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The 10\u201320% of patients who do not have AChR antibodies are now known to comprise different subgroups, the most commonly reported of which is patients with antibodies to muscle\u2010specific kinase (MuSK). The use of cell\u2010based assays has extended the repertoire of antibody tests to clustered AChRs, low\u2010density lipoprotein receptor\u2013related protein 4, and agrin. Autoantibodies against intracellular targets, namely cortactin, titin, and ryanodine receptor (the latter two being associated with the presence of thymoma), may also be helpful as biomarkers in some patients. IgG4 MuSK antibodies are clearly pathogenic, but the coexisting IgG1, IgG2, and IgG3 antibodies, collectively, have effects that question the dominance of IgG4 as the sole pathologic factor in MuSK MG. After a brief historical review, we define the different subgroups and summarize the antibody characteristics. Experiments to demonstrate the <jats:italic>in vitro<\/jats:italic> and <jats:italic>in vivo<\/jats:italic> pathogenic roles of MuSK antibodies are discussed.<\/jats:p>","DOI":"10.1111\/nyas.13592","type":"journal-article","created":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T23:30:22Z","timestamp":1517268622000},"page":"143-153","source":"Crossref","is-referenced-by-count":60,"title":["Serological and experimental studies in different forms of myasthenia gravis"],"prefix":"10.1111","volume":"1413","author":[{"given":"Angela","family":"Vincent","sequence":"first","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saif","family":"Huda","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelangelo","family":"Cao","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Cetin","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Koneczny","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Rodriguez\u2010Cruz","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Viegas","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saiju","family":"Jacob","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Woodhall","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Nagaishi","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelina","family":"Maniaol","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Damato","sequence":"additional","affiliation":[{"name":"Neuroimmunology Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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