1. Functional Signature of LRP4 Antibodies in Myasthenia Gravis.
- Author
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Chuquisana O, Stascheit F, Keller CW, Pučić-Baković M, Patenaude AM, Lauc G, Tzartos S, Wiendl H, Willcox N, Meisel A, and Lünemann JD
- Subjects
- Humans, Autoantibodies, LDL-Receptor Related Proteins, Receptor Protein-Tyrosine Kinases, Immunoglobulin G, Complement System Proteins, Receptors, Cholinergic, Myasthenia Gravis
- Abstract
Background and Objectives: Antibodies (Abs) specific for the low-density lipoprotein receptor-related protein 4 (LRP4) occur in up to 5% of patients with myasthenia gravis (MG). The objective of this study was to profile LRP4-Ab effector actions., Methods: We evaluated the efficacy of LRP4-specific compared with AChR-specific IgG to induce Ab-dependent cellular phagocytosis (ADCP), Ab-dependent cellular cytotoxicity (ADCC), and Ab-dependent complement deposition (ADCD). Functional features were additionally assessed in an independent AChR-Ab
+ MG cohort. Levels of circulating activated complement proteins and frequency of Fc glycovariants were quantified and compared with demographically matched 19 healthy controls., Results: Effector actions that required binding of Fc domains to cellular FcRs such as ADCC and ADCP were detectable for both LRP4-specific and AChR-specific Abs. In contrast to AChR-Abs, LRP4-binding Abs showed poor efficacy in inducing complement deposition. Levels of circulating activated complement proteins were not substantially increased in LRP4-Ab-positive MG. Frequency of IgG glycovariants carrying 2 sialic acid residues, indicative for anti-inflammatory IgG activity, was decreased in patients with LRP4-Ab-positive MG., Discussion: LRP4-Abs are more effective in inducing cellular FcR-mediated effector mechanisms than Ab-dependent complement activation. Their functional signature is different from AChR-specific Abs.- Published
- 2024
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