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Globotetraosylceramide (Gb4) synthesis pathway (38). The synthesis of Gb4 requires globotriaosylceramide (Gb3) as a substrate. Biosyntheses of Gb3 and Gb4 are accompanied by intracellular transport, presumably by a vesicle-bound exocytotic membrane flow, from the endoplasmic reticulum (ER) through the Golgi cisternae to the plasma membrane (57). Abbreviations: LacCer, lactose-ceramide; GlcCer, glucose-ceramide.
