In vitro treatment with liposome-encapsulated Mannose-1-phosphate restores N-glycosylation in PMM2-CDG patient-derived fibroblasts

Mol Genet Metab. 2024 Sep-Oct;143(1-2):108531. doi: 10.1016/j.ymgme.2024.108531. Epub 2024 Jul 1.

Abstract

PMM2-CDG is the most common congenital disorder of glycosylation (CDG). Patients with this disease often carry compound heterozygous mutations of the gene encoding the phosphomannomutase 2 (PMM2) enzyme. PMM2 converts mannose-6-phosphate (M6P) to mannose-1-phosphate (M1P), which is a critical upstream metabolite for proper protein N-glycosylation. Therapeutic options for PMM2-CDG patients are limited to management of the disease symptoms, as no drug is currently approved to treat this disease. GLM101 is a M1P-loaded liposomal formulation being developed as a candidate drug to treat PMM2-CDG. This report describes the effect of GLM101 treatment on protein N-glycosylation of PMM2-CDG patient-derived fibroblasts. This treatment normalized intracellular GDP-mannose, increased the relative glycoprotein mannosylation content and TNFα-induced ICAM-1 expression. Moreover, glycomics profiling revealed that GLM101 treatment of PMM2-CDG fibroblasts resulted in normalization of most high mannose glycans and partial correction of multiple complex and hybrid glycans. In vivo characterization of GLM101 revealed its favorable pharmacokinetics, liver-targeted biodistribution, and tolerability profile with achieved systemic concentrations significantly greater than its effective in vitro potency. Taken as a whole, the results described in this report support further exploration of GLM101's safety, tolerability, and efficacy in PMM2-CDG patients.

Keywords: Congenital disorders of glycosylation; GLM101; Inherited metabolic disorders; Liposome; Phosphomannomutase 2-CDG/ (PMM2); Substrate replacement therapy.

MeSH terms

  • Cells, Cultured
  • Congenital Disorders of Glycosylation* / drug therapy
  • Congenital Disorders of Glycosylation* / genetics
  • Congenital Disorders of Glycosylation* / metabolism
  • Congenital Disorders of Glycosylation* / pathology
  • Fibroblasts* / drug effects
  • Fibroblasts* / metabolism
  • Glycosylation / drug effects
  • Humans
  • Intercellular Adhesion Molecule-1 / genetics
  • Intercellular Adhesion Molecule-1 / metabolism
  • Liposomes*
  • Mannosephosphates* / metabolism
  • Mutation
  • Phosphotransferases (Phosphomutases)* / genetics
  • Phosphotransferases (Phosphomutases)* / metabolism

Substances

  • Liposomes
  • Mannosephosphates
  • Phosphotransferases (Phosphomutases)
  • phosphomannomutase 2, human
  • mannose-6-phosphate
  • Intercellular Adhesion Molecule-1