AU2012206984A1 - Diagnosis and treatment of multiple sulfatase deficiency and other using a formylglycine generating enzyme (FGE) - Google Patents

Abstract

C4XRPribKDCCDYSU 114364_I.DOC-9tWs/01 This invention relates to methods and compositions for the diagnosis and treatment of Multiple Sulfatase Deficiency (MSD) as well as other sulfatase deficiencies. More specifically, the invention relates to isolated molecules that modulate post-translational modifications on sulfatases. Such modifications are essential for proper sulfatase function.

Description

P/00/0l Regulaion 3.2 AUSTRALIA Patents Act 1990 COMPLETE SPECIFICATION STANDARD PATENT (ORIGINAL) Name of Applicant: Shire Human Genetic Therapies, Inc. of 500 Patriot Way, Lexington, Massachusetts 02421, United States of America Actual Inventors: Kurt VON FIGURA, Bernhard SCHMIDT, Thomas DIERKS, Michael W HEARTLEIN, Andrea BALLABIO, Maria Pia COSMA Address for Service: DAVIES COLLISON CAVE, Patent & Trademark Attorneys, of 1 Nicholson Street, Melbourne, 3000, Victoria, Australia Ph: 03 9254 2777 Fax: 03 9254 2770 Attorney Code: DM Invention Title: "Diagnosis and treatment of multiple sulfatase deficiency and other using a formylglycine generating enzyme (FGE)" The following statement is a full description of this invention, including the best method of performing it known to us:- DIAGNOSIS AND TREATMENT OF MULTIPLE SULFATASE EFFICIENCYY AN) OT11ER USING A FORMYLGLYCINE GENERATING ENZYME (FGE) This application is a divisional of Australian Application No. 2010212261. the entire contents of which are incorporated herein by referCnce. 1W of the Invendon This invention relates to methods and compositions for the diagnosis and treatment of . Multiple Sulfatase Deficiency (MSD) as well as other sulfatase deficiencies. More zo specifically, the invention relates to isolated molecules that modulate post-translational modifications on sulfatases. Such modifications are essential for proper sulfatase function. Background of the Invention Sulfatases are members of a highly conserved gene family, sharing extensive 15 sequence homology (Franco, B., et al., Cell, 1995, 81:15-25; Parenti, G., et al., Curr. Opin. Gen. Dev., 1997, 7:386-391), a high degree of structural similarity (Bond, C.S., et al., Structure, 1997, 5:277-289; Lukatela, G., et aL., Biochemistry, 1998, 37:3654-64), and a unique post-translational modification that is essential for sulfate ester cleavage (Schmidt, B., et al., Cell, 1995, 82:271-278; Selnmer, T., et al., Eur. J. Biochem., 1996, 238:341-345). The 2o post-translational modification involves the oxidation of a conserved cysteine (in eukaryotes) or serine (in certain prokaryotes) residue, at Cp, yielding L-Ca-formylglycine (a.ka. FGly; 2 amino-3-oxopropanoic acid) in which an aldehyde group replaces the thiomethyl group of the side chain. The aldehyde is an essential part of the catalytic site of the sulfatase and likely acts as an aldehyde hydrate. One of the geminal hydroxyl groups accepts the sulfate during 25 sulfate ester cleavage leading to the formation of a covalently sulfated enzyme intermediate. The other hydroxyl is required for the subsequent elimination of the sulfate and regeneration of the aldehyde group. This modification occurs in the endoplasmic reticulum during, or shortly after, import of the nascent sulfatase polypeptide and is directed by a short linear sequence surrounding the cysteine (or serine) residue to be modified. This highly conserved 30 sequence is hexapeptide IJV-C(S)-X-P-S-R (SEQ ID NO:32), present in the N-terminal region of all eukaryotic sulfatases and most frequently carries a hydroxyl or thiol group on residue X (Dierks, T., et al., Proc. Nati. Acad. Sci. U. S. A., 1997, 94:11963-11968). To date thirteen sulfatase genes have been identified in humans. They encode enzymes with different substrate specificity and subcellular localization such as lysosomes, 35 Golgi and ER. Four of these genes, ARSC, ARSD, ARSE, and ARSF, encoding arylsulfatase WO 2004/072275 PCT/US2004/003632 -2 C, D, E and F, respectively, are located within the same chromosomal region (Xp22.3). They share significant sequence similarity and a nearly identical genomic organization, indicating that they arose from duplication events that occurred recently during evolution (Franco B, et al., Cell, 1995, 81:15-25; Meroni G, et al., Hum Mol Genet, 1996, 5:423-3 1). 5 The importance of sulfatases in human metabolism is underscored by the identification of at least eight human monogenic diseases caused by the deficiency of individual sulfatase activities. Most of these conditions are lysosomal storage disorders in which phenotypic consequences derive from the type and tissue distribution of the stored material. Among them are five different types of mucopolysaccharidoses (MPS types I, IIA, 10 IlD, IVA, and VI) due to deficiencies of sulfatases acting on the catabolism of glycosaminoglycans (Neufeld and Muenzer, 2001, The mucopolysaccharidoses, In The Metabolic and Molecular Bases of Inherited Disease, C.R. Scriver, A.L. Beaudet, W.S. Sly, D. Valle, B. Childs, K.W. Kinzler and B. Vogelstein, eds. New York: Mc Graw-Hill, pp. 3421-3452), and metachromatic leukodystrophy (MLD), which is characterized by the 15 storage of sulfolipids in the central and peripheral nervous systems leading to severe and progressive neurologic deterioration. Two additional human diseases are caused by deficiencies of non-lysosomal sulfatases. These include X-linked ichthyosis, a skin disorder due to steroid sulfatase (STS/ARSC) deficiency, and chondrodysplasia punctata, a disorder affecting bone and cartilage due to arylsulfatase E (ARSE) deficiency. Sulfatases are also 20 implicated in drug-induced human malformation syndromes, such as Warfarin embryopathy, caused by inhibition of ARSE activity due to in utero exposure to warfarin during pregnancy. In an intriguing human monogenic disorder, multiple sulfatase deficiency (MSD), all sulfatase activities are simultaneously defective. Consequently, the phenotype of this severe multisystemic disease combines the features observed in individual sulfatase deficiencies. 25 Cells from patients with MSD are deficient in sulfatase activities even after transfection with cDNAs encoding human sulfatases, suggesting the presence of a common mechanism required for the activity of all sulfatases (Rommerskirch and von Figura, Proc. Natl. Acad. Sci., USA, 1992, 89:2561-2565). The post-translational modification of sulfatases was found to be defective in one patient with MSD, suggesting that this disorder is caused by a mutation 30 in a gene, or genes, implicated in the cysteine-to-formylglycine conversion machinery (Schmidt, B., et al., Cell, 1995, 82:271-278). In spite of intense biological and medical interest, efforts aimed at the identification of this gene(s) have been hampered by the rarity of MSD patients and consequent lack of suitable familial cases to perform genetic mapping.

