Plasma membrane derived glycosphingolipids (GSLs) destined for digestion are internalized through the endocytic pathway and delivered to the lysosomes. There, GSLs are degraded by the action of exohydrolases, which are supported, in the case of GSLs with short oligosaccharide chains, by sphingolipid activator proteins (SAPs). Four of the SAPs, SAP-A to -D (also called saposins) are synthesized from a single precursor protein (pSAP). Intracellular routing of pSAP and of the GM2 activator protein is only in part dependent on mannose-6-phosphate residues. Their endocytosis occurs in a carbohydrate-independent manner. The inherited deficiencies of individual activators, the GM2 activator, SAP-B, and SAP-C, as well as the deficiency of the precursor pSAP give rise to different, neuronal, white matter or visceral sphingolipid storage diseases. The analysis of cultured fibroblasts from corresponding patients suggests a new model for the topology of endocytosis and lysosomal digestion. It supports the hypothesis that endocytosis of plasma membrane-derived lipids occurs via small intraendosomal and intralysosomal vesicles and membrane structures, that are then digested within the lysosomes. In combined activator protein deficient cells nondegradable GSLs on the surface of intralysosomal vesicles protect them against lysosomal digestion. Mice with disrupted genes for activator proteins (SAP precursor -/-, GM2A -/-) as well as disrupted genes for ganglioside GM2 degrading hexosaminidases (HEXA -/-, HEXB -/-) turned out to be useful models for known human diseases whereas double knock out mice (HEXA -/- and HEXB -/-) show a new phenotype of both mucopolysaccharidosis and gangliosidosis.
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