title: Patients with unsolved congenital disorders of glycosylation type II can be subdivided in six distinct biochemical groups.
abstract: Defects in the biosynthesis of N- and core 1 O-glycans may be found by isoelectric focusing (IEF) of plasma transferrin and apolipoprotein C-III (apoC-III). We hypothesized that IEF of transferrin and apoC-III in combination with sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) of apoC-III may provide a classification for congenital disorders of glycosylation (CDG) patients. We analyzed plasma from 22 patients with eight different and well-characterized CDG subtypes and 19 cases with unsolved CDG. Transferrin IEF (TIEF) has been used to distinguish between N-glycan assembly (type 1 profile) and processing (type 2 profile) defects. We differentiated two different CDG type 2 TIEF profiles: The "asialo profile" characterized by elevated levels of asialo- and monosialotransferrin and the "disialo profile" characterized by increased levels of disialo- and trisialotransferrin. ApoC-III IEF gave two abnormal profiles ("apoC-III(0)" and "apoC-III(1)" profiles). The results for the eight established CDG forms exactly matched the theoretical expectations, providing a validation for the study approach. The combination of the three electrophoretic techniques was not additionally informative for the CDG-Ix patients as they had normal apoC-III IEF patterns. However, the CDG-IIx patients could be further subdivided into six biochemical subgroups. The robustness of the methodology was supported by the fact that three patients with similar clinical features ended in the same subgroup and that another patient, classified in the "CDG-IIe subgroup," turned out to have a similar defect. Dividing the CDG-IIx patients in six subgroups narrows down drastically the options of the primary defect in each of the subgroups and will be helpful to define new CDG type II defects.
authors.affiliation: Laboratory of Pediatrics and Neurology, Radboud University Nijmegen Medical Center, 6525 GA Nijmegen, The Netherlands.
authors.forename: Suzan
authors.initials: S
authors.lastname: Wopereis
authors.forename: Eva
authors.initials: E
authors.lastname: Morava
authors.forename: Stephanie
authors.initials: S
authors.lastname: Grünewald
authors.forename: Maciej
authors.initials: M
authors.lastname: Adamowicz
authors.forename: Karin M L C
authors.initials: KM
authors.lastname: Huijben
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Lefeber
authors.forename: Ron A
authors.initials: RA
authors.lastname: Wevers
mesh_terms: D053305:Apolipoprotein C-III; D001056:Apolipoproteins C / Q000235:genetics; D002239:Carbohydrate Metabolism, Inborn Errors / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism*; D003720:Densitometry; D004591:Electrophoresis, Polyacrylamide Gel; D006026:Glycoside Hydrolases / Q000737:chemistry; D006031:Glycosylation; D006801:Humans; D007525:Isoelectric Focusing; D019158:N-Acetylneuraminic Acid / Q000737:chemistry; D009439:Neuraminidase / Q000737:chemistry / Q000378:metabolism; D009844:Oligosaccharides / Q000737:chemistry; D011134:Polysaccharides / Q000737:chemistry; D020033:Protein Isoforms; D014168:Transferrin / Q000096:biosynthesis / Q000378:metabolism
chemical_list: D053305:Apolipoprotein C-III; D001056:Apolipoproteins C; D009844:Oligosaccharides; D011134:Polysaccharides; D020033:Protein Isoforms; D014168:Transferrin; D006026:Glycoside Hydrolases; D009439:Neuraminidase; D019158:N-Acetylneuraminic Acid