Antibodies Produced by CLL Phenotype B Cells in Patients With Myasthenia Gravis Are Not Directed Against Neuromuscular Endplates.
Journal
Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
24
05
2022
accepted:
28
11
2022
entrez:
8
2
2023
pubmed:
9
2
2023
medline:
11
2
2023
Statut:
epublish
Résumé
Myasthenia 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. We identified patients with acetylcholine receptor antibody-positive (AChR A 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 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 This is a single case study and provides Class IV evidence that obinutuzumab is safe to use in patients with MG.
Sections du résumé
BACKGROUND AND OBJECTIVES
Myasthenia 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.
METHODS
We identified patients with acetylcholine receptor antibody-positive (AChR
RESULTS
A 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.
Identifiants
pubmed: 36754834
pii: 10/2/e200087
doi: 10.1212/NXI.0000000000200087
pmc: PMC9909583
pii:
doi:
Substances chimiques
Receptors, Cholinergic
0
Antibodies, Monoclonal
0
Autoantibodies
0
Autoantigens
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
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