We have CHO cells over-expressing the insulin receptor isoform A and measured the degree of receptor phosphorylation by serum of different patients. One patient serum stimulates the receptor beyond the normal physiological range. The signal can neither be inhibited by removal of IgG by magnetic beads or an insulin/IGF-II antibody. How do we identify the ligand that stimulates the IR-A receptor from the patients serum? 

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