WO 2004/072275 PCT/US2004/003632 -3 Summary of the Invention This invention provides methods and compositions for the diagnosis and treatment of Multiple Sulfatase Deficiency (MIM 272200), and the treatment of other sulfatase deficiencies. More specifically, we have identified a gene that encodes Formylglycine s Generating Enzyme (FGE), an enzyme responsible for the unique post-translational modification occurring on sulfatases that is essential for sulfatase function (formation of L Ca-formylglycine; a.k.a. FGly and/or 2-amino-3-oxopropanoic acid). It has been discovered, unexpectedly, that mutations in the FGE gene lead to the development of Multiple .Sulfatase Deficiency (MSD) in subjects. It has also been discovered, unexpectedly, that FGE enhances 10 the activity of sulfatases, including, but not limited to, Iduronate 2-Sulfatase, Sulfamidase, N Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, and HSulf-6. In view of these discoveries, the molecules of the present invention can be used in the diagnosis and treatment 15 of Multiple Sulfatase Deficiency as well as other sulfatase deficiencies. Methods for using the molecules of the invention in the diagnosis of Multiple Sulfatase Deficiency, are provided. Additionally, methods for using these molecules in vivo or in vitro for the purpose of modulating FGly formation on sulfatases, methods for treating conditions associated with 20 such modification, and compositions useful in the preparation of therapeutic preparations for the treatment of Multiple Sulfatase Deficiency, as well as other sulfatase deficiencies, are also provided. The present invention thus involves, in several aspects, polypeptides modulating FGly formation on sulfatases, isolated nucleic acids encoding those polypeptides, functional 25 modifications and variants of the foregoing, useful fragments of the foregoing, as well as therapeutics and diagnostics, research methods, compositions and tools relating thereto. According to one aspect of the invention, an isolated nucleic acid molecule selected from the group consisting of: (a) nucleic acid molecules which hybridize under stringent conditions to a molecule consisting of a nucleotide sequence set forth as SEQ ID NO: 1 and 30 which code for a Formylglycine Generating Enzyme (FGE) polypeptide having Ca formylglycine generating activity, (b) nucleic acid molecules that differ from the nucleic acid molecules of (a) in codon sequence due to the degeneracy of the genetic code, and (c) complements of (a) or (b), is provided. In certain embodiments, the isolated nucleic acid molecule comprises the nucleotide sequence set forth as SEQ ID NO:1. In some WO 2004/072275 PCT/US2004/O32 4 embodiments, the isolated nucleic acid molecule consists of the nucleotide sequence set forth as SEQ ID NO:3 or a fragment thereof. The invention in another aspect provides an isolated nucleic acid molecule selected from the group consisting of (a) unique fragments of a nucleotide sequence set forth as SEQ 5 ID NO:1, and (b) complements of (a), provided that a unique fragment of (a) includes a sequence of contiguous nucleotides which is not identical to any sequence selected from the sequence group consisting of: (1) sequences identical to SEQ ID NO. 4 and/or nucleotides 20-1141 of SEQ ID NO. 4, and (2) complements of (1). In any of the foregoing embodiments, complements refer to full-length complements. 10 In one embodiment, the sequence of contiguous nucleotides is selected from the group consisting of (1) at least two contiguous nucleotides nonidentical to the sequence group, (2) at least three contiguous nucleotides nonidentical to the sequence group, (3) at least four contiguous nucleotides nonidentical to the sequence group, (4) at least five contiguous nucleotides nonidentical to the sequence group, (5) at least six contiguous nucleotides 15 nonidentical to the sequence group, and (6) at least seven contiguous nucleotides nonidentical to the sequence group. In another embodiment, the fragment has a size selected from the group consisting of at least: 8 nucleotides, 10 nucleotides, 12 nucleotides, 14 nucleotides, 16 nucleotides, 18 nucleotides, 20, nucleotides, 22 nucleotides, 24 nucleotides, 26 nucleotides, 28 nucleotides, 20 30 nucleotides, 40 nucleotides, 50 nucleotides, 75 nucleotides, 100 nucleotides, 200 nucleotides, 1000 nucleotides and every integer length therebetween. According to another aspect, the invention provides expression vectors, and host cells transformed or transfected with such expression vectors, comprising the nucleic acid molecules described above. 25 According to still another aspect, the invention provides cells expressing activated forms of the endogenous FGE gene. In one embodiment, activation of the endogenous FGE gene occurs via homologous recombination. According to another aspect of the invention, an isolated polypeptide is provided. The isolated polypeptide is encoded by the foregoing nucleic acid molecules of the invention. 30 In some embodiments, the isolated polypeptide is encoded by the nucleic acid of SEQ ID NO:1, giving rise to a polypeptide having the sequence of SEQ ID NO:2 that has Ccr formylglycine generating activity. In other embodiments, the isolated polypeptide may be a fragment or variant of the foregoing of sufficient length to represent a sequence unique within the human genome, and identifying with a polypeptide that has C-formylglycine generating WO 2004/072275 PCT/US2004/003632 -5 activity, provided that the fragment includes a sequence of contiguous amino acids which is not identical to any sequence encoded for by a nucleic acid sequence having SEQ ID NO. 4. In another embodiment, immunogenic fragments of the polypeptide molecules described above are provided. The immunogenic fragments may or may not have Ca-formylglycine 5 generating activity. According to another aspect of the invention, isolated binding polypeptides are provided which selectively bind a polypeptide encoded by the foregoing nucleic acid molecules of the invention. Preferably the isolated binding polypeptides selectively bind a polypeptide which comprises the sequence of SEQ ID NO:2, fragments thereof, or a 10 polypeptide belonging to the family of isolated polypeptides having Ceformylglycine generating activity described elsewhere herein. In preferred embodiments, the isolated binding polypeptides include antibodies and fragments of antibodies (e.g., Fab, F(ab)2, Fd and antibody fragments which include a CDR3 region which binds selectively to the FGE polypeptide). In certain embodiments, the antibodies are human. In some embodiments, the 15 antibodies are monoclonal antibodies. In one embodiment, the antibodies are polyclonal antisera. In further embodiments, the antibodies are humanized. In yet further embodiments, the antibodies are chimeric. According to another aspect of the invention, a family of isolated polypeptides having Ca-formylglycine generating activity, are provided. Each of said polypeptides comprises 20 from amino terminus to carboxyl terminus: (a) an amino-terminal subdomain 1; a subdomain 2; a carboxy-terminal subdomain 3 containing from 35 to 45 amino acids; and wherein subdomain 3 has at least about 75% homology and a length approximately equal to subdomain 3 of a polypeptide selected from the group consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78. In important embodiments, 25 subdomain 2 contains from 120 to 140 amino acids. In further important embodiments, at least 5% of the amino acids of subdomain 2 are Tryptophans. In some embodiments, subdomain 2 has at least about 50% homology to subdomain 2 of a polypeptide selected from the group consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78. In certain embodiments, subdomain 3 of each of the polypeptides has at 30 least between about 80% and about 100% homology to subdomain 3 of a polypeptide selected from the group consisting of SEQ ID NO. 2, 5, 46,48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78. According to a further aspect of the invention, a method for determining the level of FGE expression in a subject, is provided. The method involves measuring expression of FGE WO 2004/072275 PCT/US2004/00363 2 -6 in a test sample from a subject to determine the level of FGE expression in the subject. In certain embodiments, the measured FGE expression in the test sample is compared to FGE expression in a control containing a known level of FGE expression. Expression is defined as FGE mRNA expression, FGE polypeptide expression, or FGE Ca-formylglycine generating 5 activity as defined elsewhere herein. Various methods can be used to measure expression. Preferred embodiments of the invention include PCR and Northern blotting for measuring mRNA expression, FGE monoclonal antibodies or FGE polyclonal antisera as reagents to measure FGE polypeptide expression, as well as methods for measuring FGE Ca formylglycine generating activity. 10 In certain embodiments, test samples such as biopsy samples, and biological fluids such as blood, are used as test samples. FGE expression in a test sample of a subject is compared to FGE expression in control. According to another aspect of the invention, a method for identifying an agent useful in modulating Ca-formylglycine generating activity of a molecule, is provided. The method 15 involves (a) contacting a molecule having Ca-formylglycine generating activity with a candidate agent, (b) measuring Ca-formylglycine generating activity of the molecule, and (c) comparing the measured Ca-formylglycine generating activity of the molecule to a control to determine whether the candidate agent modulates Ca-formylglycine generating activity of the molecule, wherein the molecule is a nucleic acid molecule having the nucleotide sequence 20 selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87, or an expression product thereof (e.g., a peptide having a sequence selected from the group consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78). In certain embodiments, the control is Ca formylglycine generating activity of the molecule measured in the absence of the candidate 25 agent. According to still another aspect of the invention, a method of diagnosing Multiple Sulfatase Deficiency in a subject, is provided. The method involves contacting a biological sample from a subject suspected of having Multiple Sulfatase Deficiency with an agent, said agent specifically binding to a molecule selected from the group consisting of: (i) a FGE 30 nucleic acid molecule having the nucleotide sequence of SEQ ID NO: 1, 3, or 4, (ii) an expression product of the nucleic acid molecule of (i), or (iii) a fragment of the expression product of (ii); and measuring the amount of bound agent and determining therefrom if the WO 2004/072275 PCT/US2004/003632 -7 expression of said nucleic acid molecule or of an expression product thereof is aberrant, aberrant expression being diagnostic of the Multiple Sulfatase Deficiency in the subject. According to still another aspect of the invention, a method for diagnosing a condition characterized by aberrant expression of a nucleic acid molecule or an expression product s thereof, is provided. The method involves contacting a biological sample from a subject with an agent, wherein said agent specifically binds to said nucleic acid molecule, an expression product thereof, or a fragment of an expression product thereof; and measuring the amount of bound agent and determining therefrom if the expression of said nucleic acid molecule or of an expression product thereof is aberrant, aberrant expression being diagnostic of the 10 condition, wherein the nucleic acid molecule has the nucleotide sequence of SEQ ID NO: 1 and the condition is Multiple Sulfatase Deficiency. According to another aspect of the invention, a method for determining Multiple Sulfatase Deficiency in a subject characterized by aberrant expression of a nucleic acid molecule or an expression product thereof, is provided. The method involves monitoring a 15 sample from a patient for a parameter selected from the group consisting of (i) a nucleic acid molecule having the nucleotide sequence of SEQ ID NO: 1, 3, 4, or a nucleic acid molecule having a sequence derived from the FEG genomic locus, (ii) a polypeptide encoded by the nucleic acid molecule, (iii) a peptide derived from the polypeptide, and (iv) an antibody which selectively binds the polypeptide or peptide, as a determination of Multiple Sulfatase 20 Deficiency in the subject. In some embodiments, the sample is a biological fluid or a tissue as described in any of the foregoing embodiments. In certain embodiments the step of monitoring comprises contacting the sample with a detectable agent selected from the group consisting of (a) an isolated nucleic acid molecule which selectively hybridizes under stringent conditions to the nucleic acid molecule of (i), (b) an antibody which selectively 25 binds the polypeptide of (ii), or the peptide of (iii), and (c) a polypeptide or peptide which binds the antibody of (iv). The antibody, polypeptide, peptide, or nucleic acid can be labeled with a radioactive label or an enzyme. In further embodiments, the method further comprises assaying the sample for the peptide. According to another aspect of the invention, a kit is provided. The kit comprises a 3o package containing an agent that selectively binds to any of the foregoing FGE isolated nucleic acids, or expression products thereof, and a control for comparing to a measured value of binding of said agent any of the foregoing FGE isolated nucleic acids or expression products thereof. In some embodiments, the control is a predetermined value for comparing to the measured value. In certain embodiments, the control comprises an epitope of the WO 2004/072275 PCTIUS2004/003632 -8 expression product of any of the foregoing FGE isolated nucleic acids. In one embodiment, the dt further comprises a second agent that selectively binds to a polypeptide selected from the group consisting of Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosamine 6 Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase s C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, and HSulf-6, or a peptide thereof, and a control for comparing to a measured value of binding of said second agent to said polypeptide or peptide thereof. According to a further aspect of the invention, a method of treating Multiple Sulfatase Deficiency, is provided. The method involves administering to a subject in need of such 10 treatment an agent that modulates Ca-formylglycine generating activity, in an amount effective to treat Multiple Sulfatase Deficiency in the subject. In some embodiments, the method further comprises co-administering an agent selected from the group consisting of a nucleic acid molecule encoding Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, 15 Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, or HSulf-6, an expression product of the nucleic acid molecule, and a fragment of the expression product of the nucleic acid molecule. In certain embodiments, the agent that modulates Cm-formylglycine generating activity is an isolated nucleic acid molecule of the invention (e.g., a nucleic acid molecule as claimed in Claims 1 20 8, or a nucleic acid having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87). In important embodiments, the agent that modulates C-formylglycine generating activity is a peptide of the invention (e.g., a peptide as claimed in Claims 11-15, 19, 20, or a peptide having a sequence selected from the group consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 25 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78). The agent that modulates CM-formylglycine generating activity may be produced by a cell expressing an endogenous and/or exogenous FGE nucleic acid molecule. In important embodiments, the endogenous FGE nucleic acid molecule may be activated. According to one aspect of the invention, a method for for increasing Cor 30 formylglycine generating activity in a subject, is provided. The method involves administering an isolated FGE nucleic acid molecule of the invention (e.g., a nucleic acid molecule as claimed in Claims 1-8, or a nucleic acid having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, WO 2004/072275 PCT/US2004/00363 2 -9 73, 75, 77, and 80-87), and/or an expression product thereof, to a subject, in an amount effective to increase Ca-formylglycine generating activity in the subject. According to one aspect of the invention, a method for treating a subject with Multiple Sulfatase Deficiency, is provided. The method involves administering to a subject 5 in need of such treatment an agent that modulates Cformylglycine generating activity, in an amount effective to increase Ca-formylglycine generating activity in the subject. In some embodiments, the agent that modulates Ca-formylglycine generating activity is a sense nucleic acid of the invention (e.g., a nucleic acid molecule as claimed in Claims 1-8, or a nucleic acid having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 10 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87). In certain embodiments, the agent that modulates Ca-formylglycine generating activity is an isolated polypeptide of the invention (e.g., a polypeptide as claimed in Claims 11-15, 19, 20, or a peptide having a sequence selected from the group consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78). 15 According to still another aspect of the invention, a method for increasing Cx formylglycine generating activity in a cell, is provided. The method involves contacting the cell with an isolated nucleic acid molecule of the invention (e.g., a nucleic acid molecule as claimed in Claims 1-8, or a nucleic acid having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 20 80-87), or an expression product thereof, in an amount effective to increase C,-formylglycine generating activity in the cell. In important embodiments, the method involves activating the endogenous FGE gene to increase C,-formylglycine generating activity in the cell. According to a further aspect of the invention, a pharmaceutical composition is provided. The composition comprises an agent comprising an isolated nucleic acid molecule 25 of the invention (e.g., an isolated nucleic acid molecule as claimed in any one of Claims 1-8, an FGE nucleic acid molecule having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87), or an expression product thereof, in a pharmaceutically effective amount to treat Multiple Sulfatase Deficiency, or an expression product thereof, in a pharmaceutically effective 30 amount to treat Multiple Sulfatase Deficiency, and a pharmaceutically acceptable carrier. According to one aspect of the invention, a method for identifying a candidate agent useful in the treatment of Multiple Sulfatase Deficiency, is provided. The method involves determining expression of a set of nucleic acid molecules in a cell or tissue under conditions WO 2004/072275 PCT/US2004/00363 2 -10 which, in the absence of a candidate agent, permit a first amount of expression of the set of nucleic acid molecules, wherein the set of nucleic acid molecules comprises at least one nucleic acid molecule selected from the group consisting of: (a) nucleic acid molecules which hybridize under stringent conditions to a molecule consisting of a nucleotide sequence set 5 forth as SEQ ID NO: 1 and which code for a polypeptide having Ca-formylglycine generating activity (FGE), (b) nucleic acid molecules that differ from the nucleic acid molecules of (a) or (b) in codon sequence due to the degeneracy of the genetic code, (c) a nucleic acid molecule having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87, and (d) complements of (a) or (b) 1c or (c), contacting the cell or tissue with the candidate agent, and detecting a test amount of expression of the set of nucleic acid molecules, wherein an increase in the test amount of expression in the presence of the candidate agent relative to the first amount of expression indicates that the candidate agent is useful in the treatment of the Multiple Sulfatase Deficiency. 15 According to a further aspect of the invention, methods for preparing medicaments useful in the treatment of Multiple Sulfatase Deficiency and/or other sulfatase deficiencies, are provided. According to still another aspect of the invention, a solid-phase nucleic acid molecule array, is provided. The array consists essentially of a set of nucleic acid molecules, 20 expression products thereof, or fragments (of either the nucleic acid or the polypeptide molecule) thereof, each nucleic acid molecule encoding for a polypeptide selected from the group consisting of SEQ ID NO. 2, 5, 46,48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78, Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, 25 Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf 3, HSulf-4, HSulf-5, and HSulf-6, fixed to a solid substrate. In some embodiments, the solid phase array further comprises at least one control nucleic acid molecule. In certain embodiments, the set of nucleic acid molecules comprises at least one, at least two, at least three, at least four, or even at least five nucleic acid molecules, each selected from the group 30 consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78, Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf 3, HSulf-4, HSulf-5, and HSulf-6.

