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. Abnormalities in circulating IgA1 have been demonstrated  in patients with IgA nephropathy (IgAN). This study addresses the question of  the functional significance of this alteration in creating mesangial injury.  Biologic effects of selected IgA glycoforms isolated from serum of IgAN  patients and controls and  in vitro  deglycosylated normal IgA were  tested on cultured human mesangial cells (MC). IgA glycoforms, ranging from  250 to 500 kD molecular weight, were isolated by lectin affinity  chromatography followed by HPLC. IgA and IgG content was measured by  enzyme-linked immunosorbent assay. HPLC fractions were incubated with MC to  evaluate proliferation and apoptosis rates and nitric oxide synthesis.  Moreover, MC were conditioned with  in vitro  desialylated and  degalactosylated normal IgA. Patients with IgAN displayed increased levels of  IgA glycoforms exposing sialic acid in α2,6 linkage with  N-acetylgalactosamine (Neu5Acα2,6GalNAc) ( P  &lt; 0.02) and  GalNAc ( P  &lt; 0.05), indicating truncation of O-linked glycans of  IgA1. Moreover, IgA glycoforms with increased exposure of mannose were  observed ( P  &lt; 0.03), suggesting a defective N-linked  glycosylation. No modification in IgG glycosylation was detected. When  incubated with MC, the IgA glycoforms isolated from patients with increased  exposure of GalNAc, Neu5Acα2,6GalNAc, or mannose, significantly  depressed the proliferation and increased the apoptotic rate and nitric oxide  synthesis activity of cultured MC, in comparison with fractions isolated from  controls. Similarly,  in vitro  desialylated and degalactosylated IgAs  significantly depressed the proliferation and enhanced the apoptosis rates of  MC. In conclusion, a significant modulation of several human MC functions  exerted by serum IgA with increased exposure of GalNAc,  Neu5Acα2,6GalNAc, and mannose residues isolated from IgAN patients is  reported for the first time.

Glycosylation of Circulating IgA in Patients with IgA Nephropathy Modulates Proliferation and Apoptosis of Mesangial Cells