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Background: Bronchiolitis obliterans syndrome (BOS), a severe complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), presents as chronic graft-versus-host disease characterized by inflammation and fibrosis of the small airway epithelium. This progressive fibrosis obstructs bronchiolar airways, leading to respiratory distress in patients. Due to the lack of effective treatments, a deeper understanding of the underlying mechanisms is crucial. This study explored the molecular mechanisms underlying the abnormal glycosylation regulation in BOS, aiming to provide new insights for early diagnosis and treatment of this disease.
Methods: Bronchoalveolar lavage fluid (BALF) was collected from patients with and without BOS following allo-HSCT. N-glycans from the BALF were enriched using a solid-phase extraction method. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/TOF-MS) was used to detect N-glycosylation characteristics in the BALF of BOS patients. This phenomenon was validated using a graft-versus-host disease (GVHD) mouse model. The impact of MGAT3 knockdown on the biological functions of airway epithelial cells (BEAS-2B) was then examined using lentivirus transfection. The molecular mechanism by which the loss of MGAT3 enhances TGF-β signaling was explored using western blotting, enzyme-linked immunosorbent assay (ELISA), and immunofluorescence (IF).
Results: Our study investigated N-glycosylation changes in BALF of BOS patients and identified a strong correlation between the loss of bisecting-GlcNAc N-glycans and BOS progression. We found a novel mechanism where MGAT3, the enzyme synthesizing bisecting-GlcNAc structures, critically regulates TGF-β signaling. MGAT3 and bisecting-GlcNAc deficiency significantly enhance TGF-β signaling by increasing TGF-β storage through upregu-lation of latent TGF-β binding protein 1 (LTBP1) and by increasing the availability of TGF-β receptors.
Conclusions: Our discovery highlights the crucial role of aberrant glycosylation in BOS progression and holds significant promise for developing novel biomarkers for early diagnosis, identifying new therapeutic targets, and ultimately improving the quality of life for BOS patients.
DOI: 10.7754/Clin.Lab.2025.250831
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