{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:58:22Z","timestamp":1791910702226,"version":"4.3.4"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to investigate the impact of tacrolimus on peripheral T and B lymphocyte subsets in myasthenia gravis (MG) patients compared to glucocorticoid treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study retrospectively included MG patients at the First Affiliated Hospital of Fujian Medical University between January 2021 and December 2024. Patients were grouped based on immunotherapy received: tacrolimus (TAC) or glucocorticoids (GC). Peripheral blood samples were assessed for T lymphocyte subsets (CD3<jats:sup>+<\/jats:sup>, CD4<jats:sup>+<\/jats:sup>, CD8<jats:sup>+<\/jats:sup>) and B lymphocyte subsets (CD19<jats:sup>+<\/jats:sup>), alongside clinical parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 46 MG patients were included, with 23 patients in each treatment group. Baseline characteristics, including sex, age at onset, antibody profile, and thymic pathology, were comparable between the two groups (all P &amp;gt; 0.05), except for a significantly higher proportion of generalized MG in the TAC group (P = 0.017). Following treatment, the TAC group demonstrated a significantly lower absolute count of CD3<jats:sup>+<\/jats:sup>CD4<jats:sup>+<\/jats:sup> T cells compared to the GC group (663.4 \u00b1 345.5 \u00d7 10<jats:sup>6<\/jats:sup>\/L vs. 952.5 \u00b1 513.9 \u00d7 10<jats:sup>6<\/jats:sup>\/L, P = 0.030). Additionally, the percentage of peripheral B cells in the tacrolimus group decreased significantly after treatment (from 11.8 \u00b1 4.7% to 9.4 \u00b1 4.4%, P = 0.006). In contrast, patients treated with glucocorticoids showed significant post-treatment increases in the absolute counts of CD3<jats:sup>+<\/jats:sup>, CD3<jats:sup>+<\/jats:sup>CD4<jats:sup>+<\/jats:sup>, and CD3<jats:sup>+<\/jats:sup>CD8<jats:sup>+<\/jats:sup> T cells (all P = 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with patients receiving glucocorticoid therapy, those treated with tacrolimus exhibited significantly lower levels of peripheral CD3<jats:sup>+<\/jats:sup>CD4<jats:sup>+<\/jats:sup> T cells after treatment. These findings provide insight into the differential immunomodulatory effects of these therapies in MG.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1667799","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T05:41:37Z","timestamp":1760506897000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Impacts of tacrolimus and glucocorticoids on peripheral blood T and B lymphocyte subsets in myasthenia gravis"],"prefix":"10.3389","volume":"16","author":[{"given":"Xuan","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guorong","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.141.10.3361","article-title":"Regulation of antibody production by helper T cell clones in experimental autoimmune myasthenia gravis","volume":"141","author":"Fujii","year":"1988","journal-title":"J Immunol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI114948","article-title":"Phenotypic and functional characterization of T cells from patients with myasthenia gravis","volume":"86","author":"Mokhtarian","year":"1990","journal-title":"J Clin Invest"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2019.03.016","article-title":"B cell responses: cell interaction dynamics and decisions","volume":"177","author":"Cyster","year":"2019","journal-title":"Cell"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/0952-7915(92)90024-9","article-title":"FK-506 and cyclosporin A: immunosuppressive mechanism of action and beyond","volume":"4","author":"Siekierka","year":"1992","journal-title":"Curr Opin Immunol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2019.60.7.633","article-title":"Long-term safety and efficacy of tacrolimus in myasthenia gravis","volume":"60","author":"Kim","year":"2019","journal-title":"Yonsei Med J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"20406223221122538","DOI":"10.1177\/20406223221122538","article-title":"Remission and relapses of myasthenia gravis on long-term tacrolimus: a retrospective cross-sectional study of a Chinese cohort","volume":"13","author":"Bi","year":"2022","journal-title":"Ther Adv Chronic Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16466","article-title":"Treatment of juvenile myasthenia gravis with tacrolimus: A cohort study","volume":"31","author":"Wang","year":"2024","journal-title":"Eur J Neurol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-024-07819-8","article-title":"Long-term efficacy and safety of tacrolimus in anti-MuSK antibody-positive myasthenia gravis: a retrospective single-center cohort study","volume":"46","author":"Bi","year":"2025","journal-title":"Neurol Sci"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14039","article-title":"Safety of tapering tacrolimus dose in patients with well-controlled anti-acetylcholine receptor antibody-positive myasthenia gravis","volume":"27","author":"Nishida","year":"2020","journal-title":"Eur J Neurol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.7164\/antibiotics.40.1249","article-title":"FK-506, a novel immunosuppressant isolated from a Streptomyces. 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