{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:01:41Z","timestamp":1787320901017,"version":"build-2736575974"},"reference-count":102,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,8,8]],"date-time":"2019-08-08T00:00:00Z","timestamp":1565222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["nyaspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of the New York Academy of Sciences"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Myasthenia gravis (MG) is an acquired autoimmune disease affecting the postsynaptic membrane of neuromuscular junctions and characterized by antibody\u2010mediated T cell dependence and complement involvement. Cholinesterase inhibitors (e.g., pyridostigmine bromide), glucocorticoids, and azathioprine are currently recommended as first\u2010line treatments for MG, though they have limitations, including potential toxicity and ineffectiveness in patients with refractory MG. In recent years, owing to an increasing understanding of MG pathogenesis the development and execution of clinical trials with novel biologics, including monoclonal antibodies (mAbs) that have demonstrated higher safety and more specificity, provide new opportunities for the treatment of MG. In this article, we review recent advances in MG pathogenesis and the mAbs that have been used for target\u2010specific MG therapy.<\/jats:p>","DOI":"10.1111\/nyas.14195","type":"journal-article","created":{"date-parts":[[2019,8,8]],"date-time":"2019-08-08T08:58:10Z","timestamp":1565254690000},"page":"18-33","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Myasthenia gravis and specific immunotherapy: monoclonal antibodies"],"prefix":"10.1111","volume":"1452","author":[{"given":"Xiao\u2010Jun","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Huashan Hospital Fudan University  Shanghai P. R. China"},{"name":"Department of Pharmacy the Affiliated Wuxi People's Hospital of Nanjing Medical University  Wuxi P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zai\u2010Wang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shenzhen People's Hospital, the Second Clinical Medical College of Jinan University the First Affiliated Hospital of Southern University of Science and Technology  Shenzhen P. R. China"},{"name":"Department of Neurology the Affiliated Wuxi People's Hospital of Nanjing Medical University  Wuxi P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010Ying","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huashan Hospital Fudan University  Shanghai P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui\u2010Zhu","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Pharmacy the Affiliated Wuxi People's Hospital of Nanjing Medical University  Wuxi P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jue","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Huashan Hospital Fudan University  Shanghai P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Hua","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Huashan Hospital Fudan University  Shanghai P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shenzhen People's Hospital, the Second Clinical Medical College of Jinan University the First Affiliated Hospital of Southern University of Science and Technology  Shenzhen P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Jiao","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Huashan Hospital Fudan University  Shanghai P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13522"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2018.1491310"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1586265"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20950"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756285617749134"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31827b907b"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2016.08.057"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2016.11.003"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0000000000000034"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-016-2769-5"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-014-7532-3"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756285611411503"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1602678"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.89665"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2017.07.006"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-11-3900"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8751-9"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2013.12.015"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-017-0892-8"},{"key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"3752","DOI":"10.4049\/jimmunol.157.8.3752","article-title":"Expression of acetylcholine receptor genes in human thymic epithelial cells: implications for myasthenia gravis","volume":"157","author":"Wakkach A.","year":"1996","journal-title":"J.\u00a0Immunol."},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.019"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.172.9.5743"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.009"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2018.01.001"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01785"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000299"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/14728222.2017.1369960"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.1733-14.2014"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygeno.2006.08.005"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1159\/000070185"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1096\/fasebj.11.5.9141500"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.62.3.442"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-41730-z"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.1990.tb05440.x"},{"key":"e_1_2_7_36_1","first-page":"163","article-title":"Broken dogma: penetration of autoantibodies into living cells","volume":"17","author":"Alarcon\u2010Segovia