{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:51:39Z","timestamp":1772160699004,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003748","name":"Svenska S\u00e4llskapet f\u00f6r Medicinsk Forskning","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003748","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008738","name":"Jeanssons Stiftelser","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Svenska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurochemistry"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Myasthenia gravis (MG) is an autoimmune neurological disease characterized by potentially life\u2010threatening muscular fatiguability. Symptoms are directly linked to autoantibodies targeting postsynaptic receptors of the neuromuscular junction. However, the underlying immunopathogenesis remains to be elucidated. This single\u2010center study aimed to characterize peripheral blood lymphocytes in MG patients and to identify prognostic biomarkers. We retrospectively reanalyzed clinical flow cytometric data on blood B and T cells from 76 incident MG cases, comparing them to healthy individuals of relevant age range. Clinical data was collected from the Swedish MG registry and used for outcome analyses. Flow cytometry analyses were based on standardized panels established by the Human Immunology Project Consortium and included a 10\u2010color T cell panel focused on memory, polarization, and activation states and an 8\u2010color B cell panel that includes memory phenotypes, transitional B cells and plasmablasts. Groupwise comparisons, survival curves, and regression models adjusting for potential confounders were used to assess potential predictors of the primary outcome, minimal disease manifestation within one year. Untreated MG patients had higher frequencies of cluster of differentiation 4 (CD4) T cell frequencies compared to healthy individuals of approximately the same age (median 75% vs. 63% in age range 40\u201359\u2009years and 65% in 60\u201381\u2009years). High CD4 T cell frequencies (&gt;\u200975% of total T cells) were associated with lower probability of minimal disease manifestation within one year (35% vs. 67%; log rank\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.032). In a multivariable Cox regression model assessing time to minimal disease manifestation, CD4 T cell frequency was an independent risk factor (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0014). In conclusion, MG patients appear to display an altered CD4 T cell phenotype and frequency of CD4 T cells is a potential prognostic biomarker.\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/jnc70126-fig-0004-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1111\/jnc.70126","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T09:01:04Z","timestamp":1750150864000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extensive Clinical Flow Cytometric Lymphocyte Phenotyping in Myasthenia Gravis: A Single\u2010Center Study"],"prefix":"10.1111","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4447-9426","authenticated-orcid":false,"given":"Hannes","family":"Lindahl","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology and Transfusion Medicine Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malin","family":"Petersson","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara Lind","family":"Enoksson","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Transfusion Medicine Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Clinical Science, Intervention and Technology Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrik","family":"Piehl","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Neurology Karolinska University Hospital  Stockholm Sweden"},{"name":"Neuroimmunology Unit Center for Molecular Medicine, Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Brauner","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Neurology Karolinska University Hospital  Stockholm Sweden"},{"name":"Neuroimmunology Unit Center for Molecular Medicine, Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.gene.6363796"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000945"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749\u20106632.1987.tb51282.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.33.10.1316"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1177249"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.0851"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2016.1196135"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2009.12.008"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010019\u20100079\u2010y"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.gene.6363702"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2019.106130"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401\u2010021\u201002299\u2010y"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.imlet.2014.04.008"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/nri3158"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2215474119"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011124"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13297"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/cei.13491"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.2887"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.4103"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.31.2.220"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23944"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12081"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200056"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749\u20106632.2012.06840.x"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp\u20102022\u2010330519"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311\u2010022\u201001335\u20103"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.52.3.484"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10522\u2010008\u20109138\u20106"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602489"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3645157"}],"container-title":["Journal 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