Ectopic germinal centers, BAFF and anti-B-cell therapy in myasthenia gravis

• B cells from MG patients present signs of polyclonal activation.
• Ectopic thymic germinal centers are found in AChR-MG and contribute to anti-AChR Ab production.
• MG patients have long-lived plasma cells producing anti-AChR antibodies.
• BAFF is a potential target for new therapies.
• B-cell therapies are efficient in MG diseases.

Myasthenia gravis (MG) is an autoimmune disease mediated by antibodies directed to molecules of the endplate of the neuromuscular junction. B cells play a major role in MG disease since they produce the pathogenic antibodies and therapies targeting B cells are effective. The aim of this article was to review the role of B cells in myasthenia gravis. We will first describe what we know about B cells in this disease and examine the involvement of the B cells in the thymus of MG patients. We will detail the role of factors associated with B-cell function such as BAFF. Finally, we will discuss the effects of therapy targeting B cells.