Generation of cattle knockout for galactose-α1,3-galactose and N-glycolylneuraminic acid antigens

Xenotransplantation. 2019 Sep;26(5):e12524. doi: 10.1111/xen.12524. Epub 2019 May 22.


Two well-characterized carbohydrate epitopes are absent in humans but present in other mammals. These are galactose-α1,3-galactose (αGal) and N-glycolylneuraminic acid (Neu5Gc) which are introduced by the activities of two enzymes including α(1,3) galactosyltransferase (encoded by the GGTA1 gene) and CMP-Neu5Gc hydroxylase (encoded by the CMAH gene) that are inactive in humans but present in cattle. Hence, bovine-derived products are antigenic in humans who receive bioprosthetic heart valves (BHVs) or those that suffer from red meat syndrome. Using programmable nucleases, we disrupted (knockout, KO) GGTA1 and CMAH genes encoding for the enzymes that catalyse the synthesis of αGal and Neu5Gc, respectively, in both male and female bovine fibroblasts. The KO in clonally selected fibroblasts was detected by polymerase chain reaction (PCR) and confirmed by Sanger sequencing. Selected fibroblasts colonies were used for somatic cell nuclear transfer (SCNT) to produce cloned embryos that were implanted in surrogate recipient heifers. Fifty-three embryos were implanted in 33 recipients heifers; 3 pregnancies were carried to term and delivered 3 live calves. Primary cell cultures were established from the 3 calves and following molecular analyses confirmed the genetic deletions. FACS analysis showed the double-KO phenotype for both antigens confirming the mutated genotypes. Availability of such cattle double-KO model lacking both αGal and Neu5Gc offers a unique opportunity to study the functionality of BHV manufactured with tissues of potentially lower immunogenicity, as well as a possible new clinical approaches to help patients with red meat allergy syndrome due to the presence of these xenoantigens in the diet.

Keywords: CMAH; GGTA1; Neu5Gc; bioprosthetic Heart Valve (BHV); cattle; knockout; xenotransplantation; αGal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Animals, Genetically Modified*
  • Antigens, Heterophile / immunology
  • Antigens, Heterophile / metabolism*
  • Bioprosthesis
  • Cattle
  • Cytidine Monophosphate / analogs & derivatives*
  • Cytidine Monophosphate / immunology
  • Cytidine Monophosphate / metabolism
  • Female
  • Fibroblasts / immunology
  • Food Hypersensitivity / immunology
  • Galactose / immunology
  • Galactose / metabolism*
  • Galactosyltransferases / deficiency
  • Galactosyltransferases / genetics*
  • Gene Knockout Techniques*
  • Heart Valve Prosthesis
  • Humans
  • Male
  • Mixed Function Oxygenases / deficiency
  • Mixed Function Oxygenases / genetics*
  • Neuraminic Acids / immunology
  • Neuraminic Acids / metabolism*
  • Transplantation, Heterologous


  • Antigens, Heterophile
  • Neuraminic Acids
  • cytidine monophosphate-N-glycoloylneuraminic acid
  • Mixed Function Oxygenases
  • CMPacetylneuraminate monooxygenase
  • Galactosyltransferases
  • Cytidine Monophosphate
  • Galactose

Supplementary concepts

  • red meat allergy