A method for the diagnosis of the
congenital disorders of glycosylation type I (CDG-I) by SELDI-TOF-MS of serum
transferrin immunocaptured on
protein chip arrays is described. The underglycosylation of
glycoproteins in CDG-I produces glycoforms of
transferrin with masses lower than that of the normal fully glycosylated
transferrin. Immobilisation of antitransferrin
antibodies on reactive-
surface protein chip arrays (RS100) selectively enriched
transferrin by at least 100-fold and allowed the detection of patterns of
transferrin glycoforms by SELDI-TOF-MS using approximately 0.3 microL of serum/plasma. Abnormal patterns of immunocaptured
transferrin were detected in patients with known defects in glycosylation (CDG-Ia, CDG-Ib, CDG-Ic, CDG-If and CDG-Ih) and in patients in whom the basic defect has not yet been identified (CDG-Ix). The correction of the N-glycosylation defect in a patient with CDG-Ib after
mannose therapy was readily detected. A patient who had an abnormal
transferrin profile by IEF but a normal profile by SELDI-TOF-MS analysis was shown to have an
amino acid polymorphism by sequencing
transferrin by quadrupole-TOF MS. Complete agreement was obtained between analysis of immunocaptured
transferrin by SELDI-TOF-MS and the IEF profile of
transferrin, the clinical severity of the disease and the levels of
aspartylglucosaminidase activity (a
surrogate marker for the diagnosis of CDG-I). SELDI-TOF-MS of
transferrin immunocaptured on
protein chip arrays is a highly sensitive diagnostic method for CDG-I, which could be fully automated using microtitre plates and robotics.