Evidence map›Paper›PMID 36754834›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2023

Antibodies Produced by CLL Phenotype B Cells in Patients With Myasthenia Gravis Are Not Directed Against Neuromuscular Endplates.

Florian Ingelfinger, Michael Kramer, Mirjam Lutz, Corinne C Widmer, Luca Piccoli, Stefanie Kreutmair, Tobias Wertheimer, Mark Woodhall, Patrick Waters, Federica Sallusto and 4 more

Open access · goldAbstract read
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 32% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. An angel or a devil? Current view on the role of CD8Journal of translational medicine · 2024
    Review
  3. Article
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

14 authors at 1 institution in 2 countries.

Florian IngelfingerFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Michael KramerFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Mirjam LutzFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Corinne C WidmerFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Luca PiccoliFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.ORCID 0000-0002-1085-6502
Stefanie KreutmairFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.ORCID 0000-0001-8466-6675
Tobias WertheimerFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Mark WoodhallFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Patrick WatersFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Federica SallustoFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Antonio LanzavecchiaFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Sarah MundtFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom.
Burkhard BecherFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom. becher@immunology.uzh.ch bettina.schreiner@neuroimm.uzh.ch.ORCID 0000-0002-1541-7867
Bettina SchreinerFrom the Institute of Experimental Immunology (F.I., M.L., S.K., T.W., S.M., B.S., B.B.), University of Zurich, Switzerland; Department of Neurology (F.I., B.S.), University Hospital Zurich, Switzerland; Institute for Research in Biomedicine (M.K., L.P., F.S., A.L.), Università Della Svizzera Italiana, Bellinzona, Switzerland; Institute of Microbiology (M.K., F.S.), ETH Zurich, Switzerland; Department of Medical Oncology and Hematology (C.C.W.), University Hospital Zurich and University of Zurich, Switzerland; and Nuffield Department of Clinical Neurosciences (M.W., P.W.), University of Oxford, United Kingdom. becher@immunology.uzh.ch bettina.schreiner@neuroimm.uzh.ch.
University of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesMyasthenia gravis (MG) can in rare cases be an autoimmune phenomenon associated with hematologic malignancies such as chronic lymphocytic leukemia (CLL). It is unclear whether in patients with MG and CLL, the leukemic B cells are the ones directly driving the autoimmune response against neuromuscular endplates.

methodsWe identified patients with acetylcholine receptor antibody-positive (AChR

resultsA computational immune cell screen revealed a subgroup of 5/38 patients with MG and 0/21 healthy controls who displayed a CLL-like B-cell phenotype. In follow-up hematologic flow cytometry, 2 of these 5 patients were diagnosed with an MBL. An additional patient with AChR DISCUSSION: Our study suggests that AChR autoantibodies are produced by nonmalignant, polyclonal B cells The new anti-CD20 treatment obinutuzumab might be considered in effectively treating AChR CLASSIFICATION OF EVIDENCE: This is a single case study and provides Class IV evidence that obinutuzumab is safe to use in patients with MG.

Indexed as

Leukemia, Lymphocytic, Chronic, B-CellMyasthenia GravisAntibodies, MonoclonalAutoantibodiesAutoantigensB-LymphocytesHumansReceptors, CholinergicAntibodies, MonoclonalAutoantibodiesAutoantigensReceptors, Cholinergic

Identifiers

PMID36754834
PMCPMC9909583
OpenAlexW4319455931

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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.