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Terminal glycans on the Fc portion of IgG antibodies are critical for antibody‐triggered, pro‐inflammatory or anti‐inflammatory responses. Herein, the goal was to compare glycan profiles of total IgG1 and Borrelia burgdorferi (Bb)‐specific IgG1 antibodies in patients with antibiotic‐responsive or antibiotic‐refractory Lyme arthritis (LA). Patients with antibiotic‐responsive LA had Bb‐IgG1 antibodies with more balanced pro‐inflammatory/anti‐inflammatory glycan profiles. In contrast, patients with antibiotic‐refractory LA had Bb‐IgG1 antibodies with maximal, minimally opposed, pro‐inflammatory glycan profiles. Among patients with antibiotic refractory LA, antibodies with this unbalanced inflammatory glycan profile may play a role in sustaining maladaptive joint inflammation.
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