Glycogen storage disease type Ib (
GSD-Ib) is caused by a deficiency in the
glucose-6-phosphate transporter (G6PT). In addition to disrupted
glucose homeostasis,
GSD-Ib patients have unexplained and unexpected defects in neutrophil respiratory burst, chemotaxis and
calcium flux, in response to the bacterial
peptide f-
Met-Leu-Phe, as well as intermittent
neutropenia. We generated a G6PT knockout (G6PT-/-) mouse that mimics all known defects of the human disorder and used the model to further our understanding of the pathogenesis of
GSD-Ib. We demonstrate that the
neutropenia is caused directly by the loss of G6PT activity; that chemotaxis and
calcium flux, induced by the
chemokines KC and macrophage inflammatory protein-2, are defective in G6PT-/- neutrophils; and that local production of these
chemokines and the resultant neutrophil trafficking in vivo are depressed in G6PT-/-
ascites during an inflammatory response. The bone and spleen of G6PT-/- mice are developmentally delayed and accompanied by marked hypocellularity of the bone marrow, elevation of myeloid progenitor cell frequencies in both organs and a corresponding dramatic increase in
granulocyte colony stimulating factor levels in both
GSD-Ib mice and humans. So, in addition to transient
neutropenia, a sustained defect in neutrophil trafficking due to both the resistance of neutrophils to
chemotactic factors, and reduced local production of neutrophil-specific
chemokines at sites of
inflammation, may underlie the myeloid deficiency in
GSD-Ib. These findings demonstrate that G6PT is not just a G6P
transport protein but also an important immunomodulatory
protein whose activities need to be addressed in treating the myeloid complications in
GSD-Ib patients.