Mutations in B3GALT6, which Encodes a Glycosaminoglycan Linker Region Enzyme, Cause a Spectrum of Skeletal and Connective Tissue Disorders Masahiro Nakajima,

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Mutations in B3GALT6, which Encodes a Glycosaminoglycan Linker Region Enzyme, Cause a Spectrum of Skeletal and Connective Tissue Disorders Masahiro Nakajima, Shuji Mizumoto, Noriko Miyake, Ryo Kogawa, Aritoshi Iida, Hironori Ito, Hiroshi Kitoh, Aya Hirayama, Hiroshi Mitsubuchi, Osamu Miyazaki, Rika Kosaki, Reiko Horikawa, Angeline Lai, Roberto Mendoza-Londono, Lucie Dupuis, David Chitayat, Andrew Howard, Gabriela F. Leal, Denise Cavalcanti, Yoshinori Tsurusaki, Hirotomo Saitsu, Shigehiko Watanabe, Ekkehart Lausch, Sheila Unger, Luisa Bonafé, Hirofumi Ohashi, Andrea Superti-Furga, Naomichi Matsumoto, Kazuyuki Sugahara, Gen Nishimura, Shiro Ikegawa The American Journal of Human Genetics Volume 92, Issue 6, Pages 927-934 (June 2013) DOI: 10.1016/j.ajhg.2013.04.003 Copyright © 2013 The American Society of Human Genetics Terms and Conditions

Figure 1 Enzymes Involved in Biosynthesis of the Glycosaminoglycan Linker Region and Summary Features of Diseases Caused by Their Defects Based on a Conventional Concept for the Diseases The biosyntheses of GAGs start with the formation of a common tetrasaccharide linker sequence covalently attached to the core protein. The linker region synthesis involves a single linear pathway composed of four successive steps catalyzed by distinctive enzymes. Abbreviations are as follows: XYLT, β-xylosyltransferase; B4GALT7, xylosylprotein β1,4-galactosyltransferase, polypeptide 7 (β1,4-galactosyltransferase-I); B3GALT6, UDP-Gal, βGal β1,3-galactosyltransferase polypeptide 6 (β1,3-galactosyltransferase-II); B3GAT3, β-1,3-glucuronyltransferase 3 (glucuronosyltransferase I); Ser-O, the serine residue of the GAG attachment site on the proteoglycan core protein; Xyl, xylose; Gal, galactose; GlcUA, D-glucuronic acid; CS, chondroitin sulfate; DS, dermatan sulfate; HS, heparan sulfate; EDS, Ehlers-Danlos syndrome; SEMD-JL1, spondyloepimetaphyseal dysplasia with joint laxity type 1. The American Journal of Human Genetics 2013 92, 927-934DOI: (10.1016/j.ajhg.2013.04.003) Copyright © 2013 The American Society of Human Genetics Terms and Conditions

Figure 2 Analyses of B3GALT6 Missense Mutant Proteins Identified in Individuals with SEMD-JL1 In Vitro (A) Immunoblot analysis of lysates from HeLa cells expressing transfected wild-type (WT) and mutant (c.1A>G) B3GALT6. The mutant B3GALT6 yields a shortened protein. The difference of the molecular sizes between WT and mutant proteins is approximately ∼4 kD. (B) Subcellular localization of B3GALT6. HeLa cells were transfected with WT and mutant (c.1A>G) B3GALT6. Cells were stained with anti-FLAG (green), anti-α-mannosidase II (red), and 4′,6-diamidino-2-phenylindole (DAPI; blue). WT was expressed in the Golgi, but the mutant was found in cytoplasm and nucleus. (C) Decreased enzyme activities of the missense mutant proteins (p.Ser65Gly, p.Pro67Lys, p.Asp156Asn, p.Arg232Cys, and p.Cys300Ser). p.Glu174Asp is a common polymorphism in the public database. The GalT-II activity is measured by incorporation of [3H]Gal into Galβ1-O-2naphthyl (pmol/ml/hr) and represents the averages of three independent experiments performed in triplicate. Empty and mock indicate the GalT-II activity obtained with the conditioned medium transfected with or without an empty vector. ∗p < 0.0001 versus WT (one-way analysis of variance with Dunnett’s adjustment). The American Journal of Human Genetics 2013 92, 927-934DOI: (10.1016/j.ajhg.2013.04.003) Copyright © 2013 The American Society of Human Genetics Terms and Conditions