Furthermore, there are reports of antibodies against other targets, whose pathogenic mechanisms have yet to be proven, such as colQ, agrin, kv1.4 voltage-dependent potassium channel, and cortactin.35, 36, 37, 38Moreover, some authors have identified clustered AChR-Abs that might have low affinity when conventional laboratory methods are employed.9, 39Finally, although antibodies against muscle proteins such as titin and ryanodine may be used as markers of disease severity and the presence of thymoma, they play no role in the pathogenesis of MG.32 This evidence concerns the gene DDX41 and myasthenia gravis.