IgG carrying terminal α2,6-linked sialic acids added to conserved N-glycans within the Fc domain by the sialyltransferase ST6Gal1 accounts for the anti-inflammatory effects of large-dose i.v. Ig (IVIg) in autoimmunity. Here, B-cell-specific ablation of ST6Gal1 in mice revealed that IgG sialylation can occur in the extracellular environment of the bloodstream independently of the B-cell secretory pathway. We also discovered that secreted ST6Gal1 is produced by cells lining central veins in the liver and that IgG sialylation is powered by serum-localized nucleotide sugar donor CMP-sialic acid that is at least partially derived from degranulating platelets. Thus, antibody-secreting cells do not exclusively control the sialylationdependent anti-inflammatory function of IgG. Rather, IgG sialylation can be regulated by the liver and platelets through the corresponding release of enzyme and sugar donor into the cardiovascular circulation.W hile en route to the plasma membrane as integral membrane proteins or for secretion, glycoproteins exiting the endoplasmic reticulum traverse the cis-, medial-, and trans-Golgi apparatus where the associated N-linked glycans are remodeled into their final form. This classically defined secretory pathway dictates that the glycoform of all glycoproteins produced by a cell is largely determined by the cohort of enzymes within the Golgi and the metabolic circumstances of that specific cell.Protein glycosylation is known to play fundamental roles in all aspects of biology, but has recently gained significant attention in immunology. When administered at high doses, i.v. Ig (IVIg) is an effective anti-inflammatory treatment for autoimmune patients (1). In 2006, it was discovered that the ∼10% of IgG molecules that carry α2,6-linked sialic acids upon the conserved biantennary N-glycans within the Fc domain provided the potent IVIg anti-inflammatory activity in autoimmune disease (2). Indeed, enrichment for the sialylated IgG (sIgG) fraction from IVIg pools increased the efficacy of treatment in mouse models of arthritis 100-fold in an IL-4-dependent fashion through receptors such as CD209 (DC-SIGN) (3, 4). Moreover, it was reported that sialylation of IgG also impacts antibody affinity maturation, although the mechanism underlying this phenomenon remains to be fully elucidated (5). These data indicate that sialylation serves as the mechanism underlying pleotropic IgG function (3,4,6).Epidemiologic analyses published since the reports cited above are consistent with this model. For example, female rheumatoid arthritis patients often go into remission during pregnancy and then relapse following childbirth. Analysis of sIgG levels before, during, and after pregnancy showed that the level of sIgG increases rapidly during pregnancy-induced remission, whereas during periods of exacerbated disease, sIgG is essentially undetectable (7,8). To date, it is unclear whether IgG sialylation patterns precede or result from the inflammatory state, and essentially nothing is known about the regulatory mecha...