PDK4 and myasthenia gravis: In particular, insulin-like growth factor-binding protein (IGFBP1), Krüppel-like factor 15 (KLF15) transcription factor, pyruvate dehydrogenase kinase (PDK4) and hypoxia-inducible factor (HIF3A) were more expressed in Tm associated with MG than in those not associated with it, thus suggesting a role for these genes expression, especially HIF3A and IGBP1, in the pathogenesis of MG [32].