Unraveling A4GALT Mechanism and Its Modulation With Adamantyl‐Galactosylceramide Analogues: Advancing Fabry Disease Therapeutic Strategies

N Nicky de Koster (Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands) Òscar Vidal‐Gironès (Departament De Química Inorgànica i Orgànica (Secció de Química Orgànica) and Institut de Química Teòrica i Computacional (IQTCUB) Universitat de Barcelona Barcelona Spain) R Rowan de Graaf (Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands) K Ken Kok (Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands) L Lindsey T. Lelieveld (Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands) J Jackelien Hoogervorst (Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands) M Maria J. Ferraz (Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University) J José Pablo Rivas‐Fernández (Departament De Química Inorgànica i Orgànica (Secció de Química Orgànica) and Institut de Química Teòrica i Computacional (IQTCUB) Universitat de Barcelona Barcelona Spain) R Rob F. Lammers (Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands) H Herman S. Overkleeft (Leiden Institute of Chemistry) J Johannes M. F. G. Aerts (Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University) R Rolf G. Boot (Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands) C Carme Rovira (Departament de Química Inorgànica i Orgànica (Secció de Química Orgànica) and Institut de Química Teòrica i Computacional (IQTCUB)) M Marta Artola (Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University)

Abstract

ABSTRACT Fabry disease (FD), one of the most prevalent lysosomal storage disorders in Europe, is caused by mutations in the GLA gene leading to deficient α‐galactosidase A activity with lysosomal accumulation of globotriaosylceramide (Gb3). Enzyme replacement therapy (ERT) and pharmacological chaperone therapy (PCT) are used in the clinic to treat FD but are limited in efficacy, underscoring the need for alternative therapeutic strategies. Inhibiting α‐1,4‐galactosyltransferase (A4GALT), the glycosyltransferase responsible for Gb3 biosynthesis, represents an attractive strategy. Here, we reveal the molecular mechanism of human A4GALT at atomic detail using QM/MM simulations. We reveal a conformational rearrangement involving a 3 10 ‐helix that stabilizes the donor substrate and promotes a front‐face S N i‐like catalytic mechanism, in which a short‐lived oxocarbenium‐ion intermediate forms. The simulations informed the synthesis of a panel of glycosylceramide substrate analogues. Among these, AdaGalCer (Ada = adamantyl) proved able to reduce Gb3 production in fibroblasts while simultaneously being converted by A4GALT into the galactosylated product AdaGb2. These results provide a clear path towards inhibiting A4GALT, paving the way for potential new and effective FD therapeutics.

Article Details

Volume / Issue Vol. 1, Issue 1
Published August 06, 2026
ISSN 1433-7851
Publisher Wiley

Journal Info

Angewandte Chemie International Edition

Wiley

ISSN: 1433-7851 Physical Sciences

Authors (14)

N

Nicky de Koster

Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands

Òscar Vidal‐Gironès

Departament De Química Inorgànica i Orgànica (Secció de Química Orgànica) and Institut de Química Teòrica i Computacional (IQTCUB) Universitat de Barcelona Barcelona Spain

R

Rowan de Graaf

Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands

K

Ken Kok

Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands

L

Lindsey T. Lelieveld

Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands

J

Jackelien Hoogervorst

Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands

M

Maria J. Ferraz

Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University

J

José Pablo Rivas‐Fernández

Departament De Química Inorgànica i Orgànica (Secció de Química Orgànica) and Institut de Química Teòrica i Computacional (IQTCUB) Universitat de Barcelona Barcelona Spain

R

Rob F. Lammers

Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands

H

Herman S. Overkleeft

Leiden Institute of Chemistry

J

Johannes M. F. G. Aerts

Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University

R

Rolf G. Boot

Department of Medical Biochemistry and Department of Bio‐organic Synthesis Leiden Institute of Chemistry (LIC) Leiden University Leiden the Netherlands

C

Carme Rovira

Departament de Química Inorgànica i Orgànica (Secció de Química Orgànica) and Institut de Química Teòrica i Computacional (IQTCUB)

M

Marta Artola

Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University