, use of immune checkpoint inhibitors, myasthenic crisis, and advanced age, they should pay close attention to the patient's heart-related symptoms and monitor TnT changes
.
Xiao Xinyi's team found that cognitive level was not significantly correlated with the condition, AChR-ab concentration and degree of anxiety and depression, but there were different pathological characteristics compared with the healthy control group, and whether the cognitive decline in MG patients was due to cholinergic system involvement deserves further exploration, advocating clinical attention to cognitive impairment
in MG patients.
Yue Yaoxian
CHEN Hongxi
Xiao Xinyi
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At the end of this chapter, Professor Yang Huan of Xiangya Hospital of Central South University, Professor Guan Universe of Peking Union Medical College Hospital and Professor Xiao Fei of the First Affiliated Hospital of Chongqing Medical University made wonderful comments
on the above topics.
On the other hand, the three experts put forward more detailed suggestions and prospects for each topic to help encourage young scholars to conduct more in-depth research and promote the development of
MG field.
Professor Yang Huan, Professor Guan Universe, Professor Xiao Fei
The third chapter
is full of vigor and cave candle far away
In the afternoon, Luo Sushan from Huashan Hospital affiliated to Fudan University, Gui Mengcui from Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, and Huang Xin from the First Affiliated Hospital of Sun Yat-sen University presented a series of MG research
on behalf of their central team.
Susan Luo brought a number of research results, including the "clinical spectrum" of myasthenic crisis gravis, "hospital mortality", "all-cause mortality", in-hospital mortality and mortality prediction, etc.
, collected in the "Preliminary Study of the Myasthenic Gravis Crisis Cohort", the Panhuashan Myasthenia gravis diagnosis and treatment team conducted these studies aimed at reducing the death of MG patients and improving clinical outcomes, there are still a series of studies still on the way to explore, I hope that these research results can bring good news
to the majority of patients in the future.
Gui Mengcui's team focused on the field of MG in children and found that most patients with poor hormone therapy response had symptoms relief after adding immunosuppressants; In patients who respond poorly to hormonal and immunosuppressant therapy, thymectomy may be performed, and the prognosis after surgery is mainly related
to the course and type of disease.
After that, Huang Xin shared his team's research results, saying that leflunomide combined with low-dose prednisone can quickly improve the clinical symptoms of myasthenia gravis, and may be a promising treatment
option for systemic MG.
In short, teams are indispensable for clinical research, bringing more possibilities to research and pushing each individual and the entire research center forward more
aggressively.
Rossan
Gui Mengcui
Huang Xin
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Vigorous efforts to change with the times
In the second half of this chapter, Di Li from Xuanwu Hospital of Capital Medical University, Ruan Zhe from the Second Affiliated Hospital of the PLA Air Force Military Medical University Chinese and Li Huining from the General Hospital of Tianjin Medical University brought you the progress of
MG treatment-related drugs.
In the treatment of MG, hormones play an important role, Di Li reported "Clinical predictors of recurrence in MG patients with well-controlled hormone monotherapy", the results of the study found that MuSK-MG, discontinued, combined with thymoma and more severe patients have an increased risk of recurrence, need close follow-up, monitor the condition, combined with thymoma and more severe patients need long-term maintenance immunotherapy to avoid recurrence
.
As we all know, the treatment of MG is entering a new era of biologics, Ruan Zhe and Li Huining have demonstrated the efficacy and safety of tocilizumab and rituximab in the treatment of MG patients, respectively, and look forward to further research results in the future to provide new treatment options
for MG.
Di Li
Ruan Zhe
Li Huining
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In the comment session, Professor Lu Jiahong of Huashan Hospital affiliated to Fudan University, Professor Feng Huiyu of the First Affiliated Hospital of Sun Yat-sen University and Professor Yin Jian of Beijing Hospital had a lively academic discussion with young experts on the above topics, and conducted in-depth and detailed discussions on the framework and details of the research and the selection of clinical protocols from the perspective of clinical practice
.
Professor Lu Jiahong, Professor Feng Huiyu, Professor Yin Jian
Summary and discussion of the conference
After the young scholars completed the introduction of their original scientific research results, all participating experts participated in the discussion
of MG potential scientific research direction.
Experts and professors expressed their insights that China is currently in the era of great development of biological preparations, and China has a unique population advantage compared with other parts of the world, which is more convenient to carry out multi-center clinical research in the field of MG, but there are also shortcomings, and further efforts are still needed in clinical laboratory norms, continue to develop follow-up systems and accurate assessment of outcomes in the MG field, and retain more flexibility
in research design.
Professor Zhao Chongbo of Huashan Hospital affiliated to Fudan University made a wonderful summary
of the meeting.
Professor Zhao Chongbo concluded that the young scholars demonstrated the full ecology, evolution and inheritance process of clinical research, which is close to clinical practice, practical and innovative.
The comments of the experts are both harsh and warm, and encourage young scholars to continue in-depth clinical exploration and jointly promote the development of
China's MG field.
