CD19+CD11c+T-bet+ B cells in myasthenia gravis: a potential biomarker

BackgroundMyasthenia gravis (MG), an autoimmune disorder characterized by B cell-driven autoantibody production, exhibits heterogeneous B cell subsets dysregulation and incompletely defined signaling mechanisms.MethodsA cohort of 20 naïve MG patients positive for anti-acetylcholine receptor (AChR) a...

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Main Authors: Yaru Lu, Huimin Shen, Yiye Wang, Kai Ma, Ruihua Sun, Ying Zhao, Yaqiong Li, Qian Ma, Jiewen Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1623066/full
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author Yaru Lu
Huimin Shen
Yiye Wang
Kai Ma
Ruihua Sun
Ying Zhao
Yaqiong Li
Qian Ma
Jiewen Zhang
author_facet Yaru Lu
Huimin Shen
Yiye Wang
Kai Ma
Ruihua Sun
Ying Zhao
Yaqiong Li
Qian Ma
Jiewen Zhang
author_sort Yaru Lu
collection DOAJ
description BackgroundMyasthenia gravis (MG), an autoimmune disorder characterized by B cell-driven autoantibody production, exhibits heterogeneous B cell subsets dysregulation and incompletely defined signaling mechanisms.MethodsA cohort of 20 naïve MG patients positive for anti-acetylcholine receptor (AChR) antibodies and 15 healthy controls was analyzed. Peripheral blood mononuclear cells underwent proteomic profiling, flow cytometry (age-associated B cells (ABCs), plasma cells, T follicular helper cells, and regulatory B cells), and western blot validation of nuclear factor kappa-B (NF-κB)/cellular reticuloendotheliosis oncogene homolog (c-Rel) expression. Clinical severity was assessed using quantitative MG (QMG) scores. Statistical analyses included differential protein expression, pathway enrichment, and receiver operating characteristic (ROC) curve evaluation.ResultsProteomics revealed significant activation of the B cell receptor and NF-κB/c-Rel signaling pathways in MG patients, validated by upregulated NF-κB/c-Rel expression (p < 0.01). Flow cytometry demonstrated elevated ABCs (CD19+CD11c+T-bet+), plasma cells, and T follicular helper cells, alongside reduced regulatory B cells in MG (p < 0.001). The proportion of ABCs correlated positively with QMG scores (r = 0.5015, p = 0.024) but not with AChR antibody titers, suggesting antibody-independent mechanisms. ROC analysis identified moderate diagnostic utility of ABCs for moderate-to-severe MG (QMG scores ≥ 6; area under the curve = 0.68, 95% confidence intervals: 0.42–0.94).ConclusionThis study establishes ABCs and NF-κB/c-Rel signaling as central contributors to AChR-MG immunopathology. Therefore, ABCs may serve as complementary biomarkers for clinical stratification.
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spelling doaj-art-d0f6a5c4dd284f08bf75514e70e91bcc2025-08-22T08:08:25ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-08-011610.3389/fneur.2025.16230661623066CD19+CD11c+T-bet+ B cells in myasthenia gravis: a potential biomarkerYaru Lu0Huimin Shen1Yiye Wang2Kai Ma3Ruihua Sun4Ying Zhao5Yaqiong Li6Qian Ma7Jiewen Zhang8Department of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, ChinaDepartment of Neurology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, ChinaDepartment of Neurology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, ChinaBackgroundMyasthenia gravis (MG), an autoimmune disorder characterized by B cell-driven autoantibody production, exhibits heterogeneous B cell subsets dysregulation and incompletely defined signaling mechanisms.MethodsA cohort of 20 naïve MG patients positive for anti-acetylcholine receptor (AChR) antibodies and 15 healthy controls was analyzed. Peripheral blood mononuclear cells underwent proteomic profiling, flow cytometry (age-associated B cells (ABCs), plasma cells, T follicular helper cells, and regulatory B cells), and western blot validation of nuclear factor kappa-B (NF-κB)/cellular reticuloendotheliosis oncogene homolog (c-Rel) expression. Clinical severity was assessed using quantitative MG (QMG) scores. Statistical analyses included differential protein expression, pathway enrichment, and receiver operating characteristic (ROC) curve evaluation.ResultsProteomics revealed significant activation of the B cell receptor and NF-κB/c-Rel signaling pathways in MG patients, validated by upregulated NF-κB/c-Rel expression (p < 0.01). Flow cytometry demonstrated elevated ABCs (CD19+CD11c+T-bet+), plasma cells, and T follicular helper cells, alongside reduced regulatory B cells in MG (p < 0.001). The proportion of ABCs correlated positively with QMG scores (r = 0.5015, p = 0.024) but not with AChR antibody titers, suggesting antibody-independent mechanisms. ROC analysis identified moderate diagnostic utility of ABCs for moderate-to-severe MG (QMG scores ≥ 6; area under the curve = 0.68, 95% confidence intervals: 0.42–0.94).ConclusionThis study establishes ABCs and NF-κB/c-Rel signaling as central contributors to AChR-MG immunopathology. Therefore, ABCs may serve as complementary biomarkers for clinical stratification.https://www.frontiersin.org/articles/10.3389/fneur.2025.1623066/fullmyasthenia gravisNF-κB pathwayage-associated B cellsproteomicsflow cytometry
spellingShingle Yaru Lu
Huimin Shen
Yiye Wang
Kai Ma
Ruihua Sun
Ying Zhao
Yaqiong Li
Qian Ma
Jiewen Zhang
CD19+CD11c+T-bet+ B cells in myasthenia gravis: a potential biomarker
Frontiers in Neurology
myasthenia gravis
NF-κB pathway
age-associated B cells
proteomics
flow cytometry
title CD19+CD11c+T-bet+ B cells in myasthenia gravis: a potential biomarker
title_full CD19+CD11c+T-bet+ B cells in myasthenia gravis: a potential biomarker
title_fullStr CD19+CD11c+T-bet+ B cells in myasthenia gravis: a potential biomarker
title_full_unstemmed CD19+CD11c+T-bet+ B cells in myasthenia gravis: a potential biomarker
title_short CD19+CD11c+T-bet+ B cells in myasthenia gravis: a potential biomarker
title_sort cd19 cd11c t bet b cells in myasthenia gravis a potential biomarker
topic myasthenia gravis
NF-κB pathway
age-associated B cells
proteomics
flow cytometry
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1623066/full
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