Evidence map›Paper›PMID 41998298›Full record

ArticleJournal of neurology2026

Enhanced antibody detection via live cell-based assay among RIA negative myasthenia gravis patients: toward improved diagnosis and clinical correlates.

Elena Rinaldi, Elisa Puleo, Angela Di Maro, Raffaele Fusco, Amalia Canciello, Eleonora Giacopuzzi Grigoli, Rita Frangiamore, Marta Cheli, Fiammetta Vanoli, Silvia Bonanno and 5 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Elena RinaldiNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Elisa PuleoNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Angela Di MaroNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Raffaele FuscoNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Amalia CancielloNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Eleonora Giacopuzzi GrigoliNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Rita FrangiamoreNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Marta CheliNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Fiammetta VanoliNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Silvia BonannoNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Renato MantegazzaAssociazione Italiana Miastenia E Malattie Immunodegenerative, AIM, Milan, Italy.
Carlo AntozziNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Fulvio BaggiNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Francesca AndreettaNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Lorenzo MaggiNeurology 4-Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. lorenzo.maggi@istituto-besta.it.ORCID http://orcid.org/0000-0002-0932-5173

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadioimmunoprecipitation assay (RIA) is the gold standard for antibody detection in myasthenia gravis (MG), while fixed cell-based assays (CBAs) are widely used as second-line or first-line tests. Live CBA represents an alternative approach and its combined use with fixed CBA may improve diagnostic sensitivity. Our aim was to evaluate the diagnostic yield of fixed and live CBA for AChR and MuSK antibodies in a large cohort of RIA seronegative MG patients and to investigate clinical associations and outcomes.

methodsSera from 124 AChR- and MuSK-RIA seronegative MG patients and 72 control samples were tested using fixed CBA for fetal and adult AChR isoforms and MuSK. All sera were also analyzed with an in-house live CBA, with cells expressing clustered AChR or MuSK.

resultsFixed CBA identified AChR antibodies in 3/124 (2.4%) patients, all with mild early-onset MG; none were MuSK positive. Live CBA detected AChR antibodies in 11 (8.9%) and MuSK antibodies in 13 (10.5%) patients. Live CBA seronegative patients were predominantly female (77/100, 77%) compared with AChR-live (4/11, 36.4%) and MuSK-live (7/13, 53.8%) groups (p = 0.0068), and more frequently had generalized MG (87% vs 53.8% in MuSK-live; p = 0.0146). Unchanged or worsened MGFA-PIS occurred in 4/13 (30.8%) of MuSK-live patients and 18/82 (21.9%) of live CBA seronegative patients, whereas all AChR-live CBA patients achieved minimal manifestations or better.

conclusionLive CBA identifies AChR or MuSK antibodies in approximately 20% of RIA seronegative MG patients and provides clinically meaningful subgroup stratification. Fixed CBA performed only slightly better than RIA.

Indexed as

AutoantibodiesMyasthenia GravisRadioimmunoprecipitation AssayReceptor Protein-Tyrosine KinasesReceptors, CholinergicAdolescentAdultAgedFemaleHumansMaleMiddle AgedYoung AdultAutoantibodiesMUSK protein, humanReceptor Protein-Tyrosine KinasesReceptors, CholinergicAChRCBAMuSKMyasthenia gravisRadioimmunoprecipitation

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.