MUSK and myasthenia gravis: While in AChR-MG an excess of ACh caused by treatment with AChE inhibitors does not contribute significantly to AChR loss, perhaps because it is effectively counterbalanced by the activation of a functional MuSK-DOK7 pathway, AChE inhibitors exacerbate MuSK-MG symptoms; this is likely due to a downregulation of the AChR following the ACh increase without the counterbalancing provided by the MuSK pathway (see the following section regarding treatment).