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. 2021 Jun 16;12:642097. doi: 10.3389/fgene.2021.642097

Table 2.

GAG biosynthesis enzymes implicated in defects observed in patient samples.

Gene deficiency consequences evidenced in patient samples
Protein name Function GAG PG Other glycosylation defects
Linker
XYLT1 Xylosyltransferase 1 (MIM: 608124) Transfer of a Xyl residue from UDP-Xyl to specific serine residues of PG core protein Götting et al., 2007 Reduced total GAG synthesis after incubation with methylumbelliferyl-β-D-xylopyranoside in patient fibroblasts Bui et al., 2014 Reduced glycosylation of decorin in patient fibroblast supernatants Schreml et al., 2014 N.D
XYLT2 Xylosyltransferase 2 (MIM: 608125) Transfer of a Xyl residue from UDP-Xyl to specific serine residues of PG core protein Götting et al., 2007 Reduced HS staining in patient fibroblasts and reduced CS and HS chains synthesis in patient fibroblasts Munns et al., 2015 N.D. N.D.
FAM20B Glycosaminoglycan xylosylkinase (MIM: 611063) Phosphorylates initiator xylose residue Koike et al., 2009 N.D. N.D. N.D.
B4GALT7 Galactosyltransferase I (MIM: 604327) Transfer of first Gal residue to Ser-O-Xyl of tetrasaccharide linkage region Okajima et al., 1999 Reduced epimerization of GAG chain in patient fibroblasts Seidler et al., 2006 Defective biosynthesis of mature decorin and biglycan in patient fibroblasts Quentin et al., 1990; Seidler et al., 2006
Reduced level of bikunin bearing CS chain on Western blot in patient serum Bruneel et al., 2018; Haouari et al., 2020
N.D.
B3GALT6 β-1,3-Galactosyltransferase 6 (MIM: 615291) Transfer of second Gal residue to Ser-O-Xyl-Gal of tetrasaccharide linkage region Bai et al., 2001 Reduced HS chains and increased CS and DS chains in patient lymphoblastoid cells Nakajima et al., 2013
Reduced total GAG synthesis in patient fibroblasts Malfait et al., 2013
Disorganized HS GAG ECM in patient fibroblasts Ritelli et al., 2015
Impaired glycanation of decorin in patient fibroblasts Malfait et al., 2013
Reduced level of bikunin bearing CS chain on Western blot in patient serum Bruneel et al., 2018; Haouari et al., 2020
Reduced perlecan immunostaining in patient fibroblasts Ritelli et al., 2015
N.D.
B3GAT3 β-1,3-Glucuronyltransferase 3 (MIM: 606374) Transfer of a GlcUA residue to Ser-O-Xyl-Gal-Gal of tetrasaccharide linkage region Pedersen et al., 2000 Reduced CS, DS, and HS chains synthesis in patient fibroblasts Baasanjav et al., 2011 Increased level of DS-free decorin in patient fibroblasts Baasanjav et al., 2011
Reduced level of bikunin bearing CS chain on Western blot in patient serum Bruneel et al., 2018; Haouari et al., 2020
N.D.
CS/DS chain elongation
CSGALNACT1 Chondroitin sulfate N-acetylgalactosaminyltransferase 1 (MIM: 616615) Transfer of GalNAc residue onto linker region for initiation of CD/DS synthesis Sato et al., 2003 Reduced number of CS/DS chains in patient fibroblasts Mizumoto et al., 2020 Normal PG synthesis Vodopiutz et al., 2017 N.D.
CSGALNACT2 Chondroitin sulfate N-acetylgalactosaminyltransferase 1 (MIM: 616616) CS/DS chain elongation Sato et al., 2003 N.D. N.D. N.D.
CHSY1 Chondroitin sulfate synthase 1 (MIM: 608183) CS/DS chain elongation Uyama et al., 2002 Decreased CS immunostaining in patient skin Tian et al., 2010 Reduced molecular weight of bikunin bearing CS chain on Western blot in patient serum Bruneel et al., 2018 N.D.
CHPF Chondroitin polymerizing factor (MIM: 610405) CS/DS chain elongation Kitagawa et al., 2001 N.D. N.D. N.D.
CHPF2 Chondroitin polymerizing factor 2 (MIM: 608037) CS/DS chain elongation Izumikawa et al., 2008 N.D. N.D. N.D.
DSE Dermatan sulfate epimerase (MIM: 605942) Epimerization of GlcUA of CS chain into IdoUA converting CS to DS Malmström and Aberg, 1982 Decreased DS disaccharides in patient fibroblasts Müller et al., 2013 Glycanation of decorin is impaired in patient fibroblasts Müller et al., 2013
DSEL Dermatan sulfate epimerase-like (MIM: 611125) Epimerisation of GlcUA of CS chain into IdoUA converting CS to DS Pacheco et al., 2009 N.D. N.D. N.D.
HS chain elongation
EXTL1 Exostosin-like glycosyltransferase 1 (MIM: 601738) Transfer of GlcNAc residues to tetrasaccharide linkage region for initiation of HS synthesis Kim et al., 2001 N.D. N.D. N.D.
EXTL2 Exostosin-like glycosyltransferase 2 (MIM: 602411) Transfer of a GlcNAc residue to a phosphorylated tetrasaccharide linkage region to stop chain elongation Nadanaka et al., 2013b N.D. N.D. N.D.
