{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T20:01:40Z","timestamp":1787256100917,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:00:00Z","timestamp":1723075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["#2020_02040"],"award-info":[{"award-number":["#2020_02040"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>There are no blood biomarkers to monitor treatment effects in myasthenia gravis (MG) or studies visualizing the acetylcholine receptor (AChR) antibody\u2010induced membrane attack complex (MAC) at the human muscle membrane. This study aimed to compare levels of complement activation products and native complement components in MG patients and healthy controls (HCs) and to model the AChR antibody\u2010mediated attacks in human muscle cells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed the complement components and activation product levels with enzyme\u2010linked immunosorbent assay and magnetic bead\u2010based sandwich assays in plasma and sera of 23 MG patients and matched HCs. Receiver operator characteristic (ROC) curve analysis evaluated the diagnostic accuracy. Complement levels were correlated with the myasthenia gravis composite (MGC) scores. AChR+ MG modeling in human muscle cells used sera from nine MG patients and three HCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MG patients had significantly higher plasma levels of C3a (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001), C5 (<jats:italic>p<\/jats:italic>\u2009=\u2009.0003), and soluble C5b\u20109 (sC5b\u20109; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) than HCs. The ROC curve analysis showed a clear separation between MG patients and HCs for plasma C3a (AUC\u2009=\u20090.9720; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) and sC5b\u20109 (AUC\u2009=\u20090.8917, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). MG patients had higher levels of plasma complement Factor I (FI; <jats:italic>p<\/jats:italic>\u2009=\u2009.0002) and lower properdin levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). The MGC had moderate correlations with plasma Factor B (FB), FI, and Factor H. AChR+ MG patient sera triggered the deposition of MAC and reduced AChRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>We suggest validating plasma C3a and sC5b\u20109 as blood biomarkers for complement activation in MG. Further, the in vitro study allowed visualization of MAC deposition after applying AChR+ MG sera on human muscle cells.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28227","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T10:26:05Z","timestamp":1723112765000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Visualization and characterization of complement activation in acetylcholine receptor antibody seropositive myasthenia gravis"],"prefix":"10.1002","author":[{"given":"Yu\u2010Fang","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Clinical Neurophysiology Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Sandholm","sequence":"additional","affiliation":[{"name":"Linnaeus Center of Biomaterials Chemistry Linnaeus University  Kalmar Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbro","family":"Persson","sequence":"additional","affiliation":[{"name":"Department of Immunology, Genetics and Pathology Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Department of Immunology, Genetics and Pathology Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Rostedt","family":"Punga","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Clinical Neurophysiology Uppsala University  Uppsala 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