Scale up and safety parameters of antigen specific immunoadsorption of human anti-acetylcholine receptor antibodies

•Successful scale up of antigen specific immunoadsorption method for MG therapy•Several safety parameters of antigen specific immunoadsorption method were tested•Neither pyrogen nor complement activation occur•Whole blood apheresis as an alternative to plasma apheresis was successfully tested•Antigen specific apheresis seems a safe and effective treatment for myasthenia gravis

Myasthenia gravis is an autoimmune disease usually caused by autoantibodies against the muscle nicotinic acetylcholine receptor (nAChR). Current treatments are not specific, and thus often cause side effects. Here, we elaborate on our previous findings on antigen specific immunoadsorption towards scaling up the method as well as testing whole blood apheresis. The average percent of plasma or whole blood immunoadsorption was up to 79.5% ± 2.9. Moreover, neither pyrogens were co-administered nor did complement activation occur after immunoadsorption. Thus, antigen-specific apheresis of anti-AChR autoantibodies seems a safe and effective treatment for myasthenia gravis that can be scaled up for clinical testing.