Efficacy of MLN9708 (ixazomib) in experimental autoimmune myasthenia gravis and in anti-AChR producing primary thymic cell cultures from myasthenia gravis patients

Proteasome inhibitors can eliminate malignant, alloreactive, or autoreactive plasma cells. These cells are key players in antibody-mediated autoimmune disorders and thus suitable therapeutic targets for these drugs. However, certain proteasome inhibitors cause toxic peripheral neuropathy in patients...

Full description

Saved in:
Bibliographic Details
Main Authors: Marina Mané-Damas, Abhishek Saxena, Gisela Nogales-Gadea, Jo Stevens, Shannen Vincken, Maarten van Beek, Nynke J. van den Hoogen, Elbert A. J. Joosten, Nick Willcox, Hans Duimel, Jos G. Maessen, Peter C. Molenaar, Marc H. De Baets, Mario Losen, Pilar Martinez-Martinez
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Immunology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1521432/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849322106989314048
author Marina Mané-Damas
Abhishek Saxena
Abhishek Saxena
Gisela Nogales-Gadea
Gisela Nogales-Gadea
Jo Stevens
Shannen Vincken
Maarten van Beek
Nynke J. van den Hoogen
Nynke J. van den Hoogen
Nynke J. van den Hoogen
Elbert A. J. Joosten
Nick Willcox
Hans Duimel
Jos G. Maessen
Peter C. Molenaar
Marc H. De Baets
Mario Losen
Pilar Martinez-Martinez
author_facet Marina Mané-Damas
Abhishek Saxena
Abhishek Saxena
Gisela Nogales-Gadea
Gisela Nogales-Gadea
Jo Stevens
Shannen Vincken
Maarten van Beek
Nynke J. van den Hoogen
Nynke J. van den Hoogen
Nynke J. van den Hoogen
Elbert A. J. Joosten
Nick Willcox
Hans Duimel
Jos G. Maessen
Peter C. Molenaar
Marc H. De Baets
Mario Losen
Pilar Martinez-Martinez
author_sort Marina Mané-Damas
collection DOAJ
description Proteasome inhibitors can eliminate malignant, alloreactive, or autoreactive plasma cells. These cells are key players in antibody-mediated autoimmune disorders and thus suitable therapeutic targets for these drugs. However, certain proteasome inhibitors cause toxic peripheral neuropathy in patients. Ixazomib (MLN9708, Ninlaro), an oral proteasome inhibitor, has a more favorable safety profile in multiple myeloma patients. Here we tested its efficacy in preventing and treating experimental autoimmune myasthenia gravis (EAMG). Female Lewis rats were treated with two subcutaneous doses of 0.35 mg/kg of ixazomib per week, starting either 4 weeks before or at disease onset; both substantially lowered final total IgG and rat acetylcholine receptor (AChR) autoantibody levels. Interestingly, two weekly doses of 0.20 mg/kg of ixazomib for the last 4 weeks did not reduce autoantibody levels. A single dose of 0.50 mg/kg was acutely toxic in rats. In cultures of thymic cells from early-onset myasthenia gravis (EOMG) patients, 30 nM ixazomib or higher almost completely eliminated plasma cells and halted their IgG and AChR antibody production. We conclude that proteasome inhibition with ixazomib effectively depletes plasma cells from MG patients in vitro and in a rat model in vivo. These results encourage further investigations into therapeutic plasma cell targeting for MG patients.
format Article
id doaj-art-13fd9d16bbd2425892b84ce502d7bcfd
institution Kabale University
issn 1664-3224
language English
publishDate 2025-05-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Immunology
spelling doaj-art-13fd9d16bbd2425892b84ce502d7bcfd2025-08-20T03:49:32ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-05-011610.3389/fimmu.2025.15214321521432Efficacy of MLN9708 (ixazomib) in experimental autoimmune myasthenia gravis and in anti-AChR producing primary thymic cell cultures from myasthenia gravis patientsMarina Mané-Damas0Abhishek Saxena1Abhishek Saxena2Gisela Nogales-Gadea3Gisela Nogales-Gadea4Jo Stevens5Shannen Vincken6Maarten van Beek7Nynke J. van den Hoogen8Nynke J. van den Hoogen9Nynke J. van den Hoogen10Elbert A. J. Joosten11Nick Willcox12Hans Duimel13Jos G. Maessen14Peter C. Molenaar15Marc H. De Baets16Mario Losen17Pilar Martinez-Martinez18Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsAdvanced Biologics Design Group, Center for Translational Research, Shenzhen Bay Laboratory, Shenzhen, ChinaDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsBadalona Neuromuscular Research Group (GRENBA), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Badalona, SpainDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Anesthesiology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Anesthesiology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Paediatrics, University of Calgary, Calgary, AB, CanadaHotchkiss Brain Institute, University of Calgary, Calgary, AB, CanadaDepartment of Anesthesiology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Clinical Neurosciences, Weatherall Institute for Molecular Medicine, University of Oxford, Oxford, United KingdomMicroscope CORE lab, Maastricht University, Maastricht, NetherlandsDepartment of Cardiothoracic Surgery, Maastricht UMC+, Maastricht, NetherlandsDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsDepartment