PMID- 33970749
OWN - NLM
STAT- MEDLINE
DCOM- 20220401
LR  - 20220401
IS  - 1744-8352 (Electronic)
IS  - 1473-7159 (Linking)
VI  - 21
IP  - 6
DP  - 2021 Jun
TI  - Improving laboratory diagnostics in myasthenia gravis.
PG  - 579-590
LID - 10.1080/14737159.2021.1927715 [doi]
AB  - Introduction: Myasthenia gravis (MG) is a prototypical autoimmune disease, 
      characterized by pathogenic autoantibodies targeting structures of the 
      neuromuscular junction. Radioimmunoprecipitation assays (RIPAs) represent the 
      gold standard for their detection. However, new methods are emerging to 
      complement, or overcome RIPAs, also with the perspective of eliminating the use 
      of radioactive reagents.Areas covered: We discuss advances in laboratory methods, 
      prompted especially by cell-based assays (CBAs), for the detection of the 
      autoantibodies of MG diagnostics, above all those to the nicotinic acetylcholine 
      receptor (AChR), muscle-specific kinase (MuSK), and low molecular-weight 
      receptor-related low-density lipoprotein-4 (LRP4).Expert opinion: CBA technology 
      makes AChRs aggregate on cell membranes, thus allowing to detect autoantibodies 
      to clustered AChRs, with reduction of seronegative MG cases. The diagnostic 
      relevance of RIPA/CBA-measurable LRP4 antibodies is still unclear, in Caucasian 
      patients at least. Live CBAs for the detection of AChR, MuSK, and LRP4 antibodies 
      might represent an alternative to RIPAs, but first require full validation. CBAs 
      could be used as screening tests, limiting RIPAs for antibody quantification. To 
      this end, ELISAs might be an alternative.Fixation procedures preserving enough 
      degree of antigen conformationality could yield AChR and MuSK CBAs suitable for a 
      wide use in clinical-chemistry laboratories.
FAU - Gastaldi, Matteo
AU  - Gastaldi M
AD  - Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy.
FAU - Scaranzin, Silvia
AU  - Scaranzin S
AD  - Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy.
FAU - Businaro, Pietro
AU  - Businaro P
AD  - Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
FAU - Mobilia, Emanuela
AU  - Mobilia E
AD  - Autoimmunity Laboratory, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
FAU - Benedetti, Luana
AU  - Benedetti L
AD  - Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and 
      Child Health, University of Genova, Genova, Italy; IRCCS Ospedale Policlinico San 
      Martino, Genova, Italy.
FAU - Pesce, Giampaola
AU  - Pesce G
AD  - Autoimmunity Laboratory, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
AD  - Department of Internal Medicine (Dimi), University of Genova, Genova, Italy.
FAU - Franciotta, Diego
AU  - Franciotta D
AD  - Autoimmunity Laboratory, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210519
PL  - England
TA  - Expert Rev Mol Diagn
JT  - Expert review of molecular diagnostics
JID - 101120777
RN  - 0 (Autoantibodies)
SB  - IM
MH  - Autoantibodies
MH  - Biological Assay
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Humans
MH  - *Myasthenia Gravis/diagnosis
OTO - NOTNLM
OT  - Autoantibody
OT  - cell-based assay
OT  - enzyme-linked immunosorbent assay
OT  - laboratory diagnostics
OT  - low molecular weight receptor related low-density lipoprotein 4
OT  - muscle specific tyrosine kinase
OT  - myasthenia gravis
OT  - neuroimmunology
OT  - nicotinic acetylcholine receptor
OT  - radioimmunoprecipitation assay
EDAT- 2021/05/11 06:00
MHDA- 2022/04/02 06:00
CRDT- 2021/05/10 17:29
PHST- 2021/05/11 06:00 [pubmed]
PHST- 2022/04/02 06:00 [medline]
PHST- 2021/05/10 17:29 [entrez]
AID - 10.1080/14737159.2021.1927715 [doi]
PST - ppublish
SO  - Expert Rev Mol Diagn. 2021 Jun;21(6):579-590. doi: 10.1080/14737159.2021.1927715. 
      Epub 2021 May 19.