Immunostick ELISA for rapid and easy diagnosis of myasthenia gravis

Τράκας, Νικόλαος; Tzartos, Socrates J.

doi:10.1016/j.jim.2018.06.016

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…Furthermore, cell-based assays can also be useful in the diagnosis of RIPA-negative MG in children [12]. This method is the primary technique for detecting other antibodies such as anti-LRP4 and it may also be used for anti-MuSK antibodies [14].…”

Section: Anti-achr Antibodiesmentioning

confidence: 99%

Bedside and laboratory diagnostic testing in myasthenia

et al. 2022

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Myasthenia gravis (MG) and congenital myasthenic syndromes (CMS) are a group of disorders with a well characterised autoimmune or genetic and neurophysiological basis. We reviewed the literature from the last 20 years assessing the utility of various neurophysiological, immunological, provocative and genetic tests in MG and CMS. Diagnostic sensitivity of repetitive nerve stimulation test ranges between 14 and 94% and specificity between 73 and 100%; sensitivity of single-fibre EMG (SFEMG) test ranges between 64 and 100% and specificity between 22 and 100%; anti-acetylcholine receptor (AChR) antibody sensitivity ranges from 13 to 97% and specificity ranges from 95 to 100%. Overall, SFEMG has the highest sensitivity while positive anti-AChR antibodies have the highest specificity. Newer testing strategies that have been investigated over the last couple of decades include ocular vestibular-evoked myogenic potentials, otoacoustic emissions and disease-specific circulating miRNAs in serum for autoimmune myasthenia, as well as next-generation sequencing for genetic testing of CMS. While there has been significant progress in developing newer testing strategies for diagnosing MG and CMS over the last couple of decades, more research is needed to assess the utility of these newer tools regarding their sensitivity and specificity.

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Section: Anti-achr Antibodiesmentioning

confidence: 99%

Bedside and laboratory diagnostic testing in myasthenia

et al. 2022

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“…The use of cytometric CBAs could be a useful alternative, should they prove to reliably and specifically produce quantitative results (100). Efforts are also being made to develop diagnostic assays that can be easily performed in non-specialized and equipment-free settings to further decrease the time from sample collection to diagnosis (51). Assays based on CBAs or immunosticks could be adopted to simultaneously detect more than one antigen.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, efforts are made toward the establishment of easy to perform instrument-free rapid assays, that could be used in non-specialized facilities (small clinics or neurologists' offices), since this could greatly reduce the time to diagnosis and improve patient management. To this end, we have developed a modified ELISA based on immobilization of AChR onto a solid support stick (immunostick), which has shown to have good specificity and sensitivity (99 and 91%, respectively) for AChR antibodies (51). Moreover, the immobilization of additional antigens in different zones on the immunostick could allow the simultaneous detection of more than one MG autoantibodies by this method.…”

Section: Mg Autoantibodies and Their Detection Antibodies Against Thementioning

confidence: 99%

Autoantibody Specificities in Myasthenia Gravis; Implications for Improved Diagnostics and Therapeutics

2020

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Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness and fatiguability of skeletal muscles. It is an antibody-mediated disease, caused by autoantibodies targeting neuromuscular junction proteins. In the majority of patients (∼85%) antibodies against the muscle acetylcholine receptor (AChR) are detected, while in 6% antibodies against the muscle-specific kinase (MuSK) are detected. In ∼10% of MG patients no autoantibodies can be found with the classical diagnostics for AChR and MuSK antibodies (seronegative MG, SN-MG), making the improvement of methods for the detection of known autoantibodies or the discovery of novel antigenic targets imperative. Over the past years, using cell-based assays or improved highly sensitive immunoprecipitation assays, it has been possible to detect autoantibodies in previously SN-MG patients, including the identification of the low-density lipoprotein receptor-related protein 4 (LRP4) as a third MG autoantigen, as well as AChR and MuSK antibodies undetectable by conventional methods. Furthermore, antibodies against other extracellular or intracellular targets, such as titin, the ryanodine receptor, agrin, collagen Q, K v 1.4 potassium channels and cortactin have been found in some MG patients, which can be useful biomarkers. In addition to the improvement of diagnosis, the identification of the patients' autoantibody specificity is important for their stratification into respective subgroups, which can differ in terms of clinical manifestations, prognosis and most importantly their response to therapies. The knowledge of the autoantibody profile of MG patients would allow for a therapeutic strategy tailored to their MG subgroup. This is becoming especially relevant as there is increasing progress toward the development of antigen-specific therapies, targeting only the specific autoantibodies or immune cells involved in the autoimmune response, such as antigen-specific immunoadsorption, which have shown promising results. We will herein review the advances made by us and others toward development of more sensitive detection methods and the identification of new antibody targets in MG, and discuss their significance in MG diagnosis and therapy. Overall, the development of novel autoantibody assays is aiding in the more accurate diagnosis and classification of MG patients, supporting the development of advanced therapeutics and ultimately the improvement of disease management and patient quality of life.

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“…Over the past decades, several analytical methods have been developed to measure anti-AChR and anti-MuSK autoantibodies, such as RIPA and ELISA [32][33][34]. However, these methods have some important analytical drawbacks, such as the use of radioactive isotopes for RIPA or a long TAT, the lack of standardization, and excessive cost for ELISA, resulting in an inconvenience for small laboratories.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Background: The detection of anti-acetylcholine receptor (AChR) and anti-muscle-specific tyrosine kinase (MuSK) antibodies is useful in myasthenia gravis (MG) diagnosis and management. BIOCHIP mosaic-based indirect immunofluorescence is a novel analytical method, which employs the simultaneous detection of anti-AChR and anti-MuSK antibodies in a single miniature incubation field. In this study, we compare, for the first time, the BIOCHIP MG mosaic with conventional enzyme-linked immunosorbent assay (ELISA) in the diagnosis of MG. Methods: A total of 71 patients with MG diagnosis were included in the study. Anti-AChR and anti-MuSK antibodies were measured separately by two different ELISA and simultaneously by BIOCHIP. The results were then compared. Results: The overall concordance between ELISA and BIOCHIP for anti-AChR reactivity was 74%. Cohen’s kappa was 0.51 (95% CI 0.32–0.71), which corresponds to 90% of the maximum possible kappa (0.57), given the observed marginal frequencies. The overall concordance for anti-MuSK reactivity was 84%. Cohen’s kappa was 0.11 (95% CI 0.00–0.36), which corresponds to 41% of the maximum possible kappa (0.27). Conclusion: The overall concordance among assays is not optimal.

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Immunostick ELISA for rapid and easy diagnosis of myasthenia gravis

Cited by 9 publications

References 22 publications

Bedside and laboratory diagnostic testing in myasthenia

Bedside and laboratory diagnostic testing in myasthenia

Autoantibody Specificities in Myasthenia Gravis; Implications for Improved Diagnostics and Therapeutics

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

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