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The discovery by Alan Pestronk and colleagues in the mid-1980s of anti-GM1 IgM antibodies as biomarkers for multifocal motor neuropathy (MMN) represented a major milestone in inflammatory neuropathy research.1 After a plethora of complex and occasionally contentious publications over the last 25 years, it is now generally agreed that in the region of 50% of MMN cases harbour such anti-GM1 antibodies. What has remained elusive is the putative antibody specificity for the remaining ‘anti-GM1 negative’ MMN cases. Are there unidentified autoantigens out there, or is their absence indicative of alternative pathological mechanisms that we should be considering? …
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