These data, along with the gene expression in thymoma patients who are positive for anti-RYR1 and/or -TTN autoantibodies, suggest that the intra-thymic muscle autoantigen down-regulation, and the down-regulation of AIRE, are molecular alterations that may favor autosensitization and autoreactivity to muscle autoantigens in MG. Here, TTN is linked to myasthenia gravis.