EXTL3 Exostosin-like glycosyltransferase 3 (MIM: 605744) Transfer of a GlcNAc residue to tetrasaccharide linkage region for initiation of HS synthesis Kim et al., 2001 Lower HS concentration in patient fibroblasts, increased CS and DS concentrations in patient serum and urine Oud et al., 2017
Abnormal HS sulfation pattern in patient fibroblasts Volpi et al., 2017
N.D. N.D.
EXT1/EXT2 Exostosin glycosyltransferase 1 (MIM: 608177)/Exostosin glycosyltransferase 2 (MIM: 608210) HS polymerization McCormick et al., 2000 Reduced HS/CS ratio in patient serum Anower-E-Khuda et al., 2013 N.D. N.D.
Sulfation
SLC26A2 DTD sulfate transporter (MIM: 606718) Transports sulfate ions across cell membrane Hästbacka et al., 1994 Undersulfated CS in patient fibroblasts and cartilage Rossi et al., 1998 N.D. N.D.
PAPSS1 3'-phosphoadenosine
5'-phosphosulfate synthase (MIM: 603262)
Synthetizes universal sulfate donor (PAPS) Xu et al., 2000 N.D. N.D. N.D.
PAPSS2 3'-phosphoadenosine
5'-phosphosulfate synthase 2 (MIM: 603005)
Synthetizes universal sulfate donor (PAPS) Xu et al., 2000 Undersulfation of CS in patient urine Toledo et al., 1978 N.D. N.D.
SLC35B2 (PAPST1) Solute carrier family 35 (3'-phosphoadenosine 5'-phosphosulfate transporter), member B2 (MIM: 610788) Transports PAPS from cytosol to Golgi Kamiyama et al., 2003 N.D. N.D. N.D.
SLC35B2 (PAPST2) Solute carrier family 35 (3'-phosphoadenosine 5'-phosphosulfate transporter), member B2 (MIM: 610845) Transports PAPS from cytosol to Golgi Kamiyama et al., 2006 N.D. N.D. N.D.
CHST3 Carbohydrate sulfotransferase 3 (MIM: 603799) Transfers sulfate from PAPS to C6 of GalNAc residues of CS Tsutsumi et al., 1998 Reduction of 6-O-sulfated disaccharide in patient fibroblasts and urine Thiele et al., 2004. Increase of 4-O-sulfated disaccharide in patient fibroblasts Hermanns et al., 2008 N.D. N.D.
CHST11 Carbohydrate sulfotransferase 11 (MIM: 610128) Transfers sulfate from PAPS to GalNAc residues of DS Hiraoka et al., 2000 N.D. N.D. N.D.
CHST14 Carbohydrate sulfotransferase 14 (MIM: 608429) Transfers sulfate from PAPS to C4 of GalNAc residues of CS Evers et al., 2001 Reduced DS biosynthesis and increased CS concentration in patient fibroblasts Dündar et al., 2009; Miyake et al., 2010
DS not detected in patient urines Mizumoto et al., 2017
Decorin depleted of DS chains, replaced by CS chains in patient fibroblasts Miyake et al., 2010 N.D.
IMPAD1 Inositol monophosphate domain-containing protein 1 (MIM: 614010) Hydrolyses by-product of sulfotransferase reactions, PAP, in AMP and phosphate Frederick et al., 2008 N.D. N.D. N.D.
Transporter or other
SLC35D1 Solute carrier family 35 (UDP-glucuronic acid/UDP-N-acetylgalactosamine dual transporter), member D1 (MIM: 610804) Transports UDP-GlcUA/UDP-GalNAc from cytosol to Golgi Muraoka et al., 2001 N.D. N.D. N.D.
SLC35A3 Solute carrier family 35 (UDP-N-acetyl glucosamine transporter), member 3 (MIM: 605632) Transports UDP-GlcNAc from cytosol to Golgi Maszczak-Seneczko et al., 2013 N.D. Reduced molecular weight of bikunin bearing CS chain on Western blot in patient serum Haouari et al., 2020 Reduced N-glycan branching in patient cells and plasma Edvardson et al., 2013
SLC10A7 Solute carrier family 10 (sodium:bile acid cotransporter family), member 7 (MIM: 611459) Negative regulator of intracellular calcium homeostasis Karakus et al., 2020 Significant reduction of HS proportion linked to increased CS proportion in patient fibroblasts Dubail et al., 2018 N.D. Defective N glycosylation in patient serum Ashikov et al., 2018; Dubail et al., 2018
CANT1 Calcium-activated nucleotidase 1 (MIM: 613165) Hydrolyses UDP to UMP and phosphate in Golgi Smith et al., 2002 Reduced GAG synthesis after stimulation by β-D-xyloside in patient fibroblasts Nizon et al., 2012b N.D. N.D.
TGDS TDP-glucose 4,6-dehydratase (MIM: 616146) cTDP-D-glucose 4,6-dehydrogenase homologous to a UDP-glucuronate decarboxylase 1 that catalyzes synthesis of UDP-xylose from UDP-glucuronate Ehmke et al., 2014 N.D. N.D. N.D.
TMEM165 Transmembrane protein 165 (MIM: 614726) Putative role of Mn2+ transporter Dulary et al., 2017 N.D. Reduced molecular weight of bikunin bearing CS chain on Western blot in patient serum Haouari et al., 2020 Increased undersialylated and undergalactosylated glycans in patient serum Foulquier et al., 2012; Xia et al., 2013; Zeevaert et al., 2013