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Article History

Received: 27 January 2026

Accepted: 19 May 2026

First Online: 3 June 2026

Declarations

:

: All experiments and sample collections were carried out according to the Declaration of Helsinki and were approved by the local ethics committee in Muenster, Germany (Ethics Committee of the Board of Physicians of the Region Westfalen-Lippe (2022-439-f-S)). Written informed consent was obtained from all patients prior to inclusion in the study.

: This manuscript is original, not under consideration elsewhere, and all authors have approved its submission.

: G.M.z.H. was supported by grants from the Bundesministerium für Bildung und Forschung (BMBF) ‘Lipid Immune Neuropathy Consortium’ and from the Deutsche Forschungsgemeinschaft (DFG) (ME4050/12-1, ME4050/13-1).CCG received speaker honoraria from DIU Dresden AG and kath. Klinikum Bochum GmbH, travel costs from DGN and DGLN e.V., and research funding from Biogen, Roche, and SanofiSL was funded by the Medical Faculty of the University Muenster (CS-Rotation Program).HW: reported personal fees for Abbvie, Alexion, Argenx, Biogen, Bristol Myers Squibb/Celgene, EMD Serono, F. Hoffmann-La Roche Ltd., Fondazione Cariplo, Genzyme, Gossamer Bio, Idorsia, Immunic, Immunovant, Janssen, Lundbeck, Merck, Neurodiem, NexGen, Novartis, PSI CRO, Roche Pharma AG, Sanofi, Swiss Multiple Sclerosis Society TEVA, UCB Biopharma, WebMD Global, and Worldwide Clinical Trials outside the submitted work. He reported grants by the DFG (CRC128 A09 and 445569437) during the conduct of the study, and funding by German Federal Ministry for Education and Research (BMBF), Deutsche Myasthenie Gesellschaft e.V., Alexion, Amicus Therapeutics Inc., Argenx, Biogen, CSL Behring, Roche, Genzyme, Merck, Novartis Pharma, Roche Pharma, and UCB Biopharma outside of the submitted work.