WO 2004/072275 PCT/US2004/003632 -11 According to a further aspect of the invention, a method for treating a sulfatase deficiency in a subject, is provided. The method involves administering to a subject in need of such treatment a sulfatase that has been produced according to the invention, in an amount effective to treat the sulfatase deficiency in the subject and the sulfatase deficiency is not 5 Multiple Sulfatase Deficiency. In important embodiments, the sulfatase is produced by a cell that has been contacted with an an agent that modulates Ca-formylglycine generating activity. In certain embodiments, the sulfatase deficiency includes, but is not limited to, Mucopolysaccharidosis II (MPS II; Hunter Syndrome), Mucopolysaccharidosis IA (MPS 1IA; Sanfilippo Syndrome A), Mucopolysaccharidosis VIII (MPS VI), io Mucopolysaccharidosis IVA (MPS IVA; Morquio Syndrome A), Mucopolysaccharidosis VI (MPS VI; Maroteaux-Lamy Syndrome), Metachromatic Leukodystrophy (MLD), X-linked Recessive Chondrodysplasia Punctata 1, or X-linked Ichthyosis (Steroid Sulfatase Deficiency). In certain embodiments, the agent that modulates Ca-formylglycine generating activity can be a nucleic acid molecule or peptide of the invention. In one embodiment, the 15 sulfatase and the agent that modulates C-formylglycine generating activity are co-expressed in the same cell. The sulfatase and/or the agent that modulates Co-formylglycine generating activity can be endogenous or exogenous in origin. If endogenous in origin it can be activated (e.g., by insertion of strong promoter and/or other elements at the appropriates places known in the art). If exogenous, its expression can be driven by elements on the 20 expression vector, or it can be targeted to appropriated places within the cell genome that will allow for its enhanced expression (e.g., downstream of a strong promoter). According to another aspect of the invention, a pharmaceutical composition, is provided. The composition comprises an agent comprising an isolated nucleic acid molecule of the invention, or an expression product thereof, in a pharmaceutically effective amount to 25 treat a sulfatase deficiency, and a pharmaceutically acceptable carrier. According to a still further aspect of the invention, a method for increasing sulfatase activity in a cell, is provided. The method involves contacting a cell expressing a sulfatase with an isolated nucleic acid molecule of of the invention (e.g., an isolated nucleic acid molecule as claimed in any one of Claims 1-8, an FGE nucleic acid molecule having a 30 sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87), or an expression product thereof (e.g., a polypeptide as claimed in Claims 11-15, 19, 20, or a peptide having a sequence selected from the group consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78), in an amount effective to increase sulfatase activity in the cell. The cell may WO 2004/072275 PCT/US2004/003632 -12 express an endogenous and/or an exogenous sulfatase. In important embodiments, the endogenous sulfatase is activated. In certain embodiments, the sulfatase is Iduronate 2 Sulfatase, Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6 Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase 5 E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, and/or HSulf-6. In certain embodiments the cell is a mammalian cell. According to another aspect of the invention, a pharmaceutical composition, is provided. The composition comprises a sulfatase that is produced by cell, in a pharmaceutically effective amount to treat a sulfatase deficiency, and a pharmaceutically lo acceptable carrier, wherein said cell has been contacted with an agent comprising an isolated nucleic acid molecule of the invention (e.g., as claimed in Claims 1-8, or a nucleic acid molecule having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87), or an expression product thereof (e.g., a peptide selected from the group consisting of SEQ ID NO. 2, 5, 46, 15 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70,72,74,76, and 78). According to still another aspect of the invention, an isolated variant allele of a human FGE gene which encodes a variant FGE polypeptide, is provided. The isolated variant allele comprises an amino acid sequence comprising at least one variation in SEQ ID NO:2, wherein the at least one variation comprises: MetlArg; Met1Val; Leu20Phe; Ser155Pro; 20 Ala177Pro; Cys218Tyr; Arg224Trp; Asn259Ile; Pro266Leu; Ala279Val; Arg327Stop; Cys336Arg; Arg345Cys; Ala348Pro; Arg349Gln; Arg349Trp; Arg349Trp; Ser359Stop; or a combination thereof. According to yet another aspect of the invention, an isolated variant human FGE polypeptide, is provided. The isolated variant human FGE polypeptide comprises an amino 25 acid sequence comprising at least one variation in SEQ ID NO:2, wherein the at least one variation comprises: MetlArg; MetlVal; Leu20Phe; Ser155Pro; Ala177Pro; Cys218Tyr; Arg224Trp; Asn259Ile; Pro266Leu; Ala279Val; Arg327Stop; Cys336Arg; Arg345Cys; Ala348Pro; Arg349Gln; Arg349Trp; Arg349Trp; Ser359Stop; or a combination thereof. Antibodies having any of the foregoing variant human FGE polypeptides as an 30 immunogen are also provided. Such antibodies include polyclonal antisera, monoclonal, chimeric, and can also be detectably labeled. A detectable label may comprise a radioactive element, a chemical which fluoresces, or an enzyme. According to another aspect of the invention, a sulfatase-producing cell wherein the ratio of active sulfatase to total sulfatase produced by the cell is increased, is provided. The WO 2004/072275 PCT/US2004/003632 -13 cell comprises: (i) a sulfatase with an increased expression, and (ii) a Formylglycine Generating Enzyme with an increased expression, wherein the ratio of active sulfatase to total sulfatase (i.e., the specific activity of the sulfatase) produced by the cell is increased by at least 5% over the ratio of active sulfatase to total sulfatase produced by the cell in the absence 5 of the Formylglycine Generating Enzyme. In certain embodiments, the ratio of active sulfatase to total sulfatase produced by the cell is increased by at least 10%, 15%, 20%, 50%, 100%, 200%, 500%, 1000%, over the ratio of active sulfatase to total sulfatase produced by the cell in the absence of the Formylglycine. Generating Enzyme. According to a further aspect of the invention, an improved method for treating a 1o sulfatase deficiency in a subject is provided. The method involves administering to a subject in need of such treatment a sulfatase in an effective amount to treat the sulfatase deficiency in the subject, wherein the sulfatase is contacted with a Formylglycine Generating Enzyme in an amount effective to increase the specific activity of the sulfatase. In an important embodiment, the sulfatase is selected from the group consisting of Iduronate 2-Sulfatase, is Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-l, HSulf-2, HSulf-3, HSulf-4, HSulf-5, and HSulf-6. In certain embodiments, the Formylglycine Generating Enzyme is encoded by a nucleic acid molecule as claimed in Claims 1-8, or a nucleic acid having a sequence selected from the 20 group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87. In some embodiments, the Formylglycine Generating Enzyme is a peptide as claimed in Claims 11-15, 19, 20, or a peptide having a sequence selected from the group consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78. 25 These and other objects of the invention will be described in further detail in connection with the detailed description of the invention. Brief Description of the Sequences SEQ ID NO:1 is the nucleotide sequence of the human FGE cDNA. 30 SEQ ID NO:2 is the predicted amino acid sequence of the translation product of human FGE cDNA (SEQ ID NO:1). SEQ ID NO:3 is the nucleotide sequence of the human FGE cDNA encoding the polypeptide of SEQ ID NO:2 (i.e., nucleotides 20-1141 of SEQ ID NO:1). SEQ ID NO:4 is the nucleotide sequence of GenBank Acc. No. AK075459.

WO 2004/072275 PCTIUS2004/003632 -14 SEQ ID NO:5 is the predicted amino acid sequence of the translation product of SEQ ID NO:4, an unnamed protein product having GenBank Acc.No. BAC11634. SEQ ID NO:6 is the nucleotide sequence of the human Iduronate 2-Sulfatase cDNA (GenBank Acc. No. M58342). 5 SEQ ID NO:7 is the predicted amino acid sequence of the translation product of human Iduronate 2-Sulfatase cDNA (SEQ ID NO:6). SEQ ID NO:8 is the nucleotide sequence of the human Sulfamidase cDNA (GenBank Acc. No. U30894). SEQ ID NO:9 is the predicted amino acid sequence of the translation product of io human Sulfamidase cDNA (SEQ ID NO:8). SEQ ID NO: 10 is the nucleotide sequence of the human N-Acetylgalactosamine 6 Sulfatase cDNA (GenBank Acc. No. U06088). SEQ ID NO: 11 is the predicted amino acid sequence of the translation product of human N-Acetylgalactosamine 6-Sulfatase cDNA (SEQ ID NO:10). 15 SEQ ID NO: 12 is the nucleotide sequence of the human N-Acetylglucosamine 6 Sulfatase cDNA (GenBank Acc. No. Z12173). SEQ ID NO:13 is the predicted amino acid sequence of the translation product of human N-Acetylglucosamine 6-Sulfatase cDNA (SEQ ID NO:12). SEQ ID NO:14 is the nucleotide sequence of the human Arylsulfatase A cDNA 20 (GenBank Acc. No. X52151). SEQ ID NO:15 is the predicted amino acid sequence of the translation product of human Arylsulfatase A cDNA (SEQ ID NO:14). SEQ ID NO:16 is the nucleotide sequence of the human Arylsulfatase B cDNA (GenBank Acc. No. 105225). 25 SEQ ID NO: 17 is the predicted amino acid sequence of the translation product of human Arylsulfatase B cDNA (SEQ ID NO:16). SEQ ID NO: 18 is the nucleotide sequence of the human Arylsulfatase C cDNA (GenBank Acc. No. 104964). SEQ ID NO:19 is the predicted amino acid sequence of the translation product of 30 human Arylsulfatase C cDNA (SEQ ID NO:18). SEQ ID NO:20 is the nucleotide sequence of the human Arylsulfatase D cDNA (GenBank Acc. No. X83572). SEQ ID NO:21 is the predicted amino acid sequence of the translation product of human Arylsulfatase D cDNA (SEQ ID NO:20).

