Restoration of Alpha Dystroglycan Glycosylation in Disease Models of Fukuyama Muscular Dystrophy

SUMMARY Fukuyama congenital muscular dystrophy (FCMD) is a severe, intractable genetic disease that affects the skeletal muscle, eyes, and brain and is attributed to a defect in alpha dystroglycan (αDG) O-mannosyl glycosylation. We previously established disease models of FCMD; however, they did not fully recapitulate the phenotypes observed in human patients. In this study, we generated induced pluripotent stem cells (iPSCs) from a human FCMD patient and differentiated these cells into three-dimensional brain organoids and skeletal muscle. The brain organoids successfully mimicked patient phenotypes not reliably reproduced by existing models, including decreased αDG glycosylation and abnormal radial glial cell (RG) fiber migration. The basic polycyclic compound Mannan-007 (Mn007) restored αDG glycosylation in all models tested and partially rescued the abnormal RG migration observed in cortical organoids. Therefore, our study underscores the importance of αDG O -mannosyl glycans for normal RG architecture and proper neuronal migration in corticogenesis.