Clinicoserological insights into patients with immune checkpoint inhibitor‐induced myasthenia gravis

Author:

Masi Gianvito12ORCID,Pham Minh C.1ORCID,Karatz Tabitha3,Oh Sangwook4ORCID,Payne Aimee S.4ORCID,Nowak Richard J.2ORCID,Howard James F.5ORCID,Guptill Jeffrey T.3,Juel Vern C.3,O'Connor Kevin C.12ORCID

Affiliation:

1. Department of Immunobiology Yale School of Medicine New Haven Connecticut 06511 USA

2. Department of Neurology Yale School of Medicine New Haven Connecticut 06511 USA

3. Neuromuscular Division, Department of Neurology Duke University Medical Center Durham North Carolina 27710 USA

4. Department of Dermatology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania 19104 USA

5. Department of Neurology The University of North Carolina at Chapel Hill CB#7025, Houpt Building, 170 Manning Drive Chapel Hill North Carolina 27599‐7025 USA

Abstract

AbstractTo compare the immunopathology of immune checkpoint inhibitor‐induced myasthenia gravis (ICI‐MG) and idiopathic MG, we profiled the respective AChR autoantibody pathogenic properties. Of three ICI‐MG patients with AChR autoantibodies, only one showed complement activation and modulation/blocking potency, resembling idiopathic MG. In contrast, AChR autoantibody‐mediated effector functions were not detected in the other two patients, questioning the role of their AChR autoantibodies as key mediators of pathology. The contrasting properties of AChR autoantibodies in these cases challenge the accuracy of serological testing in establishing definite ICI‐MG diagnoses and underscore the importance of a thorough clinical assessment when evaluating ICI‐related adverse events.

Funder

National Institute of Allergy and Infectious Diseases

Publisher

Wiley

Subject

Neurology (clinical),General Neuroscience

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