D.","year":"1996","journal-title":"Immunol. Today"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1254.039"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.58.6.885"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1085\/jgp.201711878"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.2174\/092986607780989958"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-018-0110-z"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.4367"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004341"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26107"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25597"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182407982"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2017.05.021"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23944"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000228225.23349.5d"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.314"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2010.220475"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000202"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313984"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-06-225979"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND-170211"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1601277"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000125"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2016.11.025"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.05.001"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2011.05.006"},{"key":"e_1_2_7_61_1","first-page":"104","article-title":"Tumor necrosis factor\u2010alpha polymorphism and secretion in myasthenia gravis","volume":"20","author":"Guan Y.Z.","year":"2005","journal-title":"Chin. Med. Sci. J."},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1006\/jaut.2002.0618"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.56.4.457"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2006.00778.x"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000147242.92691.71"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1405.028"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21280"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2005.01.013"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.186.3.385"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.169.2.1077"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.6.561"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2230.2003.01411.x"},{"key":"e_1_2_7_73_1","first-page":"293","article-title":"[Neurological complications during treatment of the tumor necrosis alpha inhibitors]","volume":"34","author":"Piusinska\u2010Macoch R.","year":"2013","journal-title":"Pol. Merkur. Lekarski"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-009-1012-6"},{"key":"e_1_2_7_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(98)00129-4"},{"key":"e_1_2_7_76_1","doi-asserted-by":"publisher","DOI":"10.1038\/ni.3153"},{"key":"e_1_2_7_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5728(96)00152-X"},{"key":"e_1_2_7_78_1","first-page":"121","article-title":"Interleukin\u20106 overproduction by cultured thymic epithelial cells from patients with myasthenia gravis is potentially involved in thymic hyperplasia","volume":"4","author":"Cohen\u2010Kaminsky S.","year":"1993","journal-title":"Eur. Cytokine Netw."},{"key":"e_1_2_7_79_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-014-0179-6"},{"key":"e_1_2_7_80_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-012-2423-3"},{"key":"e_1_2_7_81_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000317"},{"key":"e_1_2_7_82_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2013.1246"},{"key":"e_1_2_7_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.03.007"},{"key":"e_1_2_7_84_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev372"},{"key":"e_1_2_7_85_1","first-page":"625","article-title":"Clinical efficacy and safety maintained up to 5 years in patients with rheumatoid arthritis treated with tocilizumab in a randomised trial","volume":"34","author":"Kremer J.M.","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"e_1_2_7_86_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2011.290"},{"key":"e_1_2_7_87_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2506"},{"key":"e_1_2_7_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0960-9822(01)00481-X"},{"key":"e_1_2_7_89_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.125.4.1678"},{"key":"e_1_2_7_90_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2016.12.017"},{"key":"e_1_2_7_91_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005323"},{"key":"e_1_2_7_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2013.03.003"},{"key":"e_1_2_7_93_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13110"},{"key":"e_1_2_7_94_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2006.06.003"},{"key":"e_1_2_7_95_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND-170294"},{"key":"e_1_2_7_96_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23839"},{"key":"e_1_2_7_97_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-018-0875-9"},{"key":"e_1_2_7_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30369-1"},{"key":"e_1_2_7_99_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-016-2065-4"},{"key":"e_1_2_7_100_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.423"},{"key":"e_1_2_7_101_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1311084"},{"key":"e_1_2_7_102_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tips.2019.04.014"},{"key":"e_1_2_7_103_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-019-00783-z"}],"container-title":["Annals of the New York Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nyas.14195","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nyas.14195","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nyas.14195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T15:27:55Z","timestamp":1694273275000},"score":1,"resource":{"primary":{"URL":"https:\/\/nyaspubs.onlinelibrary.wiley.com\/doi\/10.1111\/nyas.14195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,8]]},"references-count":102,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1111\/nyas.14195"],"URL":"https:\/\/doi.org\/10.1111\/nyas.14195","archive":["Portico"],"relation":{},"ISSN":["0077-8923","1749-6632"],"issn-type":[{"value":"0077-8923","type":"print"},{"value":"1749-6632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,8]]},"assertion":[{"value":"2019-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}