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Updated: Aug 10, 2025

Methods for Quantitative Detection of Antibody-induced Complement Activation on Red Blood Cells
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Factors affecting IgG4-mediated complement activation.

Nienke Oskam1, Timon Damelang1,2,3, Marij Streutker1

  • 1Sanquin Research and Landsteiner Laboratory, Department of Immunopathology, Academic Medical Center, Amsterdam, Netherlands.

Frontiers in Immunology
|February 13, 2023
PubMed
Summary

Human immunoglobulin G4 (IgG4) antibodies activate complement only at high concentrations via the classical pathway. Glycosylation and Fab arm exchange influence this activation, suggesting IgG4-mediated complement involvement in disease is unlikely.

Keywords:
IgG4-related diseaseantibodiescomplement activationfab arm exchangeglycoengineeringprimary membranous nephropathy

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Area of Science:

  • Immunology
  • Complement System Biology
  • Glycobiology

Background:

  • Immunoglobulin G4 (IgG4) is the least inflammatory IgG subclass, poorly activating the complement system.
  • Despite this, IgG4 antibodies are linked to complement consumption in IgG4-related disease (IgG4-RD) and autoimmune disorders.
  • The conditions under which IgG4 activates complement and the influence of glycosylation and Fab arm exchange remain unclear.

Purpose of the Study:

  • To investigate the conditions and factors influencing complement activation by IgG4.
  • To determine the role of glycosylation and Fab arm exchange in IgG4-mediated complement activation.

Main Methods:

  • Utilized well-defined, glyco-engineered monoclonal IgG4 preparations.
  • Assessed complement activation in a controlled experimental system.
  • Investigated activation via the classical and lectin pathways.

Main Results:

  • IgG4 activates complement via the classical pathway only at high antigen and antibody concentrations.
  • Fc galactosylation levels modulated complement activation; elevated galactosylation enhanced, while reduced galactosylation diminished it.
  • Fab glycans slightly reduced complement activation, and bispecific, monovalent IgG4 was a less potent activator than monospecific IgG4.

Conclusions:

  • IgG4 can activate complement under specific conditions (high concentrations, classical pathway).
  • Glycosylation and Fab arm exchange significantly influence IgG4's complement-activating potential.
  • While possible, IgG4-mediated complement activation in pathology is considered unlikely.