Aberrant Sialylation in a Patient with a HNF1α Variant and Liver Adenomatosis

Glycosylation is a fundamental post-translational modification of proteins that boosts their structural diversity providing subtle and specialized biological properties and functions. All those genetic diseases due to a defective glycan biosynthesis and attachment to the nascent glycoproteins fall within the wide area of congenital disorders of glycosylation (CDG), mostly causing multisystem involvement. In the present paper we detailed the unique serum N- glycosylation of a CDG-candidate patient with an unexplained neurological phenotype and liver adenomatosis harbouring a recurrent pathogenic HNF1α variant. Serum transferrin IEF showed a surprising N-glycosylation pattern consisting on hyposialylation as well as remarkable hypersialylation. Mass spectrometry-based glycomic analyses of individual serum glycoproteins enabled to unveil hypersialylated complex N-glycans comprising up to two sialic acids per antenna. Further advanced MS analysis showed the additional sialic acid is bonded through an α2-6 linkage to the peripheral N-acetylglucosamine residue, giving rise to disialo-epitopes never described in human N-glycoproteins.