WO 2004/072275 PCT/US2004/00363 2 -15 SEQ ID NO:22 is the nucleotide sequence of the human Arylsulfatase E cDNA (GenBank Acc. No. X83573). SEQ ID NO:23 is the predicted amino acid sequence of the translation product of human Arylsulfatase E cDNA (SEQ ID NO:22). 5 SEQ ID NO:24 is the nucleotide sequence of the human Arylsulfatase F cDNA (GenBank Acc. No. X97868). SEQ ID NO:25 is the predicted amino acid sequence of the translation product of human Arylsulfatase F cDNA (SEQ ID NO:24). SEQ ID NO:26 is the nucleotide sequence of the human Arylsulfatase G cDNA 10 (GenBank Acc.No. BC012375). SEQ ID NO:27 is the predicted amino acid sequence of the translation product of the human Arylsulfatase G (SEQ ID NO:26). SEQ ID NO:28 is the nucleotide sequence of the HSulf-1 cDNA (GenBank Acc.No. AY101175). Is SEQ ID NO:29 is the predicted amino acid sequence of the translation product of HSulf-1 cDNA (SEQ ID NO:28). SEQ ID NO:30 is the nucleotide sequence of the HSulf-2 cDNA (GenBank Acc.No. AY101176). SEQ ID NO:31 is the predicted amino acid sequence of the translation product of 20 HSulf-2 cDNA (SEQ ID NO:30). SEQ ID NO:32 is the highly conserved hexapeptide IJV-FGly-X-P-S-R present on sulfatases. SEQ ID NO:33 is a synthetic FGly formation substrate; its primary sequence is derived from human Arylsulfatase A. 25 SEQ ID NO:34 is scrambled oligopeptide PVSLPTRSCAALLTGR. SEQ ID NO:35 is Ser69 oligopeptide PVSLSTPSRAALLTGR. SEQ ID NO:36 is human FGE-specific primer 1199nc. SEQ ID NO:37 is human FGE-specific forward primer 1c. SEQ ID NO:38 is human FGE-specific reverse primer 1182c. 30 SEQ ID NO:39 is human 5'- FGE-specific primer containing EcoRI site. SEQ ID NO:40 is a HA-specific primer. SEQ ID NO:41 is a c-myc -specific primer. SEQ ID NO:42 is a RGS-His 6 - specific primer.

WO 2004/072275 PCT/US2004/003632 -16 SEQ ID NO:43 is tryptic oligopeptide SQNTPDSSASNLGFR from a human FGE preparation. SEQ ID NO:44 is tryptic oligopeptide MVPIPAGVFTMGTDDPQIK from a human FGE preparation. 5 SEQ ID NO:45 is the nucleotide sequence of the human FGE2 paralog (GenBank GI: 24308053). SEQ ID NO:46 is the predicted amino acid sequence of the translation product of the human FGE2 paralog (SEQ ID NO:45). SEQ ID NO:47 is the nucleotide sequence of the mouse FGE paralog (GenBank GI: 10 26344956). SEQ ID NO:48 is the predicted amino acid sequence of the translation product of the mouse FGE paralog (SEQ ID NO:47). SEQ ID NO:49 is the nucleotide sequence of the mouse FGE ortholog (GenBank GI: 22122361). 15 SEQ ID NO:50 is the predicted amino acid sequence of the translation product of the mouse FGE ortholog (SEQ ID NO:49). SEQ ID NO:51 is the nucleotide sequence of the fruitfly FGE ortholog (GenBank GI: 20130397). SEQ ID NO:52 is the predicted amino acid sequence of the translation product of the 20 fruitfly FGE ortholog (SEQ ID NO:51). SEQ ID NO:53 is the nucleotide sequence of the mosquito FGE ortholog (GenBank GI: 21289310). SEQ ID NO:54 is the predicted amino acid sequence of the translation product of the mosquito FGE ortholog (SEQ ID NO:53). 25 SEQ ID NO:55 is the nucleotide sequence of the closely related S. coelicolor FGE ortholog (GenBank GI: 21225812). SEQ ID NO:56 is the predicted amino acid sequence of the translation product of the S. coelicolor FGE ortholog (SEQ ID NO:55). SEQ ID NO:57 is the nucleotide sequence of the closely related C. efficiens FGE 30 ortholog (GenBank GI: 25028125). SEQ ID NO:58 is the predicted amino acid sequence of the translation product of the C. efficiens FGE ortholog (SEQ ID NO:57). SEQ ID NO:59 is the nucleotide sequence of the N. aromaticivorans FGE ortholog (GenBank GI: 23108562).

WO 2004/072275 PCT/US2004/003632 -17 SEQ ID NO:60 is the predicted amino acid sequence of the translation product of the N. aromaticivorans FGE ortholog (SEQ ID NO:59). SEQ ID NO:61 is the nucleotide sequence of the M. loti FGE ortholog (GenBank GI: 13474559). 5 SEQ ID NO:62 is the predicted amino acid sequence of the translation product of the M. loti FGE ortholog (SEQ ID NO:61). SEQ ID NO:63 is the nucleotide sequence of the B. fungorum FGE ortholog (GenBank GI: 22988809). SEQ ID NO:64 is the predicted amino acid sequence of the translation product of the 10 B. fungorum FGE ortholog (SEQ ID NO:63). SEQ ID NO:65 is the nucleotide sequence of the S. meliloti FGE ortholog (GenBank GI 16264068). SEQ ID NO:66 is the predicted amino acid sequence of the translation product of the S. meliloti FGE ortholog (SEQ ID NO:65). 15 SEQ ID NO:67 is the nucleotide sequence of the Microscilla sp. FGE ortholog (GenBank GI: 14518334). SEQ ID NO:68 is the predicted amino acid sequence of the translation product of the Microscilla sp. FGE ortholog (SEQ ID NO:67). SEQ ID NO:69 is the nucleotide sequence of the P. putida KT2440 FGE ortholog 20 (GenBank GI: 26990068). SEQ ID NO:70 is the predicted amino acid sequence of the translation product of the P. putida KT2440 FOE ortholog (SEQ ID NO:69). SEQ ID NO:71 is the nucleotide sequence of the R. metallidurans FGE ortholog (GenBank GI: 22975289). 25 SEQ ID NO:72 is the predicted amino acid sequence of the translation product of the R. metallidurans FGE ortholog (SEQ ID NO:71). SEQ ID NO:73 is the nucleotide sequence of the P. marinus FGE ortholog (GenBank GE 23132010). SEQ ID NO:74 is the predicted amino acid sequence of the translation product of the 30 P. marinus FGE ortholog (SEQ ID NO:73). SEQ ID NO:75 is the nucleotide sequence of the C. crescentus CB15 FGE ortholog (GenBank GI: 16125425). SEQ ID NO:76 is the predicted amino acid sequence of the translation product of the C. crescentus CB15 FGE ortholog (SEQ ID NO:75).

WO 2004/072275 PCT/US2004/003632 -18 SEQ ID NO:77 is the nucleotide sequence of the M. tuberculosis Ht37Rv FGE ortholog (GenBank GI: 15607852). SEQ ID NO:78 is the predicted amino acid sequence of the translation product of the M. tuberculosis Ht37Rv FGE ortholog (SEQ ID NO:77). s SEQ ID NO:79 is the highly conserved heptapeptide present on subdomain 3 of FGE orthologs and paralogs. SEQ ID NO:80 is the nucleotide sequence of FGE ortholog EST fragment having GenBank Acc. No.: CA379852. SEQ ID NO:81 is the nucleotide sequence of FGE ortholog EST fragment having 10 GenBank Acc. No.: A1721440. SEQ ID NO:82 is the nucleotide sequence of FGE ortholog EST fragment having GenBank Acc. No.: BJ505402. SEQ ID NO:83 is the nucleotide sequence of FGE ortholog EST fragment having GenBank Acc. No.: BJ054666. 15 SEQ ID NO:84 is the nucleotide sequence of FGE ortholog EST fragment having GenBank Acc. No.: AL892419. SEQ ID NO:85 is the nucleotide sequence of FGE ortholog EST fragment having GenBank Acc. No.: CA064079. SEQ ID NO:86 is the nucleotide sequence of FGE ortholog EST fragment having 20 GenBank Acc. No.: BF189614. SEQ ID NO:87 is the nucleotide sequence of FGE ortholog EST fragment having GenBank Acc. No.: AV609121. SEQ ID NO:88 is the nucleotide sequence of the HSulf-3 cDNA. SEQ ID NO:89 is the predicted amino acid sequence of the translation product of 25 HSulf-3 cDNA (SEQ ID NO:88). SEQ ID NO:90 is the nucleotide sequence of the HSulf-4 cDNA. SEQ ID NO:91 is the predicted amino acid sequence of the translation product of HSulf-4 cDNA (SEQ ID NO:90). SEQ ID NO:92 is the nucleotide sequence of the HSulf-5 cDNA. 30 SEQ ID NO:93 is the predicted amino acid sequence of the translation product of HSulf-5 cDNA (SEQ ID NO:92). SEQ ID NO:94 is the nucleotide sequence of the HSulf-6 cDNA. SEQ ID NO:95 is the predicted amino acid sequence of the translation product of HSulf-6 cDNA (SEQ ID NO:94).

