Advancements in the understanding and diagnostic techniques of pathogenic autoantibodies in serum of patients with myasthenia gravis / 中华神经科杂志

ABSTRACT

Myasthenia gravis (MG) is an autoimmune disorder mediated by autoantibodies that target the neuromuscular junction. The detection of pathogenic autoantibodies is crucial for the diagnosis and assessment of the disease. Commercial testing institutions and hospitals commonly use techniques such as radioimmunoprecipitation, enzyme-linked immunosorbent assay, or cell-based assay to test the serum of MG patients. However, these methods have limitations in terms of sensitivity and specificity, and there is a lack of direct comparative studies using high-level evidence-based medicine. The recent release of the SCREAM study using data from Chinese individuals confirms the advantages of cell-based assay, providing level Ⅰ evidence for the preferred recommendation of MG laboratory diagnosis and filling the gap in both domestic and international fields. However, the results obtained from the aforementioned testing methods are difficult to use for longitudinal comparison of patients and may not serve as the best biomarkers for disease monitoring. This article attempts to discuss this question by combining recent advances in understanding the pathogenic autoantibodies of MG and provides an outlook on future developments.