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Research Article: Anti-ALDOA antibody: a novel diagnostic-associated autoantibody in myasthenia gravis

Date Published: 2025-10-23

Abstract:
This study identified novel autoantibodies in patients with seronegative myasthenia gravis (SNMG).Autoantibodies in SNMG sera were screened using a targeted binding assay (TBA). The target antigen was identified via immunoprecipitation and mass spectrometry, and validated by western blotting using a commercial antigen. A cell-based assay (CBA) employing HEK293 cells expressing the identified antigen was established to detect specific antibodies in 676 MG patients and 20 controls.Aldolase A (ALDOA) was identified as a novel autoantigen. Anti-ALDOA antibodies (ALDOA-Ab) demonstrated high diagnostic specificity in SNMG and were also detected in seropositive MG patients, with positivity rates of 4.89% in AChR-Ab’ and 2.86% in MuSK-Ab’ subgroups. ALDOA-Ab was predominantly of the IgG1 subclass. ALDOA-Ab may serve as a potential diagnostic biomarker for MG. Further studies are needed to investigate its pathogenic role.

Introduction:
Myasthenia gravis (MG) is an antibody (Ab)-mediated autoimmune disease characterized by fluctuating muscle weakness and fatigability ( 1 , 2 ). Anti-acetylcholine receptor (AChR) ( 3 ) antibody, anti-muscle-specific receptor tyrosine kinase (MuSK) ( 4 ) antibody, and anti-low-density lipoprotein receptor-related protein 4 (LRP4) ( 5 ) antibody have been shown to be associated with MG, with reported positivity rates of approximately 85% for AChR, 1–10% for MuSK, and 1–5% for LRP4. However, LRP4 antibodies are more…

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