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

• Published in: Annals of clinical and translational neurology Vol. 10; no. 5; pp. 825 - 831
• Main Authors: Masi, Gianvito, Pham, Minh C., Karatz, Tabitha, Oh, Sangwook, Payne, Aimee S., Nowak, Richard J., Howard, James F., Guptill, Jeffrey T., Juel, Vern C., O'Connor, Kevin C.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.05.2023; John Wiley and Sons Inc; Wiley
• Subjects: Autoantibodies; Brief Communication; Complement Activation; Electromyography; Flow cytometry; Humans; Immune Checkpoint Inhibitors - adverse effects; Kidney cancer; Kinases; Laboratories; Low density lipoprotein receptors; Metastasis; Myasthenia gravis; Myasthenia Gravis - diagnosis; Pathogenesis; Patients; Plasma; Prostate cancer; Proteins; Receptors, Cholinergic; Serology
• ISSN: 2328-9503; 2328-9503
• DOI: 10.1002/acn3.51761

To 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.