N-Acetylgalactosamine (GalNAc) N-Acetylglucosamine (GlcNAc) Mannose (Man) Fucose (Fuc) Xylose (Xyl) Sialic acid (sia) Glucuronic acid (GlcA) Galactose(Gal) Glucose (Glc) Common Monosaccharide Sugars in Glycans Asn Ser/Thr Typical O-Glycan Typical N-Glycan Essential Glyconutrient: GLUCOSE

HAVE YOU HEARD OF GLYCONUTRIENT THERAPY ? Dr. Hudson, I pray you will have the time to answer a few questions for me. My daughter has cervical cancer that has metastasized into her colon and lungs. My sister-in-law, who has no medical training, insists that she will die unless we give her high doses of a nutritional supplement marketed by Mannatech called Ambrotose. According to her, this is the ONLY way she will get the necessary glyconutrients necessary to help her body rid her self of the cancer. She is laying the guilt on heavily as her oncologist has recommended against taking any nutritional supplements. I am contacting you as she has referenced you as a source of information on glyconutrients. Do you have any opinion on nutritional supplements such as Ambrotose and their effectiveness or lack of?

SOME PATIENTS HAVE HEPATIC FIBROSIS AND PROTEIN- LOSING ENTEROPATHY

anticoagulation (Marcumar R ) i. v. albumin substitution albumin (g/dl) fecal alpha1 AT (mg/g) AT III time in months BEFORE MANNOSEDURING MANNOSE

Fru-6-P PMI PMM Man Man-1-P Man-6-P Glycolysis Glc The Simple Life--Glucose, Mannose, Glycoproteins

FUCOSE THERAPY NORMALIZES NEUTROPHIL COUNTS OF ONE CDG-IIc PATIENT Serum Fucose (µM) Normal Range

THINK ABOUT A. POINTS OF CONTROL AND POTENTIAL REGULATION B. WHY THERE ARE MULTIPLE WAYS OF GENERATING THE SAME PRECURSOR QUESTIONS 1. What is meant by “ essential ” monosaccharides? 2. Mammalian plasma contains glucose (~5 mM) and mannose, which is present at uM, but no other monosaccharides. Where does mannose come from? How is it metabolized? 3. Some cells have extremely low activity of enzymes needed to generate activated monosaccharides. The inactivation of genes encoding these enzymes in a mouse is lethal, so how do deficient cells survive without the biosynthetic enzymes? 4. How are nucleotide sugar transporters distributed in the Golgi? Does this distribution influence glycosylation? What are the advantages of transporters that transfer multiple substrates?