Comparative Analysis of BIOCHIP Mosaic-Based Indirect Immunofluorescence with Enzyme-Linked Immunosorbent Assay for Diagnosing Myasthenia Gravis

Gambino, Caterina Maria; Agnello, Luisa; Sasso, Bruna Lo; Scazzone, Concetta; Giglio, Rosaria Vincenza; Candore, Giuseppina; Ciaccio, Anna Maria; Stefano, Vincenzo Di; Brighina, Filippo; Vidali, Matteo; Ciaccio, Marcello

doi:10.3390/diagnostics11112098

Cited by 7 publications

(4 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A previous study showed that the overall concordance between BIOCHIP mosaic-based indirect immunofluorescence and ELISA for anti-MuSK reactivity was 84%. 34 However, in our study, the same serum sample was not tested by both methods at the same time, and the number of samples was small, so we could not compare the sensitivities of the two methods. Therefore, more studies with larger numbers of samples are needed to compare the role of different detection methods for detecting antibodies in the diagnosis of MG.…”

Section: Discussionmentioning

confidence: 93%

Efficacy and Safety of Low-Dose Rituximab in Anti-MuSK Myasthenia Gravis Patients: A Retrospective Study

Meng¹,

Zeng²,

Wang³

et al. 2022

NDT

View full text Add to dashboard Cite

Purpose To evaluate the efficacy and safety of low dosages of rituximab (RTX) in the treatment of MuSK-antibody-positive MG patients. Patients and Methods We retrospectively analyzed the data of MuSK-antibody-positive MG patients who were treated with low dosages of RTX from January 2018 to October 2021. The long-term treatment response to RTX was assessed by Myasthenia Gravis Foundation of America (MGFA) post-interventional status (PIS), Myasthenia Gravis Status and Treatment Intensity (MGSTI), dosage of steroid, MG-related activities of daily living (MG-ADL) and myasthenic muscle score (MMS) at the end of follow-up. Results Clinical improvement was observed in all eight patients with follow-up for 8 to 29 months after treatment. At the last visit, complete stable remission had been achieved in one patient, pharmacologic remission in three patients, minimal manifestations status in three patients and improved in one patient based on the MGFA-PIS criteria. MGSTI level 2 or better had been reached in six (75%) patients at the last visit. The steroid dosage decreased from 60 mg at baseline to 15 mg at the last follow-up (p = 0.011). The average MG-ADL score decreased from 11 (range 7 to 15) to 0 (range 0 to 3; p = 0.011), and the MMS improved from 38.5 (range 24 to 60) to 100 (range 90 to 100; p = 0.012). These differences were all statistically significant. During RTX treatment and subsequent follow-up, 1 patient reported minor post-infusion malaise. Conclusion Low-dose RTX is effective and safe for treating anti-MuSK antibody positive MG patients. A long-term response is observed after treatment. Larger prospective studies are required to provide further evidence.

show abstract

Section: Discussionmentioning

confidence: 93%

Efficacy and Safety of Low-Dose Rituximab in Anti-MuSK Myasthenia Gravis Patients: A Retrospective Study

Meng¹,

Zeng²,

Wang³

et al. 2022

NDT

View full text Add to dashboard Cite

show abstract

“…To date, only a few studies have evaluated the performance of F-CBAs for anti-AChR detection. We previously demonstrated that the F-CBA for MG diagnosis did not accurately identify low anti-AChR and anti-MuSK levels, which were detected by an ELISA [26]. Mirian et al showed that F-CBAs have similar specificity and higher sensitivity compared to RIPAs but lower performance than L-CBAs [22].…”

Section: Discussionmentioning

confidence: 98%

Detection of Antibodies against the Acetylcholine Receptor in Patients with Myasthenia Gravis: A Comparison of Two Enzyme Immunoassays and a Fixed Cell-Based Assay

