Congenital dyserythropoietic anemia type II, or hereditary erythroblastic multinuclearity with a positive acidified-serum-lysis test (
HEMPAS), is a genetic
anemia in humans inherited by an autosomally recessive mode. The
enzyme defect in most
HEMPAS patients has previously been proposed as a lowered activity of
N-acetylglucosaminyltransferase II, resulting in a lack of
polylactosamine on
proteins and leading to the accumulation of polylactosaminyl
lipids. A recent
HEMPAS case, G.C., has now been analyzed by cell-surface labeling, fast-atom-bombardment mass spectrometry of
glycopeptides, and activity assay of glycosylation
enzymes. Significantly decreased glycosylation of
polylactosaminoglycan proteins and incompletely processed
asparagine-linked
oligosaccharides were detected in the erythrocyte membranes of G.C. In contrast to the earlier studied
HEMPAS cases, G.C. cells are normal in
N-acetylglucosaminyltransferase II activity but are low in
alpha-mannosidase II (alpha-ManII) activity. Northern (
RNA) analysis of
poly(A)+ mRNA from normal, G.C., and other unrelated
HEMPAS cells all showed double bands at the 7.6-kilobase position, detected by an alpha-ManII
cDNA probe, but expression of these bands in G.C. cells was substantially reduced (less than 10% of normal). In Southern analysis of G.C. and normal genomic
DNA, the restriction fragment patterns detected by the alpha-ManII
cDNA probe were indistinguishable. These results suggest that G.C. cells contain a mutation in alpha-ManII-encoding gene that results in inefficient expression of alpha-ManII
mRNA, either through reduced transcription or message instability. This report demonstrates that
HEMPAS is caused by a defective gene encoding an
enzyme necessary for the synthesis of
asparagine-linked
oligosaccharides.