{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:06:51Z","timestamp":1787238411313,"version":"build-2736575974"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify new metabolic biomarkers associated with myasthenia gravis (MG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 285 potential metabolic molecules from UK Biobank (UKB) for MG patients and identified elevated serum cystatin C (Cys-C). Validation was performed using laboratory data, ELISA, and clinical information from Chinese (CHN) acetylcholine receptor antibody (AChR-Ab) positive generalized MG (gMG) cohorts. We assessed cytokines\/chemokines\/complements and peripheral blood T lymphocytes using Luminex assays and flow cytometry. MG-relevant scores including myasthenia gravis activities of daily living score (MG-ADL) and quantitative myasthenia gravis score (QMG) were prospectively collected and retrospectively analyzed. The correlations between serum Cys-C and the ratio of T helper 1 (Th1)\/Th2 were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Serum Cys-C levels were significantly elevated in MG patients compared to healthy controls in both UKB cohorts and Chinese MG cohorts (CHN) (UKB: 0.99 \u00b1 0.20 vs. 0.86 \u00b1 0.12 mg\/L, p = 2.26E-41; CHN: 1.08 \u00b1 0.30 vs. 0.87 \u00b1 0.13 mg\/L, p = 4.83E-08). Higher serum Cys-C levels were found in MG patients with high disease burden, as stratified by MG-ADL score. Serum Cys-C correlated with MG scores, including QMG (R = 0.40, p = 3.90E-03) and MG-ADL scores (R = 0.42, p = 2.40E-03). The ratio of Th1\/Th2 correlated well with the serum Cys-C (R = 0.29, p = 3.10E-02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Serum Cys-C levels were significantly elevated in AChR-Ab positive gMG patients and correlated with disease severity and Th1\/Th2 ratio, suggesting its potential as an efficient biomarker for predicting the clinical severity of MG. Future prospective cohort studies with a large sample size are expected to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1578359","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T01:27:02Z","timestamp":1746667622000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Serum cystatin C as a potential biomarker for generalized acetylcholine receptor antibody-positive myasthenia 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