Diagnosis of CDG Enzyme Analysis and Other Investigations
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1 Diagnosis of CDG Enzyme Analysis and Other Investigations Biochemical Genetics Network Cambridge April 2005 Viki Worthington National Hospital for Neurology and Neurosurgery, London
2 EUROGLYCANET European Consortium of labs working on CDG (about 29 participants) (Research & Diagnosis) London Core Lab (with 5 others in Europe) Professor Bryan Winchester UK Coordinator Diagnostic Carousel International Patient Database Website
3 Abnormal Transferrin Glycoform Pattern Type I Next step towards diagnosis?
4 Enzymology to exclude CDG-Ia & CDG-Ib Notify Prof. Bryan Winchester (ICH) Contact Enzyme Laboratory (GOSH/ICH) Marie Jackson (Clinical Scientist) Sample requirements for enzymology Leucocytes (5-10 ml blood in Li Heparin) Derek Burke (BMS 3) If fibroblast culture is required
5 PMM or PMI deficiency Phosphomannomutase deficiency Diagnosis of CDG-Ia Phosphomannose isomerase deficiency Diagnosis of CDG-Ib (Treated by mannose therapy) Diagnosis must be confirmed by mutation analysis if PND is to be offered in the future
6 CDG-Ia/Ib - further investigations Mutation analysis (Leuven, Belgium via ICH) DNA or 5ml blood in EDTA for DNA extraction PMM2 gene (CDG-Ia) PMI1 (MPI) gene (CDG-Ib) Samples from both parents are required before PND can be offered 10ml Li Heparin (Enzymology) 5ml EDTA (DNA analysis) NOTE: investigations should be completed before the mother becomes pregnant again
7 PMM and PMI normal Next step - LLO analysis LLO = Lipid-Linked Linked Oligosaccharides
8 Glycosylation Pathway Stage 1 Activation of sugar precursors Assembly of oligosaccharides on ER membrane (lipid-linked) Lipid = dolichol Transfer to the nascent polypeptide Stage 2 Processing of N-linked glycans in the Golgi
9 Lipid-Linked Linked Oligosaccharides LLOs are intermediates in the first stage of the glycosylation pathway Specific LLOs will accumulate if there is a block in the pathway due to an enzyme defect
10 LLO Analysis Zurich, Switzerland via ICH, London Patient s skin fibroblasts growing in culture Labelled with [ 3 H]-mannose LLOs extracted HPLC analysis A specifically altered LLO profile can be diagnostic for a given type of CDG
11 Yeast Glycosylation Mutants LLO profile from a yeast mutant will reflect the specific enzyme defect Similar LLO profile in fibroblasts from a patient with the same defect E.g. CDG-Ii fibs and yeast alg2 mutant have the same LLO profile and a deficiency in the same mannosyl transferase.
12 Gene Analysis & Complementation Studies LLO profile predicts defective glycosyl transferase Mutation analysis of relevant gene Yeast mutant (temp. sensitive) studies E.g. alg2 yeast + wild type halg2 gene (temp sens corrected) alg2 yeast + defective halg2 gene (remains temp sens) Confirms that the mutant gene is the cause of the glycosylation defect
13 Abnormal Transferrin Glycoform Pattern Type II Next step Glycan Analysis
14 Glycosylation Pathway Stage 1 Activation of sugar precursors Assembly of oligosaccharides on ER membrane (lipid linked). Transfer to the nascent polypeptide Stage 2 Processing of N-linked glycans in the Golgi (addition and removal of sugars to form mature branched glycans, involving glycosyl transferases and glycosidases)
15 N-linked Glycans N-linked glycans are intermediates (attached to the growing polypeptide chain) in the second stage of the glycosylation pathway Defects in enzymes involved in glycan processing or defects in Golgi integrity may cause accumulation of aberrant N-linked glycans
16 N-linked Glycan Analysis Philippa Mills ICH, London Plasma from affected patient Enzymatic release of glycans from proteins Purified glycans analysed by MALDI-TOF-MS Glycans structures characterised Enzymology/further studies Europe
17 CDG Screening & Diagnosis Normal Serum Transferrin Analysis Abnormal Protein Variant Secondary TYPE I Underglycosylation TYPE II Aberrant Glycans Secondary Enzymology (Ia & Ib) 6 LLO Analysis 6 Gene Analysis 6 Functional Studies N-glycan Analysis 6 Enzyme or protein Analysis 6 Gene Analysis 6 Functional Studies Full Diagnosis
18 UK Contacts - London EUROGLYCANET Co-ordinator for the UK Bryan Winchester 3 Clinical Advice Stephanie Grunewald 1 Peter Clayton 1 Transferrin Analysis Geoff Keir 2 Viki Worthington 2 Enzymology (Ia & Ib) Marie Jackson 1 Fibroblast culture Derek Burke 1 Glycan Analysis Philippa Mills 3 1. GOSH/ICH 2. NHNN 3. ICH
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Certificate of Analysis LudgerPure TM APTS Labelled IgG Glycan Library Cat. #: CAPTS-IgG-0 Batch #. B-0 Size: approx. 0 pmol Description and: Source A mixture of APTS labelled fucosylated bi-antennary
Table of Contents. Acknowledgement...4 Abstract...5 Glycan structure and synthesis...6. Glycosylation Glycan-binding proteins...
The complexity of membrane-bound glycans in health and disease and the beneficial properties of glyconutrients Lynn Wagner Department of chemistry, biotechnology and food science Master Thesis 30 credits