{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:42:59Z","timestamp":1783035779285,"version":"3.54.6"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2005,9,21]],"date-time":"2005-09-21T00:00:00Z","timestamp":1127260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Myasthenia gravis (MG) in thymoma patients depends critically on intratumorous generation and export of mature autoreactive CD4<jats:sup>+<\/jats:sup> T cells. Why non\u2010MG thymomas fail to produce CD4<jats:sup>+<\/jats:sup> T cells is unknown. We studied three single\u2010nucleotide polymorphisms of the cytotoxic T\u2010lymphocyte\u2013associated antigen 4(<jats:italic>CTLA4<\/jats:italic>) gene in thymoma patients, nonthymoma early\u2010onset MG patients, and control subjects. Surprisingly, the CTLA4<jats:sup>high<\/jats:sup> genotype +49A\/A, which is protective against several autoimmune diseases, exerted a prominent predisposing effect to paraneoplastic MG in thymoma patients. The unusual disease association with a CTLA4<jats:sup>high<\/jats:sup> genotype implies a unique pathogenesis of paraneoplastic MG, with high CTLA4 levels possibly supporting the nontolerogenic selection of CD4<jats:sup>+<\/jats:sup> T cells in MG\u2010associated thymomas. Ann Neurol 2005;58:644\u2013648<\/jats:p>","DOI":"10.1002\/ana.20577","type":"journal-article","created":{"date-parts":[[2005,9,21]],"date-time":"2005-09-21T23:22:11Z","timestamp":1127344931000},"page":"644-648","source":"Crossref","is-referenced-by-count":63,"title":["A CTLA4<sup>high<\/sup> genotype is associated with myasthenia gravis in thymoma patients"],"prefix":"10.1002","volume":"58","author":[{"given":"Wen\u2010Yu","family":"Chuang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Str\u00f6bel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Gold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfred","family":"Nix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold","family":"Schalke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Kiefer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Opitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdwine","family":"Klinker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans K.","family":"M\u00fcller\u2010Hermelink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Marx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,9,21]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature01621"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/5.7.1075"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0039.1998.tb02993.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-0039.1999.530112.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20347"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.165.3.1352"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M206894200"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.gene.6363869"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/nri1085"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1254.025"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.gene.6363816"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5728(98)00119-2"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.165.11.6606"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.gene.6363752"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.2004.02424.x"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.1017"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V100.1.159"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/eji.200424918"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/eji.200324746"},{"key":"e_1_2_6_21_2","first-page":"447","article-title":"Myasthenic and nonmyasthenic thymoma. 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