Total MuSK autoantibody levels were assessed by RIA (RSR, UK) according to the manufacturer’s instructions. MuSK IgG4 levels were measured by ELISA. To this end, ELISA plates (Microlon, catalog number 655092, Greiner, Austria) were coated with 1 µg/mL MuSK extracellular domain (ECD) produced in mammalian cells (a kind gift of Dr. Bernard Rees-Smith, RSR, UK). Bound MuSK antibodies were detected with mouse anti-human IgG4:HRP (1:3,500, catalog number MCA2098P, AbD Serotec, Germany). Samples were incubated with substrate containing 3,3′,5,5′-tetramethylbenzidine, and absorbance at 450 nm was measured using a VictorX3 plate reader (PerkinElmer, USA).
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