Advancements and prospects of novel biologicals for myasthenia gravis: toward personalized treatment based on autoantibody specificities

• DOI: 10.3389/fphar.2024.1370411
• Publication Date: 2024-05-27T04:16:41Z
• Authors: Chi Ma; Dan Liu; Benqiao Wang; Yingying Yang; Ruixia Zhu
• Keywords: Plasmapheresis

Myasthenia gravis (MG) is an antibody-mediated autoimmune disease with a prevalence of 150–250 cases per million individuals. Autoantibodies include long-lived antibodies against the acetylcholine receptor (AChR), mainly IgG1 subclass, and IgG4, produced almost exclusively by short-lived plasmablasts, which are prevalent in muscle-specific tyrosine kinase (MuSK) myasthenia gravis. Numerous investigations have demonstrated that MG patients receiving conventional medication today still do not possess satisfactory symptom control, indicating substantial burden. Subsequently, based on type autoantibody pathogenesis, we synthesized published material to date reached conclusion regarding literature related personalized targeted therapy for MG. Novel agents AChR shown their efficacy clinical research, such as complement inhibitors, FcRn antagonists, B-cell activating factor (BAFF) inhibitors. Rituximab, representative drug anti-CD20 therapy, has benefits treatment MuSK patients. Due existence low-affinity or unidentified inaccessible existing methods, seronegative remains complicated; thus, special testing considerations necessary. It may be advantageous initiate application novel biologicals at early stage disease. Currently, therapies can also combined individualized according different types antibodies. With wide range drugs, how tailor strategies various conditions find most suitable solution each profile our necessary urgent aims.