{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:00:10Z","timestamp":1790352010319,"version":"4.1.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100011110","name":"UCB","doi-asserted-by":"publisher","award":["The research activity program entitled 'Study of blocking AChR Abs and correlation with clinical characteristics in patients with myasthenia gravis' received partial in-kind support from UCB, specifically in the form of reagents used during the study"],"award-info":[{"award-number":["The research activity program entitled 'Study of blocking AChR Abs and correlation with clinical characteristics in patients with myasthenia gravis' received partial in-kind support from UCB, specifically in the form of reagents used during the study"]}],"id":[{"id":"10.13039\/100011110","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the longitudinal clinical relevance of acetylcholine receptor (AChR) blocking antibodies in myasthenia gravis (MG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively studied 47 AChR-positive MG patients with 121 serial antibody measurements over a mean follow-up of 2.8 years. AChR-binding antibodies were measured by a conventional radioimmunoprecipitation assay, whereas AChR-blocking activity was measured using a competitive radioimmunoassay. Disease severity was assessed using Myasthenia Gravis Foundation of America (MGFA) classification. Longitudinal associations were analyzed using generalized estimating equations (GEE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Blocking antibodies (&gt;\u200920% inhibition) were associated with MGFA severity across repeated observations in longitudinal GEE analysis (\u03b2\u2009=\u20090.045,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas binding antibodies were not significant. Among 13 patients with ocular-onset MG, all 8 who progressed to generalized disease were blocking antibody-positive, while none of the 5 patients who remained ocular tested positive. Blocking antibodies were detected in 90.5% of generalized MG patients, whereas all persistently ocular patients were negative.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AChR blocking antibodies are associated with MG disease severity over time and may help identify ocular MG patients at risk of generalization, supporting their potential clinical relevance in MG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-026-09423-4","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:19:07Z","timestamp":1790302747000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal dynamics and clinical significance of acetylcholine receptor blocking antibodies in myasthenia gravis"],"prefix":"10.1007","volume":"47","author":[{"given":"Aigli G","family":"Vakrakou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Belimezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Strataki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleftherios","family":"Kontizas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Tzavella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Panaretos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Angelakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4652-3582","authenticated-orcid":false,"given":"Vasiliki","family":"Zouvelou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"9423_CR1","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1038\/nri916","volume":"2","author":"A Vincent","year":"2002","unstructured":"Vincent A (2002) Unravelling the pathogenesis of myasthenia gravis. Nat Rev Immunol 2:797\u2013804","journal-title":"Nat Rev Immunol"},{"key":"9423_CR2","doi-asserted-by":"publisher","first-page":"1506845","DOI":"10.3389\/fneur.2024.1506845","volume":"15","author":"L Luo","year":"2024","unstructured":"Luo L, Zhu X, Wen C, Guo Y, Yang J, Wei D et al (2024) Exploring the clinical significance of anti-acetylcholine receptor antibody titers, changes, and change rates in Myasthenia Gravis. Front Neurol 15:1506845","journal-title":"Front Neurol"},{"key":"9423_CR3","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s00401-023-02603-y","volume":"146","author":"MC Pham","year":"2023","unstructured":"Pham MC, Masi G, Patzina R, Obaid AH, Oxendine SR, Oh S et al (2023) Individual myasthenia gravis autoantibody clones can efficiently mediate multiple mechanisms of pathology. Acta Neuropathol 146:319\u2013336","journal-title":"Acta Neuropathol"},{"key":"9423_CR4","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1007\/s00401-022-02493-6","volume":"144","author":"N Rose","year":"2022","unstructured":"Rose N, Holdermann S, Callegari I, Kim H, Fruh I, Kappos L et al (2022) Receptor clustering and pathogenic complement activation in myasthenia gravis depend on synergy between antibodies with multiple subunit specificities. Acta Neuropathol 144:1005\u20131025","journal-title":"Acta Neuropathol"},{"key":"9423_CR5","doi-asserted-by":"crossref","unstructured":"Liu K, Yang W, Liu X, Yu H, Zhu D, Li Y et al (2025) Association of blocking acetylcholine receptor antibodies with clinical subtypes and disease severity in myasthenia gravis. Clin Chim Acta 577:120449","DOI":"10.1016\/j.cca.2025.120449"},{"key":"9423_CR6","doi-asserted-by":"crossref","unstructured":"Howard FM Jr., Lennon VA, Finley J, Matsumoto J, Elveback LR (1987) Clinical correlations of antibodies that bind, block, or modulate human acetylcholine receptors in myasthenia gravis, vol 505. Annals of the New York Academy of Sciences, pp 526\u2013538","DOI":"10.1111\/j.1749-6632.1987.tb51321.x"},{"key":"9423_CR7","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1007\/s10072-015-2236-8","volume":"36","author":"SY Kang","year":"2015","unstructured":"Kang SY, Oh JH, Song SK, Lee JS, Choi JC (2015) Kang. Both binding and blocking antibodies correlate with disease severity in myasthenia gravis. Neurol sciences: official J Italian Neurol Soc Italian Soc Clin Neurophysiol 36:1167\u20131171","journal-title":"Neurol sciences: official J Italian Neurol Soc Italian Soc Clin Neurophysiol"},{"key":"9423_CR8","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.1007\/s10072-024-07889-8","volume":"46","author":"F Aguirre","year":"2025","unstructured":"Aguirre F, Justo ME, Cialdella L, Paz ML (2025) AChR-blocking antibodies and complement system dynamics: evaluating their interplay and clinical implications in myasthenia gravis. Neurol sciences: official J Italian Neurol Soc Italian Soc Clin Neurophysiol 46:1827\u20131832","journal-title":"Neurol sciences: official J Italian Neurol Soc Italian Soc Clin Neurophysiol"},{"key":"9423_CR9","doi-asserted-by":"crossref","unstructured":"Rahman MM, Teng J, Worrell BT, Noviello CM, Lee M, Karlin A et al (2020) Structure of the native muscle-type nicotinic receptor and inhibition by snake venom toxins. 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The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki","order":1,"name":"Ethics","label":"Ethical standards","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"nformed consent was obtained from the patients.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":3,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"809"}}