Genetic disorders of dolichol synthesis and utilization

The polyisoprenoid lipid dolichol is critical for eukaryotic glycosylation. It is used as the membrane anchor for mono- or oligosaccharides transferred during N-glycosylation, O/C-mannosylation and glycosylphosphatidylinositol anchor biosynthesis. Disorders affecting the synthesis or utilization of dolichol cause defective glycosylation and are therefore classified as Congenital Disorders of Glycosylation (CDG). CDG are a group of approximately 200 mostly autosomal recessive inherited metabolic disorders characterized by defective glycosylation of proteins and lipids. Through recently identified defects, we have gained new insights into dolichol synthesis, important to understand the pathological mechanisms in affected patients. This review provides an overview of dolichol synthesis and utilization and an update on CDG caused by disruption of these processes. Finally, we discuss the existing biomarkers for diagnosis of these disorders and the potential for effective therapies.