WO 2004/072275 PCT/US2004/003632 -19 Brief Description of the DrawIn2s Fig. 1: A MALDI-TOF mass spectra schematic of P23 after incubation in the absence (A) or presence (B) of a soluble extract from bovine testis microsomes. Fig. 2: A phylogenetic tree derived from an alignment of human FGE and 21 proteins 5 of the PFAM-DUF323 seed. Fig. 3: Organisation of the human and urine FGE gene locus. Exons are shown to scale as boxes and bright boxes (murine locus). The numbers above the intron lines indicate the size of the introns in kilobases. Fig. 4: Diagram showing a map of FGE Expression Plasmid pXMG.1.3 10 Fig. 5: Bar graph depicting N-Acetylgalactosamine 6-Sulfatase Activity in 36F Cells Transiently Transfected with FGE Expression Plasmid. Fig. 6: Bar graph depicting N-Acetylgalactosamine 6-Sulfatase Specific Activity in 36F Cells Transiently Transfected with FGE Expression Plasmid. Fig. 7: Bar graph depicting N-Acetylgalactosamine 6-Sulfatase Production in 36F 15 Cells Transiently Transfected with FGE Expression Plasmid. Fig. 8: Graph depicting Iduronate 2-Sulfatase Activity in 30C6 Cells Transiently Transfected with FGE Expression Plasmid. Fig. 9: Depicts a kit embodying features of the present invention. 20 Detailed Description of the Invention The invention involves the discovery of the gene that encodes Formylglycine Generating Enzyme (FGE), an enzyme responsible for the unique post-translational modification occurring on sulfatases that is essential for sulfatase function: the formation of 25 L-Ca-formylglycine (a.k.a. FGly and/or 2-amino-3-oxopropanoic acid). It has been discovered, unexpectedly, that mutations in the FGE gene lead to the development of Multiple Sulfatase Deficiency (MSD) in subjects. It has also been discovered, unexpectedly, that FGE enhances the activity of sulfatases, including, but not limited to, Iduronate 2 Sulfatase, Sulfanidase, N-Acetylgalactosaniine 6-Sulfatase, N-Acetylglucosamine 6 30 Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, and HSulf 6, and sulfatases described in U.S. Provisional applications with publication numbers 20030073118, 20030147875, 20030148920, 20030162279, and 20030166283 (the contents of which are expressly incorporated herein). In view of these discoveries, the molecules of WO 2004/072275 PCT/US2004/003632 -20 the present invention can be used in the diagnosis and/or treatment of Multiple Sulfatase Deficiency, as well as the treatment of other sulfatase deficiencies. Methods for using the molecules of the invention in the diagnosis of Multiple Sulfatase Deficiency are provided. 5 Additionally, methods for using these molecules in vivo or in vitro for the purpose of modulating FGly formation on sulfatases, methods for treating conditions associated with such modification, and compositions useful in the preparation of therapeutic preparations for the treatment of Multiple Sulfatase Deficiency as well as other sulfatase deficiencies, are also provided. 10 The present invention thus involves, in several aspects, polypeptides modulating FGly formation on sulfatases, isolated nucleic acids encoding those polypeptides, functional modifications and variants of the foregoing, useful fragments of the foregoing, as well as therapeutics and diagnostics, research methods, compositions and tools relating thereto. "Cwformylglycine generating activity" refers to the ability of a molecule to form, or 15 enhance the formation of, FGly on a substrate. The substate may be a sulfatase as described elsewhere herein, or a synthetic oligopeptide (see, e.g., SEQ ID NO:33, and the Examples). The substrate preferably contains the conserved hexapeptide of SEQ ID NO:32 [JV-C(S)-X P-S-R]. Methods for assaying FGly formation are as described in the art (see, e.g., Dierks, T., et al., Proc. Natd. Acad Sci. U. S. A., 1997, 94:11963-11968), and elsewhere herein (see, 20 e.g., the Examples). A "molecule," as used herein, embraces both "nucleic acids" and "polypeptides." FGE molecules are capable of forming, or enhancing/increasing formation of, FGly both in vivo and in vitro. "Enhancing (or "increasing")" Cm-formylglycine generating activity, as used herein, typically refers to increased expression of FGE and/or.its encoded polypeptide. Increased 25 expression refers to increasing (i.e., to a detectable extent) replication, transcription, and/or translation of any of the nucleic acids of the invention (FGE nucleic acids as described elsewhere herein), since upregulation of any of these processes results in concentration/amount increase of the polypeptide encoded by the gene (nucleic acid). Enhancing (or increasing) Ca-formylglycine generating activity also refers to preventing or 30 inhibiting FGE degradation (e.g., via increased ubiquitinization), downregulation, etc., resulting, for example, in increased or stable FGE molecule t (half-life) when compared to a control. Downregulation or decreased expression refers to decreased expression of a gene and/or its encoded polypeptide. The upregulation or downregulation of gene expression can be directly determined by detecting an increase or decrease, respectively, in the level of WO 2004/072275 PCT/US2004/003632 -21 m.RNA for the gene (e.g, FGE), or the level of protein expression of the gene-encoded polypeptide, using any suitable means known to the art, such as nucleic acid hybridization or antibody detection methods, respectively, and in comparison to controls. Upregulation or downregulation of FGE gene expression can also be determined indirectly by detecting a 5 change in Cc-formylglycine generating activity. "Expression," as used herein, refers to nucleic acid and/or polypeptide expression, as well as to activity of the polypeptide molecule (e.g., Ca-formylglycine generating activity of the molecule). One aspect of the invention involves the cloning of a cDNA encoding FGE. FGE 10 according to the invention is an isolated nucleic acid molecule that comprises a nucleic acid molecule of SEQ ID NO:1, and codes for .a polypeptide with Ca-formylglycine generating activity. The sequence of the human FGE cDNA is presented as SEQ ID NO:1, and the predicted amino acid sequence of this cDNA's encoded protein product is presented as SEQ ID NO:2. Is As used herein, a subject is a mammal or a non-human mammal. In all embodiments human FGE and human subjects are preferred. The invention thus involves in one aspect an isolated FGE polypeptide, the cDNA encoding this polypeptide, functional modifications and variants of the foregoing, useful fragments of the foregoing, as well as diagnostics and therapeutics relating thereto. 20 As used herein with respect to nucleic acids, the term "isolated" means: (i) amplified in vitro by, for example, polymerase chain reaction (PCR); (ii) recombinantly produced by cloning; (iii) purified, as by cleavage and gel separation; or (iv) synthesized by, for example, chemical synthesis. An isolated nucleic acid is one which is readily manipulated by recombinant DNA techniques well known in the art. Thus, a nucleotide sequence contained 25 in a vector in which 5' and 3' restriction sites are known or for which polymerase chain reaction (PCR) primer sequences have been disclosed is considered isolated but a nucleic acid sequence existing in its native state in its natural host is not. An isolated nucleic acid may be substantially purified, but need not be. For example, a nucleic acid that is isolated within a cloning or expression vector is not pure in that it may comprise only a tiny 30 percentage of the material in the cell in which it resides. Such a nucleic acid is isolated, however, as the term is used herein because it is readily manipulated by standard techniques known to those of ordinary skill in the art. As used herein with respect to polypeptides, the term "isolated" means separated from its native environment in sufficiently pure form so that it can be manipulated or used for any WO 2004/072275 PCT/US2004/003632 -22 one of the purposes of the invention. Thus, isolated means sufficiently pure to be used (i) to raise and/or isolate antibodies, (ii) as a reagent in an assay, (iii) for sequencing, (iv) as a therapeutic, etc. According to the invention, isolated nucleic acid molecules that code for a FGE s polypeptide having Ca-formylglycine generating activity include: (a) nucleic acid molecules which hybridize under stringent conditions to a molecule consisting of a nucleic acid of SEQ ID NO: 1 and which code for a FGE polypeptide having Ca-formylglycine generating activity, (b) deletions, additions and substitutions of (a) which code for a respective FGE polypeptide having Ca-formylglycine generating activity, (c) nucleic acid molecules that differ from the io nucleic acid molecules of (a) or (b) in codon sequence due to the degeneracy of the genetic code, and (d) complements of (a), (b) or (c). "Complements," as used herein, includes "full length complementary strands or 100% complementary strands of (a), (b) or (c). Homologs and alleles of the FGE nucleic acids of the invention also having Ca formylglycine generating activity are encompassed by the present invention. Homologs, as 15 described herein, include the molecules identified elsewhere herein (see e.g., SEQ ID NOs:4, 5, 45-78, and 80-87) i.e. orthologs and paralogs. Further homologs can be identified following the teachings of the present invention as well as by conventional techniques. Since the FGE homologs described herein all share C-formylglycine generating activity, they can be used interchangeably with the human FGE molecule in all aspects of the invention. 20 Thus, an aspect of the invention is those nucleic acid sequences which code for FGE polypeptides and which hybridize to a nucleic acid molecule consisting of the coding region of SEQ ID NO:1, under stringent conditions. In an important embodiment, the term "stringent conditions," as used herein, refers to parameters with which the art is familiar. With nucleic acids, hybridization conditions are said to be stringent typically under 25 conditions of low ionic strength and a temperature just below the melting temperature (Tm..) of the DNA hybrid complex (typically, about 3*C below the T of the hybrid). Higher stringency makes for a more specific correlation between the probe sequence and the target. Stringent conditions used in the hybridization of nucleic acids are well known in the art and may be found in references which compile such methods, e.g. Molecular Cloning: A 30 Laboratory Manual, J. Sambrook, et al., eds., Second Edition, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, New York, 1989, or Current Protocols in Molecular Biolo8y, F.M. Ausubel, et al., eds., John Wiley & Sons, Inc., New York. An example of "stringent conditions" is hybridization at 65*C in 6 x SSC. Another example of stringent conditions is hybridization at 65"C in hybridization buffer that consists of 3.5 x SSC, 0.02% WO 2004/072275 PCT/US2004/003632 -23 Ficoll, 0.02% polyvinyl pyrolidone, 0.02% Bovine Serum Albumin, 2.5mM NaH 2 PO4pH7], 0.5% SDS, 2mMEDTA. (SSC is 0.15M sodium chloride/0.15M sodium citrate, pH7; SDS is sodium dodecyl sulphate; and EDTA is ethylenediaminetetracetic acid). After hybridization, the membrane upon which the DNA is transferred is washed at 2 x SSC at room temperature 5 and then at 0.1 x SSC/0.1 x SDS at temperatures up to 68 0 C. In a further example, an alternative to the use of an aqueous hybridization solution is the use of a formamide hybridization solution. Stringent hybridization conditions can thus be achieved using, for example, a 50% formamide solution and 42*C. There are other conditions, reagents, and so forth which can be used, and would result in a similar degree of stringency. The skilled io artisan will be familiar with such conditions, and thus they are not given here. It will be understood, however, that the skilled artisan will be able to manipulate the conditions in a manner to permit the clear identification of homologs and alleles of FGE nucleic acids of the invention. The skilled artisan also is familiar with the methodology for screening cells and libraries for expression of such molecules which then are routinely isolated, followed by 15 isolation of the pertinent nucleic acid molecule and sequencing. In general homologs and alleles typically will share at least 40% nucleotide identity and/or at least 50% amino acid identity to SEQ ID NO:1 and SEQ ID NO:2, respectively, in some instances will share at least 50% nucleotide identity and/or at least 65% amino acid identity and in still other instances will share at least 60% nucleotide identity and/or at least 20 75% amino acid identity. In further instances, homologs and alleles typically will share at least 90%, 95%, or even 99% nucleotide identity and/or at least 95%, 98%, or even 99% amino acid identity to SEQ ID NO: 1 and SEQ ID NO:2, respectively. The homology can be calculated using various, publicly available software tools developed by NCBI (Bethesda, Maryland). Exemplary tools include the heuristic algorithm of Altschul SF, et al., (J Mol 25 Biol, 1990, 215:403-410), also known as BLAST. Pairwise and ClustalW alignments (BLOSUM30 matrix setting) as well as Kyte-Doolittle hydropathic analysis can be obtained using public (EMBL, Heidelberg, Germany) and commercial (e.g., the MacVector sequence analysis software from Oxford Molecular Group/enetics Computer Group, Madison, WI). Watson-Crick complements of the foregoing nucleic acids also are embraced by the 30 invention. In screening for FGE related genes, such as homologs and alleles of FGE, a Southern blot may be performed using the foregoing conditions, together with a radioactive probe. After washing the membrane to which the DNA is finally transferred, the membrane can be placed against X-ray film or a phosphoimager plate to detect the radioactive signal.

