Novel methods for neural IgG characterization and validation in autoimmune neurologic disorders

Neural autoantibody testing is standard for patients with suspected autoimmune neurologic disorders. The number of neural antibodies has increased dramatically in the past 40 years, with over 50 disease-specific neural antibodies defined to date. The advent of immune-profiling assays such as protein array and phage immunoprecipitation sequencing (PhIP-Seq) has further expedited the rate of antibody discovery, with many recent targets identified using these methods. In this review, we discuss traditional and novel methods of antibody discovery, with an emphasis on the incorporation of protein array and PhIP-Seq into our antibody discovery approach. Advantages, limitations, and potential future uses of these platforms within the field of autoimmune neurology are also considered. • Immune profiling arrays expedite the discovery of neural antibody biomarkers in patients with autoimmune neurologic disorders. • Protein array and phage immunoprecipitation assays have superseded older techniques for antibody discovery, especially in the detection of antibodies against intracellular antigens • Many new antibodies will continue to be discovered using these technologies, and new disease or phenotype-specific ‘antigen signatures’ may emerge over time