{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T16:22:44Z","timestamp":1793809364764,"version":"4.6.1"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100021856","name":"Ministero dell'Universit\u00e0 e della Ricerca","doi-asserted-by":"publisher","award":["PRIN2022"],"award-info":[{"award-number":["PRIN2022"]}],"id":[{"id":"10.13039\/501100021856","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scand J Immunol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Anti\u2010acetylcholine receptor (AChR) and anti\u2010muscle\u2010specific tyrosine kinase (MuSK) autoantibody detection is crucial in the diagnosis and choice of treatment of myasthenia gravis (MG). We conducted a multicentre prospective study comparing radioimmunoprecipitation assay (RIPA), enzyme\u2010linked immunosorbent assay (ELISA) and fixed cell\u2010based assay (F\u2010CBA) for anti\u2010AChR and anti\u2010MuSK antibody detection in 78 patients with suspected MG with at least 6 months of clinical follow\u2010up. In the diagnosis of seropositive MG (anti\u2010AChR+anti\u2010MuSK abs), RIPA was most sensitive (82.8%) compared to ELISA (81.0%) and F\u2010CBA (70.7%). F\u2010CBA exhibited the highest specificity overall (95.0%). For anti\u2010AChR detection, F\u2010CBA demonstrated a sensitivity of 73.6% and specificity of 95.0%; ELISA showed sensitivity and specificity of 81.1% and 85.0%, respectively; and RIPA yielded sensitivity and specificity of 81.1% and 95.0%. Sensitivity of F\u2010CBA improved when sera were tested at lower dilution (1:5) versus the manufacturer's recommended 1:10, without compromising specificity. Agreement among methods was almost perfect for anti\u2010AChR detection (Cohen's Kappa &gt;\u20090.81). For anti\u2010MuSK detection, agreement was substantial between ELISA and RIPA, moderate between ELISA and F\u2010CBA, and fair between RIPA and F\u2010CBA. Higher anti\u2010AChR antibody levels were found in generalised versus ocular MG by both RIPA and ELISA. F\u2010CBA confirmed its optimal specificity while the sensitivity seems to be influenced by sample dilution. In conclusion, given the radioactive nature of RIPA and consequent limitations, F\u2010CBA may represent a valid alternative in anti\u2010AChR and anti\u2010MuSK antibody detection in MG diagnosis. We suggest that the use of live\u2010CBA or RIPA could be reserved for inconclusive cases.<\/jats:p>","DOI":"10.1111\/sji.70072","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:51:11Z","timestamp":1764057071000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Diagnostic Performance of Three Serological Assays in Myasthenia Gravis: A Prospective Multicentre Study"],"prefix":"10.1111","volume":"102","author":[{"given":"Laura","family":"Cuomo","sequence":"first","affiliation":[{"name":"U.O.C. Clinical Pathology San Filippo Neri Hospital, ASLRoma1  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"De Giglio","sequence":"additional","affiliation":[{"name":"Neuromuscular and Rare Neurological Diseases Center, Neurology Unit San Filippo Neri Hospital, ASLRoma1  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonietta","family":"Isgr\u00f2","sequence":"additional","affiliation":[{"name":"U.O.C. Clinical Pathology San Filippo Neri Hospital, ASLRoma1  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Totaro","sequence":"additional","affiliation":[{"name":"SOD Immunoallergology AOU Careggi  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Pratali","sequence":"additional","affiliation":[{"name":"SOD Immunoallergology AOU Careggi  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Fragomeli","sequence":"additional","affiliation":[{"name":"U.O.C. Clinical Pathology San Filippo Neri Hospital, ASLRoma1  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Cosmi","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine and Clinic Universit\u00e0 of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Annunziato","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine and Clinic Universit\u00e0 of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boaz","family":"Palterer","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine and Clinic Universit\u00e0 of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Concetta","family":"Altavista","sequence":"additional","affiliation":[{"name":"Neuromuscular and Rare Neurological Diseases Center, Neurology Unit San Filippo Neri Hospital, ASLRoma1  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Antonini","sequence":"additional","affiliation":[{"name":"NESMOS Department Sapienza University of Rome and UniCamillus\u2010St. Camillus International University of Health Science  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Brienza","sequence":"additional","affiliation":[{"name":"Neuromuscular and Rare Neurological Diseases Center, Neurology Unit San Filippo Neri Hospital, ASLRoma1  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Cambieri","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Cortese","sequence":"additional","affiliation":[{"name":"Neuromuscular and Rare Neurological Diseases Center, Neurology Unit San Filippo Neri Hospital, ASLRoma1  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fionda","sequence":"additional","affiliation":[{"name":"Neuromuscular Disease Center Sant'andrea Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gragnani","sequence":"additional","affiliation":[{"name":"Neurology Unit Ospedale Pertini  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Inghilleri","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Morino","sequence":"additional","affiliation":[{"name":"Neuromuscular Disease Center Sant'andrea Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Petrucci","sequence":"additional","affiliation":[{"name":"Center for Neuromuscular and Neurological Rare Disease San Camillo Forlanini Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Piantadosi","sequence":"additional","affiliation":[{"name":"Neurology Unit Ospedale San Giovanni  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Anastasiadou","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Vitillo","sequence":"additional","affiliation":[{"name":"U.O.C. 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