Immunological mechanisms and therapeutic innovations in Myasthenia Gravis: from pathogenesis to precision medicine

Myasthenia gravis (MG) is a prototypical autoimmune disorder characterized by autoantibody-mediated destruction of the neuromuscular junction. The immunopathogenesis involves complex interactions between B cells, T cells, complement activation, and the thymus microenvironment. Recent advances have identified distinct clinical subtypes including early-onset MG (EOMG), late-onset MG (LOMG), and thymoma-associated MG (TAMG) which has unique immunological signatures. The emergence of novel therapeutic targets, including the neonatal Fc receptor (FcRn), complement inhibitors, and immune checkpoint pathways, has transformed treatment paradigms. However, significant challenges remain in understanding the precise immunological mechanisms underlying disease heterogeneity, predicting treatment responses, and managing immune-related complications in the era of immunotherapy.This Research Topic aims to comprehensively address the unmet clinical and scientific needs in MG immunology by:1. Elucidating immunopathogenic mechanisms: Investigating the roles of autoantibodies (AChR-Ab, MuSK-Ab, LRP4-Ab), T-cell dysregulation, complement activation, and thymic abnormalities in MG subtypes;2. Advancing therapeutic strategies: Evaluating the efficacy and safety of novel immunotherapies including FcRn antagonists (efgartigimod), complement inhibitors, B-cell depleting agents, and CAR-T cell therapies;3. Optimizing precision medicine approaches: Identifying biomarkers for treatment response prediction, disease monitoring, and personalized therapeutic selection;4. Addressing immune-related complications: Exploring the management of MG in the context of immune checkpoint inhibitor therapy, thymic epithelial tumors, and polyautoimmunity (e.g., MG-SLE co-occurrence);5. Translating bench to bedside: Bridging molecular immunology discoveries with clinical applications to improve patient outcomes and quality of life.This Research Topic welcomes original research articles, reviews, and clinical trials focusing on: - Autoantibody pathogenicity and novel antibody targets in MG;- T-cell and B-cell immunology in MG pathogenesis;- Complement system activation and inhibition strategies;- Thymus microenvironment and germinal center biology;- Immune checkpoint inhibitors and MG-related adverse events;- Biomarker discovery and precision medicine approaches;- Novel immunotherapies and clinical trial outcomes;- Polyautoimmunity and overlapping autoimmune mechanisms;- Pediatric and seronegative MG immunology.Manuscript types accepted: Original Research, Review, Clinical Trial, Methods, Perspective, and Hypothesis & Theory. Topic editors: Yongliang Jia, Hao Hu Source: https://www.frontiersin.org/research-topics/82539/immunological-mechanisms-and-therapeutic-innovations-in-myasthenia-gravis-from-pathogenesis-to-precision-medicine