Glycosphingolipid synthesis is impaired in SLC35A2-CDG and improves with galactose supplementation

SLC35A2-CDG is an X-linked congenital disorder of glycosylation (CDG), characterized by defective UDP-galactose transport into the Golgi and endoplasmic reticulum and consequent insufficient galactosylation of glycans. Clinically, this translates into a range of predominantly neurological symptoms. Although the pathomechanism of this disorder is not fully understood, oral galactose supplementation has led to clinical and biochemical improvement in some patients. Here, we show that protein glycosylation (N- and O-linked) was only minimally disturbed in SLC35A2-CDG patient-derived fibroblasts. However, lipid glycosylation was significantly impaired, with accumulation of glucosylceramide and deficiency of digalactosylated glycosphingolipids (GSLs) and complex gangliosides. Galactose supplementation increased UDP-galactose, its transport into the Golgi, and improved deficient GSL synthesis through direct incorporation of the provided galactose. This improved GSL homeostasis in all patient-derived fibroblasts and in another SLC35A2 deficient cell model (CHO-Lec8). Additionally, SLC35A2-CDG serum analysis identified hydroxylated GSLs, particularly GM3, as potential disease biomarkers. Given the essential role of gangliosides in central nervous system function, their deficiency is likely a key factor in the neurological involvement of this disorder. These findings pave the way for new nutritional therapies with GSL supplements and highlight the importance of studying lipid glycosylation to better understand the complex pathophysiology of CDG.

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Publication Details

Journal
Cellular and Molecular Life Sciences
Published
2025-06-27
DOI
https://doi.org/10.1007/s00018-025-05759-w
Citations
5
Primary Topic
Glycosylation and Glycoproteins Research
Type
article
Field-Weighted Citation Impact
4.03

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article

Glycosphingolipid synthesis is impaired in SLC35A2-CDG and improves with galactose supplementation

Peter Witters, Johannes V. Swinnen, Christian Thiel, David Cassiman et al.
5 citations
Cellular and Molecular Life Sciences
Glycosylation and Glycoproteins Research
4.03
article

Glycosphingolipid synthesis is impaired in SLC35A2-CDG and improves with galactose supplementation

Peter Witters, Johannes V. Swinnen, Christian Thiel, David Cassiman, Bart Ghesquière, Daisy Rymen, Tomáš Honzík, Pieter Vermeersch, Sam De Craemer, Rita Maria Elisa Barone, Jakub Idkowiak, Dries Verdegem, Andrea Jáñez Pedrayes, Éva Morava, Mercedes Serrano, Willy Morelle, François Foulquier
article en
5 citations

Abstract

SLC35A2-CDG is an X-linked congenital disorder of glycosylation (CDG), characterized by defective UDP-galactose transport into the Golgi and endoplasmic reticulum and consequent insufficient galactosylation of glycans. Clinically, this translates into a range of predominantly neurological symptoms. Although the pathomechanism of this disorder is not fully understood, oral galactose supplementation has led to clinical and biochemical improvement in some patients. Here, we show that protein glycosylation (N- and O-linked) was only minimally disturbed in SLC35A2-CDG patient-derived fibroblasts. However, lipid glycosylation was significantly impaired, with accumulation of glucosylceramide and deficiency of digalactosylated glycosphingolipids (GSLs) and complex gangliosides. Galactose supplementation increased UDP-galactose, its transport into the Golgi, and improved deficient GSL synthesis through direct incorporation of the provided galactose. This improved GSL homeostasis in all patient-derived fibroblasts and in another SLC35A2 deficient cell model (CHO-Lec8). Additionally, SLC35A2-CDG serum analysis identified hydroxylated GSLs, particularly GM3, as potential disease biomarkers. Given the essential role of gangliosides in central nervous system function, their deficiency is likely a key factor in the neurological involvement of this disorder. These findings pave the way for new nutritional therapies with GSL supplements and highlight the importance of studying lipid glycosylation to better understand the complex pathophysiology of CDG.

Cellular and Molecular Life SciencesVol. 82(1)
Centre National de la Recherche Scientifique (FR), Hospital Sant Joan de Déu Barcelona (ES), Charles University (CZ), Heidelberg University (DE), University Hospital Heidelberg (DE), University of Catania (IT), Oasi Maria SS (IT), VIB-KU Leuven Center for Cancer Biology (BE), Unité de Glycobiologie Structurale et Fonctionnelle (FR), General University Hospital in Prague (CZ), Heidelberg University (US), Icahn School of Medicine at Mount Sinai (US), KU Leuven (BE)
Univerzita Karlova v Praze, Fonds Wetenschappelijk Onderzoek, Ministerstvo Zdravotnictví Ceské Republiky, KU Leuven, Agentura Pro Zdravotnický Výzkum České Republiky, Vlaamse regering
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Glycosylation and Glycoproteins Research
4.03
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