Exosomes in Myasthenia Gravis—Review

Myasthenia gravis (MG) is a rare autoimmune disorder characterized by muscle weakness and fatigue, caused by autoantibodies produced by B-cells that target proteins in the postsynaptic membrane of the neuromuscular junction. Clinical manifestations are heterogeneous and may include diplopia, ptosis, dysarthria, dysphagia, and limb muscle weakness, with severity ranging from mild symptoms to life-threatening myasthenic crisis. Despite advances in diagnostic approaches and the availability of immunomodulatory and biological therapies, there remains a need for an improved understanding of the disease mechanisms and biomarker development in MG. Blood-derived exosomes are small extracellular vesicles that carry proteins, lipids, nucleic acids, and glycoconjugates, and are involved in intercellular communication and the transfer of biological material between cells. Circulating exosomes may reflect aspects of cellular and immune status and have been proposed as a minimally invasive source of biomarkers in various diseases. In this review, we summarize current evidence on the potential role of exosomes in MG, with a focus on their involvement in disease-associated processes and their possible utility as biomarkers, as well as directions for future research.