Muscle-specific kinase (MuSK) myasthenia gravis (MG) is a neuromuscular autoimmune disorder caused by predominantly IgG4 antibodies targeting the MuSK protein. IgG4 has the unique ability to... Show moreMuscle-specific kinase (MuSK) myasthenia gravis (MG) is a neuromuscular autoimmune disorder caused by predominantly IgG4 antibodies targeting the MuSK protein. IgG4 has the unique ability to exchange half-molecules with other IgG4s, resulting in monovalent binding to their antigen. To investigate if MuSK-antibody valency influences its pathogenicity, recombinant bivalent and functionally monovalent MuSK antibodies were generated from B-cell receptor sequences isolated from MuSK MG patients. Passive transfer studies revealed that monovalency amplifies MuSK antibody pathogenicity in vivo. This may be because monovalent MuSK antibodies inhibit MuSK signaling (antagonist), while bivalent MuSK antibodies activate MuSK signaling (agonist) in vitro. The binding epitope on MuSK further influences the consequences and pathogenicity of MuSK antibodies. Collectively, these results suggest that the pathophysiology in individual patients depends on their unique antibody composition and that class-switching to IgG4 is a critical step in developing MuSK MG. Furthermore, the IgG4 response against MuSK does not appear to result from a global increase in IgG4 responses, as MuSK MG patients only had mildly elevated serum IgG4. Instead, it is thought to be driven by the antigen itself. Importantly, MUSK and other MG associated genes are also expressed outside skeletal muscle. These locations are at risk for non-motor symptoms caused by autoantibodies or mutations, or for side-effects of targeted therapeutic strategies. Show less
Cytotoxic T cell epitopes are the targets for a T cell mediated immunotherapy of cancer. The thesis reports on their identification in the tumor associated proteins BCR-ABL and PRAME by the reverse... Show moreCytotoxic T cell epitopes are the targets for a T cell mediated immunotherapy of cancer. The thesis reports on their identification in the tumor associated proteins BCR-ABL and PRAME by the reverse immunology (prediction) strategy. An extended strategy is used, including the analysis of the C-terminal generation of potential epitopes by the proteasome. Novel HLA class I peptide binding assays were developed to enable further epitope discovery. Fundamental studies were performed to identify novel non-proteasomal cytosolic endopeptidases in the HLA class I antigen processing pathway. Nardilysin and thimet oligopeptidase were identified to generate in a concerted action an HLA-A3 restricted CTL epitope from PRAME. The general roles of nardilysin and TOP in class I processing were investigated. Show less
