A single sugar found responsible for an antibody's ability to treat inflammation

ther activating or inhibitory Fc receptors. Earlier work had shown that IVIG infusion changed this ratio of activating and inhibitory receptors on the cells that trigger inflammation, rendering the pro-inflammatory autoantibodies in autoimmune diseases, like lupus and arthritis, less inflammatory. The next logical step then, Ravetch says, was determining how the IgG molecules in IVIG preparation could have an anti-inflammatory effect.

Because a therapeutic, anti-inflammatory response to IVIG requires a concentration of IgG antibodies that's hundreds of times greater than is normally used for antibody therapy for cancer or infection, for example, Ravetch and his colleagues began to look for something that was only present in IVIG in small amounts. That's how they discovered that just the very terminal sialic acid on the Fc portions of the IgG molecule were the root of the anti-inflammatory activity. When the researchers removed the sialic acid, the molecule retained its structure and its half-life, but it lost its protective abilities. "This is a very interesting condition that's set up," Ravetch says. "IgG can shift from a state that is quite inflammatory to a state that is actively anti-inflammatory by just changing a sugar." This switch occurs during a normal immune response to a foreign substance, shifting the IgG antibodies from an anti-inflammatory state to one that is pro-inflammatory and able to efficiently dispose of the foreign challenge.

To test the theory, Ravetch and his colleagues tried enriching IVIG for the IgG molecules that contained sialic acid. They found that just enriching for this IgG species increased IVIG activity by a factor of ten, while removing it wiped out the therapeutic activity altogether. This discovery, Ravetch says, has potentially huge implications, and his lab is now working to generate a recombinant form of IgG that, by virtue of a sialic acid molecule attached in the right place, will be anti-inflammat

Contact: Kristine Kelly
Rockefeller University

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