WO 2004/072275 PCT/US2004/003632 -24 Given the teachings herein of a full-length human FGE cDNA clone, other mammalian sequences such as the mouse cDNA clone corresponding to the human FGE gene can be isolated from a cDNA library, using standard colony hybridization techniques. The invention also includes degenerate nucleic acids which include alternative codons 5 to those present in the native materials. For example, seine residues are encoded by the codons TCA, AGT, TCC, TCG, TCT and AGC. Thus, it will be apparent to one of ordinary skill in the art that any of the serine-encoding nucleotide triplets may be employed to direct the protein synthesis apparatus, in vitro or in vivo, to incorporate a serine residue into an elongating FGE polypeptide. Similarly, nucleotide sequence triplets which encode other 10 amino acid residues include, but are not limited to: CCA, CCC, CCG and CCT (proline codons); CGA, CGC, CGG, CGT, AGA and AGG (arginine codons); ACA, ACC, ACG and ACT (threonine codons); AAC and AAT (asparagine codons); and ATA, ATC and ATT (isoleucine codons). Other amino acid residues may be encoded similarly by multiple nucleotide sequences. Thus, the invention embraces degenerate nucleic acids that differ from 15 the biologically isolated nucleic acids in codon sequence due to the degeneracy of the genetic code. The invention also provides isolated unique fragments of SEQ ID NO: 1 or SEQ ID NO:3 or complements of thereof. A unique fragment is one that is a 'signature' for the larger nucleic acid. For example, the unique fragment is long enough to assure that its precise 20 sequence is not found in molecules within the human genome outside of the FGE nucleic acids defined above (and human alleles). Those of ordinary skill in the art may apply no more than routine procedures to determine if a fragment is unique within the human genome. Unique fragments, however, exclude fragments completely composed of the nucleotide sequences selected from the group consisting of SEQ ID NO:4, and/or other previously 25 published sequences as of the filing date of this application. A fragment which is completely composed of the sequence described in the foregoing GenBank deposits is one which does not include any of the nucleotides unique to the sequences of the invention. Thus, a unique fragment according to the invention must contain a nucleotide sequence other than the exact sequence of those in the GenBank deposits or 3o fragments thereof. The difference may be an addition, deletion or substitution with respect to the GenBank sequence or it may be a sequence wholly separate from the GenBank sequence. Unique fragments can be used as probes in Southern and Northern blot assays to identify such nucleic acids, or can be used in amplification assays such as those employing PCR. As known to those skilled in the art, large probes such as 200, 250, 300 or more WO 2004/072275 PCT/US2004/003632 -25 nucleotides are preferred for certain uses such as Southern and Northern blots, while smaller fragments will be preferred for uses such as PCR. Unique fragments also can be used to produce fusion proteins for generating antibodies or determining binding of the polypeptide fragments, as demonstrated in the Examples, or for generating immunoassay components. 5 Likewise, unique fragments can be employed to produce nonfused fragments of the FGE polypeptides, useful, for example, in the preparation of antibodies, immunoassays or therapeutic applications. Unique fragments further can be used as antisense molecules to inhibit the expression of FGE nucleic acids and polypeptides respectively. As will be recognized by those skilled in the art, the size of the unique fragment will 10 depend upon its conservancy in the genetic code. Thus, some regions of SEQ ID NO: 1 or SEQ ID NO:3 and complements will require longer segments to be unique while others will require only short segments, typically between 12 and 32 nucleotides long (e.g. 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 and 32 bases) or more, up to the entire length of the disclosed sequence. As mentioned above, this disclosure intends to 15 embrace each and every fragment of each sequence, beginning at the first nucleotide, the second nucleotide and so on, up to 8 nucleotides short of the end, and ending anywhere from nucleotide number 8, 9, 10 and so on for each sequence, up to the very last nucleotide, (provided the sequence is unique as described above). Virtually any segment of the region of SEQ ID NO:1 beginning at nucleotide 1 and ending at nucleotide 1180, or SEQ ID NO:3 20 beginning at nucleotide 1 and ending at nucleotide 1122, or complements thereof, that is 20 or more nucleotides in length will be unique. Those skilled in the art are well versed in methods for selecting such sequences, typically on the basis of the ability of the unique fragment to selectively distinguish the sequence of interest from other sequences in the human genome of the fragment to those on known databases typically is all that is necessary, 25 although in vitro confirmatory hybridization and sequencing analysis may be performed. As mentioned above, the invention embraces antisense oligonucleotides that selectively bind to a nucleic acid molecule encoding a FGE polypeptide, to decrease FGE activity. As used herein, the term "antisense oligonucleotide" or "antisense" describes an 30 oligonucleotide that is an oligoribonucleotide, oligodeoxyribonucleotide, modified oligoribonucleotide, or modified oligodeoxyribonucleotide which hybridizes under physiological conditions to DNA comprising a particular gene or to an mRNA transcript of that gene and, thereby, inhibits the transcription of that gene and/or the translation of that mRNA. The antisense molecules are designed so as to interfere with transcription or WO 2004/072275 PCT/US2004/003632 -26 translation of a target gene upon hybridization with the target gene or transcript. Those skilled in the art will recognize that the exact length of the antisense oligonucleotide and its degree of complementarity with its target will depend upon the specific target selected, including the sequence of the target and the particular bases which comprise that sequence. It 5 is preferred that the antisense oligonucleotide be constructed and arranged so as to bind selectively with the target under physiological conditions, i.e., to hybridize substantially more to the target sequence than to any other sequence in the target cell under physiological conditions. Based upon SEQ ID NO:1 or upon allelic or homologous genomic and/or cDNA sequences, one of skill in the art can easily choose and synthesize any of a number of 1o appropriate antisense molecules for use in accordance with the present invention. In order to be sufficiently selective and potent for inhibition, such antisense oligonucleotides should comprise at least 10 and, more preferably, at least 15 consecutive bases which are complementary to the target, although in certain cases modified oligonucleotides as short as 7 bases in length have been used successfully as antisense oligonucleotides (Wagner et al., Nat. 15 Med, 1995, 1(11):1116-1118; Nat. Biotech., 1996, 14:840-844). Most preferably, the antisense oligonucleotides comprise a complementary sequence of 20-30 bases. Although oligonucleotides may be chosen which are antisense to any region of the gene or mRNA transcripts, in preferred embodiments the antisense oligonucleotides correspond to N-terminal or 5' upstream sites such as translation initiation, transcription initiation or promoter sites. In 20 addition, 3'-untranslated regions may be targeted by antisense oligonucleotides. Targeting to mRNA splicing sites has also been used in the art but may be less preferred if alternative mRNA splicing occurs. In addition, the antisense is targeted, preferably, to sites in which mRNA secondary structure is not expected (see, e.g., Sainio et al., Cell Mol. Neurobiol. 14(5):439-457, 1994) and at which proteins are not expected to bind. Finally, although, SEQ 25 ID No: 1 discloses a cDNA sequence, one of ordinary skill in the art may easily derive the genomic DNA corresponding to this sequence. Thus, the present invention also provides for antisense oligonucleotides which are complementary to the genomic DNA corresponding to SEQ ID NO: 1. Similarly, antisense to allelic or homologous FGE cDNAs and genomic DNAs are enabled without undue experimentation. 30 In one set of embodiments, the antisense oligonucleotides of the invention may be composed of "natural" deoxyribonucleotides, ribonucleotides, or any combination thereof. That is, the 5' end of one native nucleotide and the 3' end of another native nucleotide may be covalently linked, as in natural systems, via a phosphodiester internucleoside linkage. These oligonucleotides may be prepared by art recognized methods which may be carried out WO 2004/072275 PCT/US2004/003632 -27 manually or by an automated synthesizer. They also may be produced recombinantly by vectors. In preferred embodiments, however, the antisense oligonucleotides of the invention also may include "modified" oligonucleotides. That is, the oligonucleotides may be modified 5 in a number of ways which do not prevent them from hybridizing to their target but which enhance their stability or targeting or which otherwise enhance their therapeutic effectiveness. The term "modified oligonucleotide" as used herein describes an oligonucleotide in which (1) at least two of its nucleotides are covalently linked via a synthetic internucleoside io linkage (i.e., a linkage other than a phosphodiester linkage between the 5' end of one nucleotide and the 3' end of another nucleotide) and/or (2) a chemical group not normally associated with nucleic acids has been covalently attached to the oligonucleotide. Preferred synthetic internucleoside linkages are phosphorothioates, alkylphosphonates, phosphorodithioates, phosphate esters, alkylphosphonothioates, phosphoramidates, 15 carbamnates, carbonates, phosphate triesters, acetamidates, carboxymethyl esters and peptides. The term "modified oligonucleotide" also encompasses oligonucleotides with a covalently modified base and/or sugar. For example, modified oligonucleotides include oligonucleotides having backbone sugars which are covalently attached to low molecular weight organic groups other than a hydroxyl group at the 3' position and other than a 20 phosphate group at the 5' position. Thus modified oligonucleotides may include a 2'-0 alkylated ribose group. In addition, modified oligonucleotides may include sugars such as arabinose instead of ribose. The present invention, thus, contemplates pharmaceutical preparations containing modified antisense molecules that are complementary to and hybridizable with, under physiological conditions, nucleic acids encoding FGE polypeptides, 25 together with pharmaceutically acceptable carriers. Antisense oligonucleotides may be administered as part of a pharmaceutical composition. Such a pharmaceutical composition may include the antisense oligonucleotides in combination with any standard physiologically and/or pharmaceutically acceptable carriers which are known in the art. The compositions should be sterile and contain a therapeutically effective amount of the antisense 30 oligonucleotides in a unit of weight or volume suitable for administration to a patient. The term "pharmaceutically acceptable" means a non-toxic material that does not interfere with the effectiveness of the biological activity of the active ingredients. The term "physiologically acceptable" refers to a non-toxic material that is compatible with a biological system such as a cell, cell culture, tissue, or organism. The characteristics of the WO 2004/072275 PCT/US2004/003632 -28 carrier will depend on the route of administration. Physiologically and pharmaceutically acceptable carriers include diluents, fillers, salts, buffers, stabilizers, solubilizers, and other materials which are well known in the art. The invention also involves methods for increasing C-formylglycine generating s activity in a cell. In important embodiments, this is accomplished by the use of vectors ("expression vectors" and/or "targeting vectors"). "Vectors," as used herein, may be any of a number of nucleic acids into which a desired sequence may be inserted by restriction and ligation for transport between different genetic environments or for expression in a host cell. Vectors are typically composed of 10 DNA although RNA vectors are also available. Vectors include, but are not limited to, plasmids, phagemids and virus genones. A cloning vector is one which is able to replicate in a host cell, and which is further characterized by one or more endonuclease restriction sites at which the vector may be cut in a determinable fashion and into which a desired DNA sequence may be ligated such that the new recombinant vector retains its ability to replicate 15 in the host cell. In the case of plasmids, replication of the desired sequence may occur many times as the plasmid increases in copy number within the host bacterium or just a single time per host before the host reproduces by mitosis. In the case of phage, replication may occur actively during a lytic phase or passively during a lysogenic phase. An "expression vector" is one into which a desired DNA sequence (e.g., the FGE cDNA of SEQ ID NO:3) may be 20 inserted by restriction and ligation such that it is operably joined to regulatory sequences and may be expressed as an RNA transcript. Vectors may further contain one or more marker sequences suitable for use in the identification of cells which have or have not been transformed or transfected with the vector. Markers include, for example, genes encoding proteins which increase or decrease either resistance or sensitivity to antibiotics or other 25 compounds, genes which encode enzymes whose activities are detectable by standard assays known in the art (e.g., p-galactosidase or alkaline phosphatase), and genes which visibly affect the phenotype of transformed or transfected cells, hosts, colonies or plaques (e.g., green fluorescent protein). A "targeting vector" is one which typically contains targeting constructs/sequences 30 that are used, for example, to insert a regulatory sequence within an endogenous gene (e.g., within the sequences of an exon and/or intron), within the endogenous gene promoter sequences, or upstream of the endogenous gene promoter sequences. In another example, a targeting vector may contain the gene of interest (e.g., encoded by the cDNA of SEQ ID NO: 1) and other sequences necessary for the targeting of the gene to a preferred location in WO 2004/072275 PCT/US2004/003632 -29 the genome (e.g., a trascriptionally active location, for example downstream of an enogenous promoter of an unrelated gene). Construction of targeting constructs and vectors are described in detail in U.S. Patents 5,641,670 and 6,270,989, and which are expressly incorporated herein by reference. s Virtually any cells, prokaryotic or eukaryotic, which can be transformed with heterologous DNA or RNA and which can be grown or maintained in culture, may be used in the practice of the invention. Examples include bacterial cells such as Escherichia coli, insect cells, and mammalian cells such as human, mouse, hamster, pig, goat, primate, etc. They may be primary or secondary cell strains (which exhibit a finite number of mean 10 population doublings in culture and are not immortalized) and immortalized cell lines (which exhibit an apparently unlimited lifespan in culture). Primary and secondary cells include, for example, fibroblasts, keratinocytes, epithelial cells (e.g., mammary epithelial cells, intestinal epithelial cells), endothelial cells, glial cells, neural cells, formed elements of the blood (e.g., lymphocytes, bone marrow cells), muscle cells and precursors of these somatic cell types 15 including embryonic stem cells. Where the cells are to be used in gene therapy, primary cells are preferably obtained from the individual to whom the manipulated cells are administered. However, primary cells can be obtained from a donor (other than the recipient) of the same species. Examples of immortalized human cell lines which may be used with the DNA constructs and methods of the present invention include, but are not limited to, HT-1080 cells 20 (ATCC CCL 121), HeLa cells and derivatives of HeLa cells (ATCC CCL 2, 2.1 and 2.2), MCF-7 breast cancer cells (ATCC BTH 22), K-562 leukemia cells (ATCC CCL 243), KB carcinoma cells (ATCC CCL 17), 2780AD ovarian carcinoma cells (Van der Blick, A. M. et al., Cancer Res, 48:5927-5932 (1988), Raji cells (ATCC CCL 86), WiDr colon adenocarcinoma cells (ATCC CCL 218), SW620 colon adenocarcinoma cells (ATCC CCL 25 227), Jurkat cells (ATCC TIB 152), Namalwa cells (ATCC CRL1432), HL-60 cells (ATCC CCL 240), Daudi cells (ATCC CCL 213), RPMI 8226 cells (ATCC CCL 155), U-937 cells (ATCC CRL 1593), Bowes Melanoma cells (ATCC CRL 9607), WI-38VA13 sublime 2R4 cells (ATCC CLL 75.1), and MOLT-4 cells (ATCC CRL 1582), CHO cells, and COS cells, as well as heterohybridoma cells produced by fusion of human cells and cells of another 30 species. Secondary human fibroblast strains, such as WI-38 (ATCC CCL 75) and MRC-5 (ATCC CCL 171) may also be used. Further discussion of the types of cells that may be used in practicing the methods of the present invention are described in U.S. Patents 5,641,670 and 6,270,989. Cell-free transcription systems also may be used in lieu of cells.

