{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:02:19Z","timestamp":1792425739505,"version":"4.5.0"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3501303"],"award-info":[{"award-number":["2022YFC3501303"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3501305"],"award-info":[{"award-number":["2022YFC3501305"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82471426"],"award-info":[{"award-number":["82471426"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82571592"],"award-info":[{"award-number":["82571592"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myasthenia gravis (MG) is an autoimmune disorder characterized by antibody\u2010mediated complement activation. Efgartigimod, a neonatal Fc receptor (FcRn) antagonist, is approved for treating generalized MG (gMG). However, its modulatory effects on upstream innate and adaptive immune cells remain largely unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We first quantified FcRn expression in peripheral immune subsets from acetylcholine receptor antibodies (AChR\u2010Ab) positive gMG. Then we assessed efgartigimod's impact on immune cells via in\u2010depth profiling in\u00a0vitro and later validated these findings in a prospective real\u2010world cohort treated with efgartigimod.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      High FcRn expression was abundantly expressed on monocytes and lymphocytes in an exploratory MG cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929), with notable intracellular presence. In\u00a0vitro studies showed efgartigimod significantly decreased intracellular FcRn in monocytes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lymphocytes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). After efgartigimod treatment, non\u2010classical monocytes (CD14\n                      <jats:sup>low<\/jats:sup>\n                      CD16\n                      <jats:sup>+<\/jats:sup>\n                      , 17.89\u2009\u00b1\u20099.60 vs. 14.58\u2009\u00b1\u20099.89 cells\/\u03bcl,\n                      <jats:italic>p\u2009&lt;<\/jats:italic>\n                      \u20090.001; 3.20\u2009\u00b1\u20092.06 vs. 2.61%\u2009\u00b1\u20092.12%,\n                      <jats:italic>p\u2009&lt;<\/jats:italic>\n                      \u20090.001) and Th17.1 cells (CXCR3\n                      <jats:sup>+<\/jats:sup>\n                      CCR6\n                      <jats:sup>+<\/jats:sup>\n                      , 95.83\u2009\u00b1\u200966.56 vs. 84.06\u2009\u00b1\u200961.70\u2009cells\/\u03bcl,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010; 10.42\u2009\u00b1\u20094.82 vs. 9.06%\u2009\u00b1\u20094.46%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.000) were significantly downregulated. In contrast, antibody\u2010producing B cells and effector\u2010memory CD4\n                      <jats:sup>+<\/jats:sup>\n                      and CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cells were expanded. Longitudinal assessments in the gMG cohort displayed similar findings, which likely reflect the direct inhibitory effect of efgartigimod on monocytes, coupled with negative feedback due to decreased IgG levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>By integrating in\u00a0vitro and clinical findings, we demonstrate that efgartigimod modulates peripheral immune cell populations, highlighting its significant immunomodulatory effects and clinical potential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70283","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T03:49:39Z","timestamp":1766116179000},"page":"1028-1040","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["In\u2010Depth Profiling Highlights the Effect of Efgartigimod on Peripheral Innate and Adaptive Immune Cells in Myasthenia Gravis"],"prefix":"10.1002","volume":"13","author":[{"given":"Lei","family":"Jin","sequence":"first","affiliation":[{"name":"Huashan Rare Disease Centre and Department of Neurology Huashan Hospital, Shanghai Medical College, National Centre for Neurological Disorders, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingxian","family":"He","sequence":"additional","affiliation":[{"name":"Huashan Rare Disease Centre and Department of Neurology Huashan 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