ArticleProceedings of the National Academy of Sciences of the United States of America2020
Thymus-derived B cell clones persist in the circulation after thymectomy in myasthenia gravis.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
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40 citing papers in PubMed, 64 citations in OpenAlex.
- Trial
- Longitudinal omics reveals immune repertoire remodeling in myasthenia gravis patients post-tacrolimus therapy.Genes and immunity · 2026Article
- Efgartigimod Versus Lymphoplasmapheresis as Preoperative Rapid Antibody-Clearing Therapies for Thymectomy in Generalized Myasthenia Gravis: Effectiveness, Safety and Cost Outcomes Compared to Conventional Preparation.CNS neuroscience & therapeutics · 2026Article
- Immune remodeling after thymectomy in patients with anti-AChR antibodies.Frontiers in immunology · 2026Article
- Single-cell atlas reveals heterogeneous response to FcRn blockade in anti-AChR antibody-positive generalised myasthenia gravis.Clinical and translational medicine · 2025Article
- Myasthenia gravis in 2025: five new things and four hopes for the future.Journal of neurology · 2025Review
- Cross-species analyses of thymic mimetic cells reveal evolutionarily ancient origins and both conserved and species-specific elements.Immunity · 2025Article
- Thymus research in relation to myasthenia gravis: a new perspective on cell subpopulations and future directions.Frontiers in immunology · 2025Review
- Real world study in Italian public hospital with Efgartigimod in patients affected by generalized myasthenia gravis: influence of clinical and serological factors.Frontiers in neurology · 2025Article
- Review
- Therapeutic challenges and unmet needs in the management of myasthenia gravis: an Italian expert opinion.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Review
- Computational detection of antigen-specific B cell receptors following immunization.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Article
- Myasthenia gravis: the future is here.The Journal of clinical investigation · 2024Review
- Comparison of juvenile and adult myasthenia gravis in a French cohort with focus on thymic histology.Scientific reports · 2024Article
- Inferring B Cell Phylogenies from Paired H and L Chain BCR Sequences with Dowser.Journal of immunology (Baltimore, Md. : 1950) · 2024Article
- Anti-titin antibodies in a cohort of myasthenia gravis patients.Journal of thoracic disease · 2024Article
- Targeting autoimmune mechanisms by precision medicine in Myasthenia Gravis.Frontiers in immunology · 2024Review
- B cell phylogenetics in the single cell era.Trends in immunology · 2024Review
- Independent risk factors for in-hospital outcome of myasthenic crisis: a prospective cohort study.Therapeutic advances in neurological disorders · 2024Article
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13 authors at 4 institutions in 2 countries.
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Abstract
Myasthenia gravis (MG) is a neuromuscular, autoimmune disease caused by autoantibodies that target postsynaptic proteins, primarily the acetylcholine receptor (AChR) and inhibit signaling at the neuromuscular junction. The majority of patients under 50 y with AChR autoantibody MG have thymic lymphofollicular hyperplasia. The MG thymus is a reservoir of plasma cells that secrete disease-causing AChR autoantibodies and although thymectomy improves clinical scores, many patients fail to achieve complete stable remission without additional immunosuppressive treatments. We speculate that thymus-associated B cells and plasma cells persist in the circulation after thymectomy and that their persistence could explain incomplete responses to resection. We studied patients enrolled in a randomized clinical trial and used complementary modalities of B cell repertoire sequencing to characterize the thymus B cell repertoire and identify B cell clones that resided in the thymus and circulation before and 12 mo after thymectomy. Thymus-associated B cell clones were detected in the circulation by both mRNA-based and genomic DNA-based sequencing. These antigen-experienced B cells persisted in the circulation after thymectomy. Many circulating thymus-associated B cell clones were inferred to have originated and initially matured in the thymus before emigration from the thymus to the circulation. The persistence of thymus-associated B cells correlated with less favorable changes in clinical symptom measures, steroid dose required to manage symptoms, and marginal changes in AChR autoantibody titer. This investigation indicates that the diminished clinical response to thymectomy is related to persistent circulating thymus-associated B cell clones.
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