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B cells produce the autoantibodies responsible for all 3 primary generalized myasthenia gravis (gMG) serotypes:2-4

AChR+ contained icon

AChR+

~80% of cases5

MuSK+ contained icon

MuSK+

~7 to 10% of cases5

LRP4+ contained icon

LRP4+

~1% of cases
(seronegative:* 10 to 15% of cases)6

*While seronegative gMG is believed to be an autoimmune condition, its pathophysiology remains unclear.4

Image of a female gMG patient talking to her doctor

CD19 and CD20: Markers Across the B Cell Maturation Pathway7,8

CD19 and CD20 are expressed at different stages of B cell development. through much of the lifecycle, including on plasmablasts and some plasma cells that produce autoantibodies.2,8 CD20 appears later and is not present on these antibody-secreting cells.7,8

CD19 Expression Spans the Autoantibody-Producing Lineage7,8

B Cell Lineage Graphic for Desktop: CD19 Expression Spans the Autoantibody-Producing LineageAutoantibody-producing B cells
B Cell Lineage Graphic for Mobile: CD19 Expression Spans the Autoantibody-Producing LineageAutoantibody-producing B cells

  • SUMMARY: Role of B Cells in gMG

    • CD19 is expressed on B cells that produce the autoantibodies associated with gMG (anti-AChR, anti-MuSK, and anti-LRP4)2-4
    • These autoantibodies drive core disease processes and contribute to patient burden2
    • Understanding the expression of CD19 and CD20 helps contextualize the role of different B-cell subsets in disease activity
Globe icon

Global MG prevalence has more than doubled in the past 20 years, likely due to improvements in diagnosis, survival, and life expectancy9

gMG has a bimodal distribution, with a higher incidence in5

Female icon

women between 30 to 50 years old

Male icon

and men between 60 and 89 years old

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Explore the common symptoms of gMG

AChR+, acetylcholine receptor positive; LRP4, low-density lipoprotein receptor-related protein 4; MuSK+, muscle-specific kinase positive.

  • References

    1. Lazaridis K, Tzartos SJ. Front Neurol. 2020;11:596981.

    2. Yi JS, Guptill JT, Stathopoulos P, Nowak RJ, O'Connor KC. Muscle Nerve. 2018;56(2):172-184.

    3. Sun B, Ramberger M, O’Connor KC, et al. Nat Rev Neurol. 2020;16(9):481-492.

    4. Fichtner ML, Jiang R, Bourke A, et al. Front Immunol. 2020;11.

    5. Dresser L, Wlodarski R, Rezania K, Soliven B. J Clin Med. 2021;10:2235.

    6. Evoli A, Palace J, Spagni G, et al. Neuromusc Disord. 2024;(44):104468.

    7. Baker D, Marta M, Pryce G, et al. EBioMedicine. 2017;16:41-50.

    8. Forsthuber TG, Cimbora DM, Ratchford JN, et al. Ther Adv Neurol Disord. 2018;11:1-13.

    9. Park JY, Kim M, McCloskey C, Patterson KR, Meyers A. Poster presented at: American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM): October 2024 Savannah, GA.