As cytokines secreted by Th1 and Th2 cells, the levels of INF-γ, IL-6 and IL-18 can reflect the immune balance maintained by Th1 and Th2 cells.22,23 In this study, after 3 months of treatment, the experimental group showed better performance in the above indexes, suggesting that high-dose methylprednisolone pulse therapy and medium-dose periodic therapy of methylprednisolone can effectively regulate the immune function and related cytokine secretion in patients with MG at the early stage of treatment, and promote the improvement of patients’ quality of life. Here, IL18 is linked to myasthenia gravis.