Key result
A cell-based assay using rapsyn-clustered AChR successfully detected anti-AChR antibodies in 45.83% (11/24) of patients previously diagnosed with seronegative myasthenia gravis by traditional ELISA.
Why the study?
Does a cell-based assay using clustered AChRs improve the detection of anti-AChR antibodies in patients with seronegative myasthenia gravis compared to traditional ELISA?
Cross-Sectional (n=52)
No
Does a cell-based assay using clustered AChRs improve the detection of anti-AChR antibodies in patients with seronegative myasthenia gravis compared to traditional ELISA?
Absolute Event Rate: 45.83% vs 0%
p-value: p=<0.05
A novel cell-based assay using clustered AChRs can detect autoantibodies in nearly half of patients previously diagnosed with seronegative myasthenia gravis, significantly improving diagnostic sensitivity.
May aid reclassification of some seronegative myasthenia gravis cases; leaves open need for prospective validation before clinical use.
Myasthenia gravis (MG) is an autoantibody-mediated disease of the neuromuscular junction (NMJ). However, accumulating evidence has indicated that MG patients whose serum anti-acetylcholine receptor (AChR) antibodies are not detectable (serumnegative MG; SNMG) in routine assays share similar clinical features with anti-AChR antibody-positive MG patients. We hypothesized that SNMG patients would have low-affinity antibodies to AChRs that would not be detectable using traditional methods but that might be detected by binding to AChR on the cell membrane, particularly if they were clustered at the high density observed at the NMJ. We expressed AChR subunits with the clustering protein rapsyn (an AChR-associated protein at the synapse) in human embryonic kidney (HEK) cells, and we tested the binding of the antibodies using immunofluorescence. With this approach, AChR antibodies to rapsyn-clustered AChR could be detected in the sera from 45.83% (11/24) of SNMG patients, as confirmed with fluorescence-activated cell sorting (FACS). This was the first application in China of cell-based AChR antibody detection. More importantly, this sensitive (and specific) approach could significantly increase the diagnosis rate of SNMG.
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Zhao et al. (2015) conducted a cross-sectional in Seronegative Myasthenia Gravis (SNMG) (n=52). Cell-based assay with rapsyn-clustered AChR vs. Traditional ELISA was evaluated on Detection of anti-AChR antibodies in SNMG patients (p=<0.05). A cell-based assay using rapsyn-clustered AChR successfully detected anti-AChR antibodies in 45.83% (11/24) of patients previously diagnosed with seronegative myasthenia gravis by traditional ELISA.