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Typical tumor-associated carbohydrate antigens are two carbohydrate structures named sialyl Lewis a and sialyl Lewis x. Sialyl Lewis a (also known as CA19.9) is a tetrasaccharide, which is selectively and highly expressed on advanced adenocarcinomas including colon, stomach, and pancreatic cancers. The expression of sialyl Lewis a antigen is associated with tumor progression. A gradual increase in the amount of sialyl Lewisa was found in the colon and rectum during neoplastic transformation and progression. Moreover, it has long been considered an attractive target for active and passive vaccination. Sialyl Lewis a serves as a ligand for vascular cell adhesion molecule E-selectin/P-selectin and plays an important role in the binding of several types of cancer cells to vascular endothelium and the subsequent formation of metastases. As the result, sialyl Lewis a remains the most consolidated and used carbohydrate tumor marker.
The biosynthesis of sialylated Lewis antigens (sialyl Lewis a and sialyl Lewis x) requires first the α2,3-sialylation of Gal prior toα-1,3/4-fucosylation. ST3Gal III, preferentially acting on type 1 rather than on type 2 disaccharides, is involved in sialyl Lewis a synthesis. For the subsequent fucosylation, FucT III is the main enzyme involved in the biosynthesis of sialyl Lewis a.
Fig.1 Structure of sialyl Lewis a antigen. (Martinez-Duncker, 2011)
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