{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:17:19Z","timestamp":1786976239672,"version":"build-2736575974"},"reference-count":70,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Although 5\u2010Hydroxytryptamine (5\u2010HT) indirectly stimulates muscle contraction and participates in regulating Acetylcholine receptor (AChR) cluster homeostasis in cellular, animal, and clinical studies, evidence regarding its potential to modulate muscle contraction in myasthenia gravis (MG) remains limited. We aim to determine the levels of 5\u2010HT in MG and investigate its potential role as a regulatory neurotransmitter in promoting muscle contraction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected serum from 109 patients with MG and 110 healthy volunteers, and recorded clinical variables, including myasthenia gravis classification (MGFA), quantitative myasthenia gravis score (QMG), and serological examination. The effects of 5\u2010HT on the neuromuscular junction (NMJ) were further identified using cellular and molecular experiments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In this study, we observed that serum 5\u2010HT levels decrease in patients with MG (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) compared with disease\u2010free control. The thymoma\u2010associated complications alleviated this reduction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Our functional studies showed that 5\u2010HT promotes the development of motor (cholinergic) neuron\u2010like axons and increases intracellular calcium peaks, which is proportional to the amount of neurotransmitter released (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). AChR\u2010autoantibody treatment increases the expression of 5\u2010HT\n                      <jats:sub>2<\/jats:sub>\n                      R mRNA in muscle tube cells (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and the downstream signaling pathway of 5\u2010HT\n                      <jats:sub>2<\/jats:sub>\n                      R is involved in the regulation of AChR cluster homeostasis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>This first report of clinical characteristics and serum 5\u2010HT levels from a cross\u2010sectional cohort study on MG suggests that 5\u2010HT plays a critical role in maintaining NMJ homeostasis. Additional cross\u2010sectional data on more MG phenotypes and longitudinal monitoring data are needed to explore the role of 5\u2010HT in the pathophysiological mechanisms of MG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70222","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T05:00:15Z","timestamp":1760418015000},"page":"367-378","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Decreased Serum 5\u2010\n                    <scp>HT<\/scp>\n                    : Clinical Correlates and Regulatory Role in\n                    <scp>NMJ<\/scp>\n                    of\n                    <scp>MG<\/scp>"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4937-0526","authenticated-orcid":false,"given":"Xinru","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Neuroimmunology, Henan Institute of Medical and 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