Mucopolysaccharidosis type VI: Structural and clinical implications of mutations in N-acetylgalactosamine-4-sulfatase

Tom Litjens, John J. Hopwood

Research output: Contribution to journalReview articlepeer-review

64 Citations (Scopus)


Mucopolysaccharidosis type VI (MPS-VI) is an autosomal recessive lysosomal storage disorder caused by the deficiency of N-acetylgalactosamine-4-sulfatase (4S; or ARSB). Mutations in the 4S gene are responsible for 4S deficiency, which leads to the intralysosomal storage of partially degraded glycosaminoglycans, dermatan sulfate, and chondroitin 4-sulfate. To date, a total of 45 clinically relevant mutations have been identified in the human 4S gene. Missense mutations are the largest group, with 31 identified mutations. Nonsense mutations and small insertions or deletions comprise the remainder, with seven mutations each. Six polymorphisms have also been reported: two amino acid substitutions and four silent transitions. Mapping of the missense mutations onto the 4S structure shows that they are distributed throughout the three subunits of the mature 4S polypeptide. Mutations have been identified in active site residues, in residues adjacent to the active site, in potential substrate binding residues, in residues exposed on the surface, and in residues buried within the protein core. Missense mutations have also been identified in disulfide crosslinks. Molecular modeling of MPS-VI mutations onto the 4S structure suggests that the majority cause 4S deficiency via destabilization and the consequent reduction of 4S protein concentration. The vast majority of MPS-VI mutant alleles are either unique to a patient or are present in a small number of patients. So far, no common mutations have been described. Therefore, screening of the general population for MPS-VI alleles will be difficult. Hum Mutat.

Original languageEnglish
Pages (from-to)282-295
Number of pages14
JournalHuman Mutation
Issue number4
Publication statusPublished or Issued - 11 Oct 2001


  • 4S
  • ARSB
  • Arylsulfatase B
  • Lysosomal storage disorder
  • Maroteaux-Lamy syndrome
  • Mucopolysaccharidosis type VI (MPS-VI)
  • N-acetylgalactosamine-4-sulfatase
  • Sulfatase

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)

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