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After this process, IgG4 becomes functional, monovalent, and bispecific, that is, it has two Fab arms with different specificities (Huijbers et al., 2018), resulting in its inability to cross-link the AChR (the process requires the binding of two identical fab arms to two antigens)
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492 The E3 ligases TRAF2 and TRAF6 play a central role in this process, linking the UPS to RA pathogenesis
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