K. C. O'Connor

The paper investigates how self-antigen-driven affinity maturation contributes to the development of pathogenic monovalent IgG4 autoantibodies in myasthenia gravis, showing that high-affinity Fab-arm exchanged antibodies require specific mutations for pathogenic capacity.

The paper isolates and characterizes MuSK-specific autoantibody-producing B cells from MuSK myasthenia gravis patients, generating monoclonal antibodies that reveal distinct binding specificities and functional effects on AChR clustering.