Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Sep 17;84(12):1092-1103.
doi: 10.1016/j.jacc.2024.05.077.

Prognostic Value of Plasma Immunoglobulin G N-Glycome Traits in Pulmonary Arterial Hypertension

Ze-Jian Zhang  1 , Chao Liu  2 , Jie-Ling Ma  3 , Jing-Si Ma  4 , Jia Wang  5 , Ruo-Nan Li  4 , Dan Lu  6 , Yu-Ping Zhou  3 , Tian-Yu Lian  2 , Si-Jin Zhang  2 , Jing-Hui Li  7 , Lan Wang  8 , Kai Sun  1 , Chun-Yan Cheng  2 , Wen-Hui Wu  8 , Xin Jiang  9 , Zhi-Cheng Jing  10
Affiliations
Free article
Observational Study

Prognostic Value of Plasma Immunoglobulin G N-Glycome Traits in Pulmonary Arterial Hypertension

Ze-Jian Zhang et al. J Am Coll Cardiol. .
Free article

Abstract

Background: B-type natriuretic peptide or N-terminal pro-B-type natriuretic peptide is the only blood biomarker in established risk calculators for pulmonary arterial hypertension (PAH). Profiling systemic-originated plasma immunoglobulin G (IgG) N-glycans, which reflect different components of the pathophysiology of PAH including immune dysregulation and inflammation, may improve PAH risk assessment.

Objectives: This study sought to identify plasma IgG N-glycan biomarkers that predict survival in PAH to improve risk assessment.

Methods: This cohort study examined 622 PAH patients from 2 national centers (Beijing [discovery] cohort: n = 273; Shanghai [validation] cohort: n = 349). Plasma IgG N-glycomes were profiled by a robust mass spectrometry-based method. Prognostic IgG N-glycan traits were identified and validated in the 2 cohorts using Cox regression and Kaplan-Meier survival analyses. The added value of IgG N-glycan traits to previously established risk models was assessed using Harrell C-indexes and survival analysis.

Results: Plasma IgG fucosylation was found to predict survival independent of age and sex in the discovery cohort (HR: 0.377; 95% CI: 0.168-0.845; P = 0.018) with confirmation in the validation cohort (HR: 0.445; 95% CI: 0.264-0.751; P = 0.005). IgG fucosylation remained a robust predictor of mortality in combined cohorts after full adjustment and in subgroup analyses. Integrating IgG fucosylation into previously established risk models improved their predictive capacity, marked by an overall elevation in Harrell C-indexes. IgG fucosylation was useful in further stratifying the intermediate-risk patients classified by a previously established model.

Conclusions: Plasma IgG fucosylation informs PAH prognosis independent of established factors, offering additional value for predicting PAH outcomes.

Keywords: IgG N-glycans; biomarker; fucosylation; pulmonary arterial hypertension; risk stratification.

PubMed Disclaimer

Conflict of interest statement

Funding Support and Author Disclosures This work was supported by grants from the National Key Research and Development Program of China (2022YFC2703902 and 2022YFC2703901), the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2021-I2M-1-018), National Natural Science Foundation of China (82241020 and 32371506), Natural Science Foundation of Shanghai (22ZR1452400), Pujiang Talent Program (22PJD064), and National High-Level Hospital Clinical Research Funding (2022-PUMCH-A-200 and 2022-PUMCH-B-099). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Publication types

LinkOut - more resources