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. 2021 Sep 14;14:1227–1246. doi: 10.2147/CCID.S328671

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© 2021 Wang et al.

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Mechanism of GAG alterations by C-xyloside. Under homeostasis, GAG chains are attached to the xyloside residue of a protein backbone followed by sulfation, and the newly-formed chain is transported to the cell membrane as a membrane-associated complex or released into the extracellular space. C-xyloside penetrates the cell membrane and acts as the primer for the core tetrasaccharide to assemble GAG chains on, which are then released as soluble GAG. These soluble chains are considerably shorter than in the absence of C-xyloside, and are predominately DS in keratinocytes, CS/DS in fibroblasts, and exhibit altered sulfation patterns. The levels of proteoglycan-associated GAG chains are not significantly reduced, but they too are shorter and exhibit altered sulfation patterns, including for HS.