Evidence map›Paper›PMID 34279044›Full record

ArticleAnnals of neurology2021

Genomic Insights into Myasthenia Gravis Identify Distinct Immunological Mechanisms in Early and Late Onset Disease.

Lahiru Handunnetthi, Bogdan Knezevic, Silva Kasela, Katie L Burnham, Lili Milani, Sarosh R Irani, Hai Fang, Julian C Knight

Open access · hybridAbstract read
In one paragraph

Article in Annals of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
1.5field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 29 citations in OpenAlex.

  1. Review
  2. Article
  3. Narcolepsy is (not) an autoimmune disease.Nature reviews. Neurology · 2026
    Review
  4. Article
  5. Article
  6. Review
  7. Frontiers in genetics · 2026
    Review
  8. Circulating inflammatory proteins as pathogenic mediators and potential therapeutic targets in myasthenia gravis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Article
  9. Review
  10. Review
  11. Review
  12. Article
  13. Article
  14. Myasthenia gravis: the future is here.The Journal of clinical investigation · 2024
    Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Antibody Therapies in Autoimmune Neuromuscular Junction Disorders: Approach to Myasthenic Crisis and Chronic Management.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Lahiru Handunnetthi *Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.ORCID 0000-0002-8242-3722
Bogdan Knezevic *Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK.
Silva KaselaEstonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia.
Katie L BurnhamWellcome Sanger Institute, Cambridge, UK.
Lili MilaniEstonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia.
Sarosh R IraniNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.ORCID 0000-0002-7667-9748
Hai FangWellcome Centre for Human Genetics, University of Oxford, Oxford, UK.ORCID 0000-0003-3961-8572
Julian C KnightWellcome Centre for Human Genetics, University of Oxford, Oxford, UK.
Centre for Human Genetics · GBUniversity of Tartu · EEUniversity of Oxford · GBWellcome Sanger Institute · GB

Funding

Medical Research Council MR/V007173/1National Institute for Health ResearchWellcome Trust 204969/Z/16/ZWellcome Trust 206194Wellcome Trust WT204969/Z/16/Z
6 · The paper itself

Abstract

objectiveThe purpose of this study was to identify disease relevant genes and explore underlying immunological mechanisms that contribute to early and late onset forms of myasthenia gravis.

methodsWe used a novel genomic methodology to integrate genomewide association study (GWAS) findings in myasthenia gravis with cell-type specific information, such as gene expression patterns and promotor-enhancer interactions, in order to identify disease-relevant genes. Subsequently, we conducted additional genomic investigations, including an expression quantitative analysis of 313 healthy people to provide mechanistic insights.

resultsWe identified several genes that were specifically linked to early onset myasthenia gravis including TNIP1, ORMDL3, GSDMB, and TRAF3. We showed that regulators of toll-like receptor 4 signaling were enriched among these early onset disease genes (fold enrichment = 3.85, p = 6.4 × 10

interpretationThe disease-relevant genes identified in this study are a unique resource for many disciplines, including clinicians, scientists, and the pharmaceutical industry. The distinct immunological pathways linked to early and late onset myasthenia gravis carry important implications for drug repurposing opportunities and for future studies of drug development. ANN NEUROL 2021;90:455-463.

Indexed as

AdultAge of OnsetFemaleGenetic VariationGenome-Wide Association StudyHumansImmunity, InnateMaleMiddle AgedMyasthenia GravisPolymorphism, Single Nucleotide

Identifiers

PMID34279044
PMCPMC8581766
OpenAlexW3183778204

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.