Gambino

Agnello

Ciaccio

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

The detection of serum anti-acetylcholine receptor (AChR) antibodies is currently an important tool for diagnosing myasthenia gravis (MG) since they are present in about 85% of MG patients. Many serological tests are now available. Nevertheless, results from these tests can be different in some patients. The aim of this study is to compare the sensitivity of a commercially available fixed cell-based assay (F-CBA) to that of enzyme-linked immunosorbent assay (ELISA) kits for anti-AChR detection in patients with a diagnosis of MG. Overall, 143 patients with a confirmed MG diagnosis were included in the study. The detection and measurement of serum anti-AChR antibodies were performed by three analytical methods, namely, a competitive ELISA (cELISA), an indirect ELISA (iELISA), and an F-CBA, according to the manufacturers’ instructions. Anti-AChR antibody titers were positive in 94/143 (66%) using the cELISA, in 75/143 (52%) using the iELISA and in 61/143 (43%) using the F-CBA (adult and/or fetal). Method agreement, evaluated by concordant pairs and Cohen’s kappa, was as follows: cELISA-iELISA: 110/143 (77%), k = 0.53 (95%CI 0.40–0.66); cELISA-F-CBA: 108/143 (76%), k = 0.53 (95%CI 0.41–0.66); iELISA-F-CBA: 121/143 (85%), k = 0.70 (95%CI 0.57–0.80). Our findings show that the cELISA has better analytical performance than the iELISA and F-CBA. However, the iELISA and F-CBA show the highest concordance.

show abstract

“…Testing for autoantibodies (i.e., anti-AChR, anti-GAD) was performed by the radioimmunoassay method using a radio-receptor assay kit. The results were reported as positive for AChR if > 0.50 nmol/l, and positive for anti-GAD if > 5.0 UI/ml [16]. All the MG patients underwent total IgG, thyroid hormones and thyroid stimulating hormone serum testing, antinucleus antibodies testing, complete blood count, creatinine, blood urea nitrogen, liver transaminases, gamma glutamyl transferase, and total and fractionated bilirubin.…”

Section: Methodsmentioning

confidence: 99%

Efgartigimod beyond myasthenia gravis: the role of FcRn-targeting therapies in stiff-person syndrome

Di Stefano,

Alonge,

Rini

et al. 2023

J Neurol

Self Cite

View full text Add to dashboard Cite

Stiff-person syndrome (SPS) is a rare autoimmune neurological disorder characterized by high titers of antibodies against glutamic acid decarboxylase (GAD) causing impaired GABAergic inhibitory neurotransmission. To date, there is not a defined therapy for such condition, but immunomodulating therapies, such as plasma exchange, intravenous immunoglobulins, and rituximab, have been widely used in clinical practice. However, the efficacy and tolerability of these treatments is not well established. Efgartigimod, a new neonatal Fc receptor (FcRn) blocker, is a human IgG1 antibody Fc fragment engineered with increased affinity for FcRn binding, leading to a reduction in IgGs levels, including pathogenic IgG autoantibody showing promising results in neurological autoimmune disorders and has been approved for the treatment of AChR-seropositive generalized myasthenia gravis (MG). In this study, we report and describe the first data on treatment with efgartigimod in three patients affected by both AChR-seropositive generalized MG and anti-GAD-seropositive SPS. Patients were followed since the start of efgartigimod and for the whole treatment period (12 weeks). MG symptoms were assessed with the “MG activity of daily living score” and the Quantitative Myasthenia Gravis score, while SPS ones were assessed with the “SPS activity of daily living score”; muscle strength was assessed with the Medical Research Council Sum score; the overall disability from MG and SPS was assessed by the modified Rankin Scale. All patients showed an improvement in symptoms of both SPS and MG after 2 cycles of treatment. Our data suggest that efgartigimod may be considered as a candidate drug for SPS and other autoantibody-mediated neurological disorders.

show abstract

Comparative Analysis of BIOCHIP Mosaic-Based Indirect Immunofluorescence with Enzyme-Linked Immunosorbent Assay for Diagnosing Myasthenia Gravis

Cited by 7 publications

References 43 publications

Efficacy and Safety of Low-Dose Rituximab in Anti-MuSK Myasthenia Gravis Patients: A Retrospective Study

Efficacy and Safety of Low-Dose Rituximab in Anti-MuSK Myasthenia Gravis Patients: A Retrospective Study

Detection of Antibodies against the Acetylcholine Receptor in Patients with Myasthenia Gravis: A Comparison of Two Enzyme Immunoassays and a Fixed Cell-Based Assay

Efgartigimod beyond myasthenia gravis: the role of FcRn-targeting therapies in stiff-person syndrome

Contact Info

Product

Resources

About