Myasthenia gravis is the most frequent acquired disorder of neuromuscular 
transmission. In the majority of cases, pathogenic antibodies against components 
of the postsynaptic muscle endplate membrane can be detected. In recent years 
there have been significant advances in the pathophysiological understanding and 
therapy of the disease. Areas covered: PubMed searches were conducted for the 
term 'myasthenia gravis' cross-referenced with the terms 'immunology', 
'subgroups', 'antibody', 'ocular', 'thymoma', 'treatment' and 'thymectomy'. 
Additionally, we summarized the current state of immunopathology and therapy. 
Expert commentary: Immunological research defined new target antigens at the 
postsynaptic neuromuscular junction which along with clinical features allow a 
refined definition of disease subgroups. Overall the prognosis of myasthenia 
gravis with best possible symptomatic, immunosuppressive and supportive 
treatment is good but new immunomodulatory treatment options are developed for 
patients who do not respond well to the first line therapy. For most patients 
individually adapted long-term drug therapy is needed.