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. 2022 Oct 12;13:916098. doi: 10.3389/fimmu.2022.916098

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Copyright © 2022 He, Zhou, Ji, Zhang, Lv, Quan, Zhang, Zhao, Cui, Li, Liu, Zhang, Shen, Fang, Yang, Zhang, Cui, Zhang and Gao

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Underlying mechanism by which SNX17 increases cell surface LRP4 expression to promote AChR aggregation and neuromuscular excitatory transmission restoration. SNX17 recognizes and binds LRP4 that is internalized into early endosomes and mediates the transformation of LRP4 to circulating endosomes and then back to the muscle cell membrane. LRP4 returning to the membrane induces AChR aggregation through the Agrin–LRP4–MuSK signaling pathway, which binds ACh released from the presynaptic membrane and further restores the neuromuscular excitation transmission. AChR, acetylcholine receptor; LRP4, low-density lipoprotein receptor-related protein 4; MuSK, muscle-specific receptor tyrosine kinase; NMJ, neuromuscular junction; SNX17, sorting nexin 17.