WO 2004/072275 PCTUS20041003632 -30 The cells of the invention are maintained under conditions, as are known in the art, which result in expression of the FGE protein or functional fragments thereof. Proteins expressed using the methods described may be purified from cell lysates or cell supematants. Proteins made according to this method can be prepared as a pharmaceutically-useful 5 formulation and delivered to a human or .non-human animal by conventional pharmaceutical routes as is known in the art (e.g., oral, intravenous, intramuscular, intranasal, intratracheal or subcutaneous). As described elsewhere herein, the recombinant cells can be immortalized, primary, or secondary cells, preferably human. The use of cells from other species may be desirable in cases where the non-human cells are advantageous for protein production io purposes where the non-human FGE produced is useful therapeutically. As used herein, a coding sequence and regulatory sequences are said to be "operably" joined when they are covalently linked in such a way as to place the expression or transcription of the coding sequence under the influence or control of the regulatory sequences. If it is desired that the coding sequences be translated into a functional protein, is two DNA sequences are said to be operably joined if induction of a promoter in the 5' regulatory sequences results in the transcription of the coding sequence and if the nature of the linkage between the two DNA sequences does not (1) result in the introduction of a frame-shift mutation, (2) interfere with the ability of the promoter region to direct the transcription of the coding sequences, or (3) interfere with the ability of the corresponding 2o RNA transcript to be translated into a protein. Thus, a promoter region would be operably joined to a coding sequence if the promoter region were capable of effecting transcription of that DNA sequence such that the resulting transcript might be translated into the desired protein or polypeptide. The precise nature of the regulatory sequences needed for gene expression may vary 25 between species or cell types, but shall in general include, as necessary, 5' non-transcribed and 5' non-translated sequences involved with the initiation of transcription and translation respectively, such as a TATA box, capping sequence, CAAT sequence, and the like. Especially, such 5' non-transcribed regulatory sequences will include a promoter region which includes a promoter sequence for transcriptional control of the operably joined gene. 30 Regulatory sequences may also include enhancer sequences or upstream activator sequences as desired. The vectors of the invention may optionally include 5' leader or signal sequences. The choice and design of an appropriate vector is within the ability and discretion of one of ordinary skill in the art.

WO 2004/072275 PCTUS2004/003632 -31 Expression vectors containing. all the necessary elements for expression are commercially available and known to those skilled in the art. See, e.g., Sambrook et al., Molecular Cloning: A Laboratory Manual, Second Edition, Cold Spring Harbor Laboratory Press, 1989. Cells are genetically engineered by the introduction into the cells of s heterologous DNA (RNA) encoding FGE polypeptide or fragment or variant thereof. That heterologous DNA (RNA) is placed under operable control of transcriptional elements to permit the expression of the heterologous DNA in the host cell. Preferred systems for mRNA expression in mammalian cells are those such as pRc/CMV (available from Invitrogen, Carlsbad, CA) that contain a selectable marker such as io a gene that confers G418 resistance (which facilitates the selection of stably transfected cell lines) and the human cytomegalovirus (CMV) enhancer-promoter sequences. Additionally, suitable for expression in primate or canine cell lines is the pCEP4 vector (Invitrogen, Carlsbad, CA), which contains an Epstein Barr virus (EBV) origin of replication, facilitating the maintenance of plasmid as a multicopy extrachromosomal element. Another expression 15 vector is the pEF-BOS plasmid containing the promoter of polypeptide Elongation Factor loa, which stimulates efficiently transcription in vitro. The plasmid is described by Mishizuma and Nagata (Nuc. Acids Res. 18:5322, 1990), and .its use in transfection experiments is disclosed by, for example, Demoulin (Mol. Cell. Biol. 16:4710-4716, 1996). Still another preferred expression vector is an adenovirus, described by Stratford-Perricaudet, which is 20 defective for El and E3 proteins (J. Clin. Invest. 90:626-630, 1992). The use of the adenovirus as an Adeno.PlA recombinant is disclosed by Warnier et al., in intradermal injection in mice for immunization against PlA (Int. J. Cancer, 67:303-310, 1996). The invention also embraces so-called expression kits, which allow the artisan to prepare a desired expression vector or vectors. Such expression kits include at least separate 25 portions of each of the previously discussed coding sequences. Other components may be added, as desired, as long as the previously mentioned sequences, which are required, are included. It will also be recognized that the invention embraces the use of the above described, FGE cDNA sequence containing expression vectors, to transfect host cells and cell lines, be 30 these prokaryotic (e.g., Escherichia coli), or eukaryotic (e.g., CHO cells, COS cells, yeast expression systems and recombinant baculovirus expression in insect cells). Especially useful are mammalian cells such as human, mouse, hamster, pig, goat, primate, etc. They may be of a wide variety of tissue types, and include primary cells and immortalized cell lines as described elsewhere herein. Specific examples include HT-1080 cells, CHO cells, WO 2004/072275 PCTIUS2004/003632 -32 dendritic cells, U293 cells, peripheral blood leukocytes, bone marrow stem cells, embryonic stem cells, and insect cells. The invention also permits the construction of FGE gene "knock outs" in cells and in animals, providing materials for studying certain aspects of FGE activity. The invention also provides isolated polypeptides (including whole proteins and s partial proteins), encoded by the foregoing FGE nucleic acids, and include the polypeptide of SEQ ID NO:2 and unique fragments thereof.. Such polypeptides are useful, for example, alone or as part of fusion proteins to generate antibodies, as components of an immunoassay, etc. Polypeptides can be isolated from biological samples including tissue or cell homogenates, and can also be expressed recombinantly in a variety of prokaryotic and 10 eukaryotic expression systems by constructing an expression vector appropriate to the expression system, introducing the expression vector into the expression system, and isolating the recombinantly expressed protein. Short polypeptides, including antigenic peptides (such as are presented by MHC molecules on the surface of a cell for immune recognition) also can be synthesized chemically using well-established methods of peptide 15 synthesis. A unique fragment of a FGE polypeptide, in general, has the features and characteristics of unique fragments as discussed above in connection with nucleic acids. As will be recognized by those skilled in the art, the size of the unique fragment will depend upon factors such as whether the fragment constitutes a portion of a conserved protein 20- domain. Thus, some regions of SEQ ID NO:2 will require longer segments to be unique while others will require only short segments, typically between 5 and 12 amino acids (e.g. 5, 6, 7, 8, 9, 10, 11 and 12 amino acids long or more, including each integer up to the full length, 287 amino acids long). Unique fragments of a polypeptide preferably are those fragments which retain a 25 distinct functional capability of the polypeptide. Functional capabilities which can be retained in a unique fragment of a polypeptide include interaction with antibodies, interaction with other polypeptides or fragments thereof, interaction with other molecules, etc. One important activity is the ability to act as a signature for identifying the polypeptide. Those skilled in the art are well versed in methods for selecting unique amino acid sequences, 3o typically on the basis of the ability of the unique fragment to selectively distinguish the sequence of interest from non-family members. A comparison of the sequence of the fragment to those on known databases typically is all that is necessary. The invention embraces variants of the FGE polypeptides described above. As used herein, a "variant" of a FGE polypeptide is a polypeptide which contains one or more WO 2004/072275 PCT/US2004/003632 -33 modifications to the primary amino acid sequence of a FGE polypeptide. Modifications which create a FGE polypeptide variant are typically made to the nucleic acid which encodes the FGE polypeptide, and can include deletions, point mutations, truncations, amino acid substitutions and addition of amino acids or non-amino acid moieties to: 1) reduce or 5 eliminate an activity of a FGE polypeptide; 2) enhance a property of a FGE polypeptide, such as protein stability in an expression system or the stability of protein-ligand binding; 3) provide a novel activity or property to a FGE polypeptide, such as addition of an antigenic epitope or addition of a detectable moiety; or 4) to provide equivalent or better binding to a FGE polypeptide receptor or other molecule. Alternatively, modifications can be made io directly to the polypeptide, such as by cleavage, addition of a linker molecule, addition of a detectable moiety, such as biotin, addition of a fatty acid, and the like. Modifications also embrace fusion proteins comprising all or part of the FGE amino acid sequence. One of skill in the art will be familiar with methods for predicting the effect on protein conformation of a change in protein sequence, and can thus "design" a variant FGE polypeptide according to is known methods. One example of such a method is described by Dahiyat and Mayo in Science 278:82-87, 1997, whereby proteins can be designed de novo. The method can be applied to a known protein to vary only a portion of the polypeptide sequence. By applying the computational methods of Dahiyat and Mayo, specific variants of the FGE polypeptide can be proposed and tested to determine whether the variant retains a desired conformation. 20 Variants can include FGE polypeptides which are modified specifically to alter a feature of the polypeptide unrelated to its physiological activity. For example, cysteine residues can be substituted or deleted to prevent unwanted disulfide linkages. Similarly, certain amino acids can be changed to enhance expression of a FGE polypeptide by eliminating proteolysis by proteases in an expression system (e.g., dibasic amino acid 25 residues in yeast expression systems in which KEX2 protease activity is present). Mutations of a nucleic acid which encodes a FGE polypeptide preferably preserve the amino acid reading frame of the coding sequence, and preferably do not create regions in the nucleic acid which are likely to hybridize to form secondary structures, such a hairpins or loops, which can be deleterious to expression of the variant polypeptide. 30 Mutations can be made by selecting an amino acid substitution, or by random mutagenesis of a selected site in a nucleic acid which encodes the polypeptide. Variant polypeptides are then expressed and tested for one or more activities to determine which mutation provides a variant polypeptide with the desired properties. Further mutations can be made to variants (or to non-variant FGE polypeptides) which are silent as to the amino acid WO 2004/072275 PCT/IJS2004/003632 -34 sequence of the polypeptide, but which provide preferred codons for translation in a particular host, or alter the structure of the mRNA to, for example, enhance stability and/or expression. The preferred codons for translation of a nucleic acid in, e.g., Escherichia coli, mammalian cells, etc. are well known to those of ordinary skill in the art. Still other 5 mutations can be made to the noncoding sequences of a FGE gene or cDNA clone to enhance expression of the polypeptide. The skilled artisan will realize that conservative amino acid substitutions may be made in FGE polypeptides to provide functionally equivalent variants of the foregoing polypeptides, i.e, the variants retain the functional capabilities of the FGE polypeptides. As 10 used herein, a "conservative amino acid substitution" refers to an amino acid substitution which does not significantly alter the the tertiary structure and/or activity of the polypeptide. Variants can be prepared according to methods for altering polypeptide sequence known to one of ordinary skill in the art, and include those that are found in references which compile such methods, e.g. Molecular Cloning: A Laboratory Manual, J. Sambrook, et al., eds., 15 Second Edition, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, New York, 1989, or Current Protocols in Molecular Biology, F.M. Ausubel, et al., eds., John Wiley & Sons, Inc., New York. Exemplary functionally equivalent variants of the FGE polypeptides include conservative amino acid substitutions of SEQ ID NO:2. Conservative substitutions of amino acids include substitutions made amongst amino acids within the following groups: (a) M, I, 20 L, V; (b) F, Y, W; (c) K, R, H; (d) A, G; (e) S, T; (f) Q, N; and (g) E, D. Thus functionally equivalent variants of FGE polypeptides, i.e., variants of FGE polypeptides which retain the function of the natural FGE polypeptides, are contemplated by the invention. Conservative amino-acid substitutions in the amino acid sequence of FGE polypeptides to produce functionally equivalent variants of FGE polypeptides typically are 25 made by alteration of a nucleic acid encoding FGE polypeptides (SEQ ID NOs:1, 3). Such substitutions can be made by a variety of methods known to one of ordinary skill in the art. For example, amino acid substitutions may be made by PCR-directed mutation, site-directed mutagenesis according to the method of Kunkel (Kunkel, Proc. Nat. Acad. Sci. U.SA. 82: 488-492, 1985), or by chemical synthesis of a gene encoding a FGE polypeptide. The 3o activity of functionally equivalent fragments of FGE polypeptides can be tested by cloning the gene encoding the altered FGE polypeptide into a bacterial or mammalian expression vector, introducing the vector into an appropriate host cell, expressing the altered FGE polypeptide, and testing for a functional capability of the FGE polypeptides as disclosed herein (e.g., Ca-formylglycine generating activity, etc.).

