What is the role of the post-synaptic membrane in myasthenia gravis (MG)?

Updated: Aug 27, 2018
  • Author: Abbas Jowkar, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

The post-synaptic membrane is a highly specialized area of the muscle fiber membrane, known as the end-plate. The end-plate is a convoluted structure with numerous junction folds enhancing the surface area of the post-synaptic membrane. On the crests of each junctional fold are AChR clusters aligned in proximity with an active zone on the presynaptic terminal. The basal lamina of the endplate contains the enzyme acetylcholinesterase (AChE), which are located in the troughs of the junctional folds. [16] The concentration of AChE is five- to eight-fold lower than concentration of ACh receptors, but is enough to hydrolyze most of the ACh release by the nerve terminal and prevents repeated binding of ACh to AChRs. Voltage-gated sodium channels are present in large numbers on the post-synaptic membrane and are particularly concentrated in the depths of the secondary synaptic clefts.


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