of Psychiatry and Neuropsychology, Mental Health and Neuroscience Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, NetherlandsProteasome inhibitors can eliminate malignant, alloreactive, or autoreactive plasma cells. These cells are key players in antibody-mediated autoimmune disorders and thus suitable therapeutic targets for these drugs. However, certain proteasome inhibitors cause toxic peripheral neuropathy in patients. Ixazomib (MLN9708, Ninlaro), an oral proteasome inhibitor, has a more favorable safety profile in multiple myeloma patients. Here we tested its efficacy in preventing and treating experimental autoimmune myasthenia gravis (EAMG). Female Lewis rats were treated with two subcutaneous doses of 0.35 mg/kg of ixazomib per week, starting either 4 weeks before or at disease onset; both substantially lowered final total IgG and rat acetylcholine receptor (AChR) autoantibody levels. Interestingly, two weekly doses of 0.20 mg/kg of ixazomib for the last 4 weeks did not reduce autoantibody levels. A single dose of 0.50 mg/kg was acutely toxic in rats. In cultures of thymic cells from early-onset myasthenia gravis (EOMG) patients, 30 nM ixazomib or higher almost completely eliminated plasma cells and halted their IgG and AChR antibody production. We conclude that proteasome inhibition with ixazomib effectively depletes plasma cells from MG patients in vitro and in a rat model in vivo. These results encourage further investigations into therapeutic plasma cell targeting for MG patients.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1521432/fullixazomibtargeting autoimmune plasma cellsmyasthenia gravisproteasome inhibitionautoantibodytherapy
spellingShingle Marina Mané-Damas
Abhishek Saxena
Abhishek Saxena
Gisela Nogales-Gadea
Gisela Nogales-Gadea
Jo Stevens
Shannen Vincken
Maarten van Beek
Nynke J. van den Hoogen
Nynke J. van den Hoogen
Nynke J. van den Hoogen
Elbert A. J. Joosten
Nick Willcox
Hans Duimel
Jos G. Maessen
Peter C. Molenaar
Marc H. De Baets
Mario Losen
Pilar Martinez-Martinez
Efficacy of MLN9708 (ixazomib) in experimental autoimmune myasthenia gravis and in anti-AChR producing primary thymic cell cultures from myasthenia gravis patients
Frontiers in Immunology
ixazomib
targeting autoimmune plasma cells
myasthenia gravis
proteasome inhibition
autoantibody
therapy
title Efficacy of MLN9708 (ixazomib) in experimental autoimmune myasthenia gravis and in anti-AChR producing primary thymic cell cultures from myasthenia gravis patients
title_full Efficacy of MLN9708 (ixazomib) in experimental autoimmune myasthenia gravis and in anti-AChR producing primary thymic cell cultures from myasthenia gravis patients
title_fullStr Efficacy of MLN9708 (ixazomib) in experimental autoimmune myasthenia gravis and in anti-AChR producing primary thymic cell cultures from myasthenia gravis patients
title_full_unstemmed Efficacy of MLN9708 (ixazomib) in experimental autoimmune myasthenia gravis and in anti-AChR producing primary thymic cell cultures from myasthenia gravis patients
title_short Efficacy of MLN9708 (ixazomib) in experimental autoimmune myasthenia gravis and in anti-AChR producing primary thymic cell cultures from myasthenia gravis patients
title_sort efficacy of mln9708 ixazomib in experimental autoimmune myasthenia gravis and in anti achr producing primary thymic cell cultures from myasthenia gravis patients
topic ixazomib
targeting autoimmune plasma cells
myasthenia gravis
proteasome inhibition
autoantibody
therapy
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1521432/full
work_keys_str_mv AT marinamanedamas efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT abhisheksaxena efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT abhisheksaxena efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT giselanogalesgadea efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT giselanogalesgadea efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT jostevens efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT shannenvincken efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT maartenvanbeek efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT nynkejvandenhoogen efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT nynkejvandenhoogen efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT nynkejvandenhoogen efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT elbertajjoosten efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT nickwillcox efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT hansduimel efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT josgmaessen efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT petercmolenaar efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT marchdebaets efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT mariolosen efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients
AT pilarmartinezmartinez efficacyofmln9708ixazomibinexperimentalautoimmunemyastheniagravisandinantiachrproducingprimarythymiccellculturesfrommyastheniagravispatients