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Research paper
Sialylated IgG-Fc: a novel biomarker of chronic inflammatory demyelinating polyneuropathy
  1. Anna Hiu Yi Wong1,
  2. Yuki Fukami1,
  3. Makoto Sudo1,
  4. Norito Kokubun2,
  5. Shinsuke Hamada3,
  6. Nobuhiro Yuki1,4
  1. 1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  2. 2Department of Neurology, Dokkyo Medical University, Tochigi, Japan
  3. 3Department of Neurology, Hokuyukai Neurological Hospital, Sapporo, Japan
  4. 4Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  1. Correspondence to Professor Nobuhiro Yuki, Departments of Medicine and Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Unit 09-01, Centre for Translational Medicine, 14 Medical Drive, Singapore 117599, Singapore; mdcyuki{at}nus.edu.sg

Abstract

Objective Sialylation in Fc portion of IgG plays a crucial role in the pathogenesis of autoimmune diseases and the working mechanism of intravenous immunoglobulin (IVIG). We aim to test whether IgG-Fc sialylation is a biomarker of disease activity for chronic inflammatory demyelinating polyneuropathy (CIDP).

Methods By using specific lectins for sialylation, galactosylation and agalactosylation, lectin-enzyme assay and lectin blotting with pretreatment of IgG degradating enzyme of Streptococcus pyogenes were performed to compare the glycosylation levels of serum IgG-Fc (1) between patients of untreated CIDP (n=107) and normal control subjects (n=27), (2) among patients with untreated CIDP of different clinical severities and (3) before and after IVIG treatment of patients with CIDP (n=12).

Results Sialylation and galactosylation of IgG-Fc were significantly reduced in patients with CIDP than normal control subjects (p=0.003 and 0.033, respectively), whereas agalactosylation was increased in CIDP (p=0.21). Ratios of sialylated/agalactosylated IgG-Fc levels were significantly reduced in CIDP (p<0.001) and inversely related to disease severity (p=0.044). After IVIG treatment, levels of sialylated IgG-Fc significantly increased (p=0.003).

Conclusions Sialylation of IgG-Fc is reduced in CIDP. Its level correlated with clinical severity and increased after IVIG treatment. Sialylated as well as ratio of sialylated/agalactosylated IgG-Fc could be new measures to monitor the disease severity and treatment status in CIDP.

  • NEUROPATHY
  • IMMUNOLOGY

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