Document Detail

Immunoglobulin G glycosylation and clinical outcome in rheumatoid arthritis during pregnancy.
MedLine Citation:
PMID:  10852257     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether clinical outcome during pregnancy in rheumatoid arthritis (RA) is associated with changes in the levels of exposed immunoglobulin G (IgG) terminal sugars. METHODS: Serum IgG glycosylation from 23 pregnant patients with RA was analyzed during the prenatal, antenatal, and post-partum periods. Patients were randomly selected on the basis of whether they achieved spontaneous remission (n = 11) or did not remit (n = 12); of the latter group 6 patients experienced a relapse in disease activity. Levels of exposed terminal IgG sugars, galactose (Gal), N-acetylglucosamine (GlcNAc), and sialic acid (SA), were estimated in a lectin binding assay using Ricinis (communis, Bandeiraea simplicifolia II, and Sambucus nigra, respectively. RESULTS: Exposed Gal levels increased (p<0.02) and GlcNAc levels decreased (p<0.05) in the antenatal period, and returned to preconception levels during post-partum. GlcNAc rebound was instantaneous (p<0.005), whereas Gal remained high for a further 10 weeks. SA did not undergo any major changes. Remission was associated with an earlier and significantly greater antenatal reduction in GlcNAc (2nd and 3rd trimester; p<0.02) in comparison to the groups that did not experience a decrease in disease activity. Analysis of individual IgG samples during the first trimester revealed a significant negative correlation between Gal and GlcNAc in the remission group (r = -0.80; p<0.05), which was opposite to that found in the relapse group (r = +0.87; p<0.03). There was no significant difference between the groups with regard to the timing and/or incidence of a post-partum flare of disease. CONCLUSION: Temporal changes in the levels of IgG terminal sugars, in particular exposed GlcNAc, are integrally associated with the clinical manifestation of RA in pregnancy. Generation of IgG sugar micro-heterogeneity is complex and understanding it may help unravel pathogenic features associated with RA.
A Alavi; N Arden; T D Spector; J S Axford
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  27     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-10-11     Completed Date:  2000-10-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  1379-85     Citation Subset:  IM    
Academic Unit for Musculoskeletal Diseases, St. George's Hospital Medical School, London, UK.
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MeSH Terms
Acetylglucosamine / immunology,  metabolism
Arthritis, Rheumatoid / immunology*,  metabolism*
Case-Control Studies
Galactose / immunology,  metabolism
Immunoglobulin G / immunology,  metabolism*
N-Acetylneuraminic Acid / immunology,  metabolism
Oligosaccharides / immunology,  metabolism
Pregnancy Complications / immunology*,  metabolism*
Prospective Studies
Remission, Spontaneous
Reg. No./Substance:
0/Immunoglobulin G; 0/Lectins; 0/Oligosaccharides; 131-48-6/N-Acetylneuraminic Acid; 26566-61-0/Galactose; 7512-17-6/Acetylglucosamine

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