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Background:   Although the pathogenesis of myasthenia gravis (MG) is well known, prognostic markers are not yet available. We assessed the utility of anti-acetylcholine receptor (AChR) antibody (AChR-ab) titer and concentration of C3, C4, and C5a as potential severity biomarkers in MG.Methods:   Levels of C3, C4, C5a, and AChR-ab were measured in 60 AChR-ab-positive patients with MG. Their relationship with clinical severity was analyzed using the activities of daily living (ADL) and MG composite (MGC) scales.Results:   AChR-ab titer correlated with severity of MG according to ADL ( p = 0.002) and MGC scales ( p = 0.001). When patients were classified according to disease duration, a statistically significant correlation between AChR-ab titer and clinical severity was only found in the subgroup of patients with fewer than 5 years from symptoms onset. C5a levels showed a positive correlation with MG severity according to the ADL scale ( p = 0.041; τb = 0.18), although C5a levels were not different from the control group.Discussion:   AChR-ab titers and C5a levels could potentially be considered markers of severity in patients with MG.

C3, C5a and anti-acetylcholine receptor antibody as severity biomarkers in myasthenia gravis