Herein we will review the role of glycans in determining the functionality and specificity of various components of the immune system. Specific topics covered include: the specific glycosylation sites of IgE, IgM, IgD, IgE, IgA, and IgG; how glycans can encode “self” identity by functioning as either danger associated molecular patterns (DAMPs) or self-associated molecular patterns (SAMPs); the role of glycans as markers of protein integrity and age; how the glycocalyx can dictate the migration pattern of immune cells; and how the combination of Fc N-glycans and Ig isotype dictate the effector function of immunoglobulins. We speculate that the latter may be responsible for the well-documented association between alterations of the serum glycome and autoimmunity. Due to technological limitations, the extent of these autoimmune-associated glycan alterations and their role in disease pathophysiology has not been fully elucidated to date. Thus, we also review the current technologies available for glycan analysis, placing an emphasis on Multiple Reaction Monitoring (MRM), a rapid high-throughput technology that has great potential for glycan biomarker research. Finally, we put forth The Altered Glycan Theory of Autoimmunity, which states that each autoimmune disease will have a unique glycan signature characterized by the site-specific relative abundances of individual glycan structures on immune cells and serum proteins, especially the site-specific glycosylation patterns of specific antibody classes and subclasses.

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Psoriasis in childhood is not uncommon. We report data collected from 223 pediatric onset and 484 adult onset psoriasis patients. In the pediatric onset psoriasis patients (POPPs), prevalence of family history was 68.2% compared to 54% in the adult onset psoriasis patients (AOPPs). Also we noticed that exacerbation of psoriasis induced by precipitating factors such as stress (50.4% in POPPs, 42. 7% in AOPPs), pharyngitis (27.9% in POPPs, 12.2% in AOPPs), and trauma (49.6% in POPPs and 38.9% in AOPPs) were more frequent in POPPs. Our data show that the frequency of spontaneous remission in POPPs was 35.3% compared to 24.3% in AOPPs. A disfiguring skin disease in childhood may have profound emotional effects. Childhood psoriasis needs special attention. To achieve a prolonged remission it is essential that children with psoriasis and their parents have an understanding of the exogenous and endogenous factors responsible for the increased morbidity of psoriasis.