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Publication : Selective Depletion of Autoreactive Plasma Cells as a Novel Strategy to Treat Acetylcholine Receptor Antibody-Positive Myasthenia Gravis.

First Author  Khodadadi L Year  2026
Journal  Eur J Immunol Volume  56
Issue  4 Pages  e70166
PubMed ID  41906599 Mgi Jnum  J:383402
Mgi Id  MGI:8318997 Doi  10.1002/eji.70166
Citation  Khodadadi L, et al. (2026) Selective Depletion of Autoreactive Plasma Cells as a Novel Strategy to Treat Acetylcholine Receptor Antibody-Positive Myasthenia Gravis. Eur J Immunol 56(4):e70166
abstractText  Myasthenia gravis (MG) is a chronic autoimmune disease mediated by autoantibodies targeting the neuromuscular junction and leading to muscle weakness. Although there are autoantibodies of different specificities, most MG patients have autoantibodies directed against the nicotinic acetylcholine receptor (AChR), in particular against the extracellular domain of the alpha1 subunit (alphaECD), containing the main immunogenic region (MIR). Here, we demonstrate an original approach to selectively deplete plasma cells secreting autoantibodies targeting alphaECD. An antibody-mediated cytotoxicity-engager (ACE) consisting of an anti-hCD38-antibody conjugated to hAChR alphaECD (alphaECD) was used to deplete hAChR alphaECD-specific cells selectively in vivo. The reduction of pathogenic cells was accompanied by lower antibody titers, a reduction of MG disease score, protection of grip strength, and maintenance of body weight. Notably, antibody-secreting cells that are nonspecific for hAChR alphaECD were not affected. The resulting amelioration of MG pathology in ACE-treated animals highlights the decisive role of alphaECD-antibodies in the pathogenesis of MG and the clinical relevance of the novel therapeutic strategy.
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