Objective
To examine the association of IgG galactosylation aberrancy with disease parameters in rheumatoid arthritis (RA).
Methods
N-glycan analysis of serum from multiple cohorts was performed. IgG N-glycan content and timing of N-glycan aberrancy relative to disease onset was compared in healthy and RA subjects. Correlations between aberrant galactosylation and disease activity were assessed in the RA cohorts. The impact of disease activity, gender, age, anti-CCP titer, disease duration, and CRP on aberrant galactosylation was determined using multivariate analysis. N-glycan content was also compared between epitope affinity purified autoantibodies and the remaining repertoire IgG in RA subjects.
Results
Our results confirm the aberrant galactosylation of IgG in RA (1.36 ± 0.43) compared to healthy controls (1.01 ± 0.23) (P < 0.0001). We observe a significant correlation between levels of aberrant IgG galactosylation and disease activity (Spearman rho = 0.37, p<0.0001). This correlation is higher in females [Spearman rho = 0.60 (P<0.0001)] than males [Spearman rho = 0.16 (P = 0.10)]. Further, IgG galactosylation aberrancy substantially predates onset of arthritis and the diagnosis of RA (3.5 years) and resides selectively in the anti-citrullinated peptide autoantibody fraction.
Conclusions
Our findings identify aberrant IgG galactosylation as a dysregulated component of the humoral immune response in RA that begins prior to disease onset, that associates with disease activity in a gender specific manner, and that resides preferentially in autoantibodies.