It is more evident than ever that in treatment and prevention of multiple diseases we need to expand our focus from purely molecular mechanisms of pathogenesis and invest in the understanding of the body's natural defences from a variety of external and internal factors. A testament to this approach is this year's (2018) Nobel prize for Medicine, awarded for the discovery of the exceptional ability of the immune system in treating cancer. Immunoglobulins are key molecules of the immune system. Under normal conditions, they act by establishing the efficient defence of the organism, while mistakes in their function can directly or indirectly cause a whole spectrum of inflammatory and autoimmune diseases. In their essence, immunoglobulins are proteins. Their function and structure are determined by the combination of the protein backbone (the sequence of which is always defined by stable genes) and variable glycans.
Glycosylation is the most complex post-translational modification, and it is associated with multicellular life-forms. Almost all proteins that evolved after the appearance of multicellular organisms contain glycans. Unlike polypeptide part of the protein, the glycan part requires several degrees of complexity between genes and final structures. Therefore, complex dynamic interactions between numerous genetic and environmental factors regulate glycan structure. In other words, the structure of glycans is not directly coded in the DNA, it is determined by our environment, as well as our lifestyle.
Addition of glycans to immunoglobulins is a crucial mechanism for controlling their function, and it is considered to be one of the underlying mechanisms for regulating low-intensity chronic inflammation. Variations in glycosylation have significant consequences for many biological processes. Changes in the protein glycosylation are connected with different diseases, and those changes often appear several years before the first symptoms. American national academies listed glycans in their strategic document as one of the research priorities in medicine, since they are involved in the pathophysiology of almost every disease. It is also why glycans are excellent predictors of general health and early mediators of the inflammation. St. Katarina is the first hospital in the world that offers the analysis of the glycans on Immunoglobulin G in collaboration with Genos, the world leader in the field of glycomics.