Extensive Clinical Flow Cytometric Lymphocyte Phenotyping in Myasthenia Gravis: A Single‐Center Study

PMCID: PMC12172393

PMID: 40525756

DOI: 10.1111/jnc.70126

Journal: Journal of neurochemistry

Publication Date: 2025-6-17

Authors: Lindahl H, Petersson M, Enoksson SL, Piehl F, Brauner S

Key Points

• Untreated MG patients show distinctive lymphocyte subset alterations, particularly elevated CD4 T cell frequencies
• High CD4 T cell percentages (>75%) associated with 32% reduced likelihood of minimal disease manifestation
• CD4 T cell frequency may serve as a potential prognostic marker, though prospective validation is needed

Summary

This exploratory study investigated peripheral blood lymphocyte phenotypes in myasthenia gravis (MG) patients, revealing significant immunological alterations that may provide prognostic insights. By analyzing flow cytometry data from 76 MG patients, researchers discovered that untreated patients exhibited notably higher CD4 T cell frequencies compared to age-matched healthy controls, with a median of 75% versus 63-65% in reference populations.

The most critical finding was the association between high CD4 T cell frequencies and disease progression. Patients with CD4 T cell percentages above 75% demonstrated a lower probability of achieving minimal disease manifestation within one year (35% vs. 67%, log-rank p=0.032). In a multivariable Cox regression model, CD4 T cell frequency emerged as an independent risk factor (p=0.0014), suggesting potential utility as a prognostic biomarker for MG disease trajectory.