Glycans: The Next Frontier in Preventive Medicine

For much of medical history, the focus has been on diagnosing and treating disease after it occurs. Only recently has medicine begun to shift toward prevention, identifying subtle molecular changes that precede symptoms and using them to guide early interventions. This transformation is driven by our growing ability to decode biology in unprecedented detail. 

From the genome to the microbiome, every layer of molecular information offers a new way to understand why some people remain healthy while others develop chronic disease. Yet even with all this knowledge, an important piece of the puzzle has remained largely overlooked.

The next frontier in this evolution is glycomics, the study of glycans, the complex carbohydrate structures that modify proteins and fine-tune nearly every biological process in the body. By decoding the glycome, we can move closer to predicting disease before it manifests and personalizing prevention in ways that were not possible before.

Glycome - The Missing Layer in Precision Medicine

Glycans are complex sugar molecules attached to proteins through a process known as glycosylation, one of the most important post-translational modifications of proteins. By altering the structure and stability of proteins, glycans fine-tune nearly every process in the body, from cell communication to immune defense.

What makes glycans particularly fascinating is that their structures are not directly encoded in our DNA. Instead, they are shaped by the interplay of genes, their regulation, and environmental factors such as stress, diet, and hormonal balance. This means each person’s glycan profile is unique — a molecular reflection of how their body is responding to the world around them.

Over the past two decades, genetics and proteomics have transformed our understanding of human health. We can now identify disease-associated genes, map protein networks, and even predict certain risks long before symptoms appear. Yet despite these advances, people with similar genes and lifestyles often experience very different health outcomes. Why do some age gracefully while others develop chronic disease early? Why do two individuals with similar clinical profiles respond differently to the same treatment? Glycans may help explain these differences, providing a molecular snapshot of how various biological layers interact in each individual.

Glycans as Biomarkers of Health and Disease

Glycans have diverse roles throughout the body, with one of the most important being their regulation of the immune system. A key aspect of immunity influenced by glycans is low-grade chronic inflammation, a persistent background inflammatory state that contributes to disease development as we age, a process known as inflammaging.

Unlike acute inflammation, which serves to protect us, chronic inflammation reflects cumulative damage that builds up over time due to genetic, epigenetic, and lifestyle factors. It underlies most chronic diseases, including cardiovascular, metabolic, autoimmune, neurodegenerative, and cancer.

Glycans help regulate the activity of antibodies by either promoting or suppressing inflammation. The balance between different glycans shifts naturally with age but is also influenced by overall health. Unhealthy lifestyle factors or underlying disease can drive this balance toward a more pro-inflammatory state.

Glycans change with health status, showing distinct patterns in health and disease. Changes in IgG glycosylation have been observed in more than 70 diseases and conditions. Yet glycans are not passive biomarkers. They are active molecular effectors that help shape the environment in which diseases develop, often long before clinical diagnosis. 

Glycans Precede Disease Development

Glycans can be viewed as the body’s early warning system, signaling subtle shifts in health years before disease symptoms appear. By tracking these changes, we can observe the gradual buildup of chronic inflammation and the body’s trajectory toward disease.

These early shifts have been observed in a wide range of conditions, from insulin resistance and type 2 diabetes to cardiovascular disease, rheumatoid arthritis, and neurodegenerative disorders. Remarkably, glycans often change before other commonly used biomarkers, making them one of the earliest measurable signals of developing disease. 

By looking at the balance between pro- and anti-inflammatory glycans, we can better understand the body’s inflammatory load and detect early signs of chronic inflammation. Glycans act as functional effectors, actively shaping immune activity rather than simply reflecting it. Tracking these molecular changes over time provides insight into the processes driving disease and offers an early window for prevention and intervention before clinical symptoms appear.

A Personalized Insight Into Health

Beyond their ability to reflect disease risk, glycans also reveal how the body responds to change. Their patterns shift as inflammation rises or resolves, making them sensitive indicators of how health is evolving in real time. 

This responsiveness allows glycans to be used not only for early detection but also for monitoring how health changes in response to different interventions. Two individuals can follow the same therapy, diet, or lifestyle plan and show completely different molecular outcomes. Glycan profiling captures these individual trajectories, revealing whether an intervention is truly improving health or potentially contributing to disease risk.

Because of this sensitivity, glycans enable a truly personalized approach to health management. They can help distinguish responders from non-responders to specific treatments, track disease remission or relapse, and assess how the immune system adapts over time. By translating these molecular changes into measurable data, glycans provide a feedback loop between biology and intervention, turning prevention and recovery into an ongoing, individualized process. 

Glycans respond to every factor that shapes inflammation, from diet, exercise, and sleep to medication and hormone balance. This makes them one of the few biomarkers that can capture the combined impact of lifestyle and therapeutic interventions, offering a measurable link between daily habits, medical treatments, and long-term immune health.

Conclusion

To truly understand human biology, we must view it from multiple perspectives. Over the past few decades, fields like genomics, transcriptomics, proteomics, and metabolomics have transformed our understanding of how the body functions and what drives disease. Yet even with these insights, part of the biological picture has remained incomplete. Glycomics, the study of glycans, adds an important missing layer, helping to explain how our genetic potential is shaped by environment, lifestyle, and time.

While genomics tells us what could happen and proteomics what is happening, glycomics shows how the body responds. It reflects the constant interaction between our biology and environment, offering a more dynamic view of health. This perspective does not replace other omics but complements them, bringing us closer to understanding the complex, adaptive systems that define health.

Integrating glycomics into preventive medicine can help shift the focus from treating disease to maintaining resilience. Measuring changes in glycans allows us to detect early inflammation, track responses to lifestyle and therapeutic interventions, and assess how health evolves over time. The future of medicine lies in this integrative approach, one that unites all layers of molecular insight to predict, prevent, and preserve health before disease appears.