WO 2004/072275 PCTIUS2004/003632 -35 The invention as described herein has a number of uses, some of which are described elsewhere herein. First, the invention permits isolation of FGE polypeptides. A variety of methodologies well-known to the skilled practitioner can be utilized to obtain isolated FGE molecules. The polypeptide may be purified from cells which naturally produce the 5 polypeptide by chromatographic means or immunological recognition. Alternatively, an expression vector may be introduced into cells to cause production of the polypeptide. In another method, mRNA transcripts may be microinjected or otherwise introduced into cells to cause production of the encoded polypeptide. Translation of FGE mRNA in cell-free extracts such as the reticulocyte lysate system also may be used to produce FGE 10 polypeptides. Those skilled in the art also can readily follow known methods for isolating FGE polypeptides. These include, but are not limited to, immunochromatography, HPLC, size-exclusion chromatography, ion-exchange chromatography and immune-affinity chromatography. The invention also provides, in certain embodiments, "dominant negative" 15 polypeptides derived from FGE polypeptides. A dominant negative polypeptide is an inactive variant of a protein, which, by interacting with the cellular machinery, displaces an active protein from its interaction with the cellular machinery or competes with the active protein, thereby reducing the effect of the active protein. For example, a dominant negative receptor which binds a ligand but does not transmit a signal in response to binding of the 20 ligand can reduce the biological effect of expression of the ligand. Likewise, a dominant negative catalytically-inactive kinase which interacts normally with target proteins but does not phosphorylate the target proteins can reduce phosphorylation of the target proteins in response to a cellular signal. Similarly, a dominant negative transcription factor which binds to a promoter site in the control region of a gene but does not increase gene transcription can 25 reduce the effect of a normal transcription factor by occupying promoter binding sites without increasing transcription. The end result of the expression of a dominant negative polypeptide in a cell is a reduction in function of active proteins. One of ordinary skill in the art can assess the potential for a dominant negative variant of a protein, and use standard mutagenesis 30 techniques to create one or more dominant negative variant polypeptides. See, e.g., U.S. Patent No. 5,580,723 and Sambrook et al, Molecular Cloning: A Laboratory Manual, Second Edition, Cold Spring Harbor Laboratory Press, 1989. The skilled artisan then can test the population of mutagenized polypeptides for diminution in a selected activity and/or for WO 2004/072275 PCT/US2004/OO3632 -36 retention of such an activity. Other similar methods for creating and testing dominant negative variants of a protein will be apparent to one of ordinary skill in the art. The isolation of the FGE cDNA also makes it possible for the artisan to diagnose a disorder characterized by an aberrant expression of FGE. These methods involve 5 determining expression of the FGE gene, and/or FGE polypeptides derived therefrom. In the former situation, such determinations can be carried out via any standard nucleic acid determination assay, including the polymerase chain reaction, or assaying with labeled hybridization probes as exemplified below. In the latter situation, such determination can be carried out via any standard immunological assay using, for example, antibodies which bind io to the secreted FGE protein. A preferred disorder that can be diagnosed according to the invention is Multiple Sulfatase Deficiency. The invention also embraces isolated peptide binding agents which, for example, can be antibodies or fragments of antibodies ("binding polypeptides"), having the ability to selectively bind to FGE polypeptides. Antibodies include polyclonal and monoclonal 15 antibodies, prepared according to conventional methodology. In certain embodiments, the invention excludes binding agents (e.g., antibodies) that bind to the polypeptides encoded by the nucleic acids of SEQ ID NO:4. Significantly, as is well-known in the art, only a small portion of an antibody molecule, the paratope, is involved in the binding of the antibody to its epitope (see, in 20 general, Clark, W.R. (1986) The Experimental Foundations of Modem Immunology Wiley & Sons, Inc., New York; Roitt, I. (1991) Essential Immunology, 7th Ed., Blackwell Scientific Publications, Oxford). The pFc' and Fc regions, for example, are effectors of the complement cascade but are-not involved in antigen binding. An antibody from which the pFc' region has been enzymatically cleaved, or which has been produced without the pFc' 25 region, designated an F(ab') 2 fragment, retains both of the antigen binding sites of an intact antibody. Similarly, an antibody from which the Fc region has been enzymatically cleaved, or which has been produced without the Fc region, designated an Fab fragment, retains one of the antigen binding sites of an intact antibody molecule. Proceeding further, Fab fragments consist of a covalently bound antibody light chain and a portion of the antibody heavy chain 30 denoted Fd. The Fd fragments are the major determinant of antibody specificity (a single Fd fragment may be associated with up to ten different light chains without altering antibody specificity) and Fd fragments retain epitope-binding ability in isolation. Within the antigen-binding portion of an antibody, as is well-known in the art, there are complementarity determining regions (CDRs), which directly interact with the epitope of WO 2004/072275 PCT/US2004/003632 -37 the antigen, and framework regions (FRs), which maintain the tertiary structure of the paratope (see, in general, Clark, 1986; Roitt, 1991). In both the heavy chain Fd fragment and the light chain of IgG immunoglobulins, there are four framework regions (FRI through FR4) separated respectively by three complementarity determining regions (CDR1 through CDR3). 5 The CDRs, and in particular the CDR3 regions, and more particularly the heavy chain CDR3, are largely responsible for antibody specificity. It is now well-established in the art that the non-CDR regions of a mammalian antibody may be replaced with similar regions of conspecific or heterospecific antibodies while retaining the epitopic specificity of the original antibody. This is most clearly 10 manifested in the development and use of "humanized" antibodies in which non-human CDRs are covalently joined to human FR and/or Fc/pFc' regions to produce a functional antibody. See, e.g., U.S. patents 4,816,567, 5,225,539, 5,585,089, 5,693,762 and 5,859,205. Thus, for example, PCI International Publication Number WO 92/04381 teaches the production and use of humanized murine RSV antibodies in which at least a portion of the 15 murine FR regions have been replaced by FR regions of human origin. Such antibodies, including fragments of intact antibodies with antigen-binding ability, are often referred to as "chimeric" antibodies. Thus, as will be apparent to one of ordinary skill in the art, the present invention also provides for F(ab') 2 , Fab, Fv and Fd fragments; chimeric antibodies in which the Fc and/or 20 FR and/or CDR1 and/or CDR2 and/or light chain CDR3 regions have been replaced by homologous human or non-human sequences; chimeric F(ab')2 fragment antibodies in which the FR and/or CDR1 and/or CDR2 and/or light chain CDR3 regions have been replaced by homologous human or non-human sequences; chimeric Fab fragment antibodies in which the FR and/or CDR1 and/or CDR2 and/or light chain CDR3 regions have been replaced by 25 homologous human or non-human sequences; and chimeric Fd fragment antibodies in which the FR and/or CDR1 and/or CDR2 regions have been replaced by homologous human or non human sequences. The present invention also includes so-called single chain antibodies. Thus, the invention involves polypeptides of numerous size and type that bind specifically to FGE polypeptides, and complexes of both FGE polypeptides and their binding 30 partners. These polypeptides may be derived also from sources other than antibody technology. For example, such polypeptide binding agents can be provided by degenerate peptide libraries which can be readily prepared in solution, in immobilized form, as bacterial flagella peptide display libraries or as phage display libraries. Combinatorial libraries also WO 2004/072275 PCT/US2004/003632 -38 can be synthesized of peptides containing one or more amino acids. Libraries further can be synthesized of peptides and non-peptide synthetic moieties. Phage display can be particularly effective in identifying binding peptides useful according to the invention. Briefly, one prepares a phage library (using e.g. m13, fd, or 5 lambda phage), displaying inserts from 4 to about 80 amino acid residues using conventional procedures. The inserts may represent, for example, a completely degenerate or biased array. One then can select phage-bearing inserts which bind to the FGE polypeptide or a complex of FGE and a binding partner. This process can be repeated through several cycles of reselection of phage that bind to the FGE polypeptide or complex. Repeated rounds lead to 1o enrichment of phage bearing particular sequences. DNA sequence analysis can be conducted to identify the sequences of the expressed polypeptides. The minimal linear portion of the sequence that binds to the FGE polypeptide or complex can be determined. One can repeat the procedure using a biased library containing inserts containing part or all of the minimal linear portion plus one or more additional degenerate residues upstream or downstream 15 thereof. Yeast two-hybrid screening methods also may be used to identify polypeptides that bind to the FGE polypeptides. Thus, the FGE polypeptides of the invention, or a fragment thereof, or complexes of FGE and a binding partner can be used to screen peptide libraries, including phage display libraries, to identify and select peptide binding partners of the FGE polypeptides of the invention. Such molecules can be used, as described, for screening 20 assays, for purification protocols, for interfering directly with the functioning of FGE and for other purposes that will be apparent to those of ordinary skill in the art. An FGE polypeptide, or a fragment thereof, also can be used to isolate their native binding partners. Isolation of binding partners may be performed according to well-known methods. For example, isolated FGE polypeptides can be attached to a substrate, and then a 25 solution suspected of containing a FGE binding partner may be applied to the substrate. If the binding partner for FGE polypeptides is present in the solution, then it will bind to the substrate-bound FGE polypeptide. The binding partner then may be isolated. Other proteins which are binding partners for FGE, may be isolated by similar methods without undue experimentation. A preferred binding partner is a sulfatase. 30 The invention also provides methods to measure the level of FGE expression in a subject. This can be performed by first obtaining a test sample from the subject. The test sample can be tissue or biological fluid. Tissues include brain, heart, serum, breast, colon, bladder, uterus, prostate, stomach, testis, ovary, pancreas, pituitary gland, adrenal gland, thyroid gland, salivary gland, mammary gland, kidney, liver, intestine, spleen, thymus, blood WO 2004/072275 PCT/US2004/003632 -39 vessels, bone marrow, trachea, and lung. In certain embodiments, test samples originate from heart and blood vessel tissues, and biological fluids include blood, saliva and urine. Both invasive and non-invasive techniques can be used to obtain such samples and are well documented in the art. At the molecular level both PCR and Northern blotting can be used to 5 determine the level of FGE mRNA using products of this invention described herein, and protocols well known in the art that are found in references which compile such methods. At the protein level, FGE expression can be determined using either polyclonal or monoclonal anti-FGE sera in combination with standard immunological assays. The preferred methods will compare the measured level of FGE expression of the test sample to a control. A control 10 can include a known amount of a nucleic acid probe, a FGE epitope (such as a FGE expression product), or a similar test sample of a subject with a control or 'normal' level of FGE expression. FGE polypeptides preferably are produced recombinantly, although such polypeptides may be isolated from biological extracts. Recombinantly produced FGE polypeptides include is chimeric proteins comprising a fusion of a FGE protein with another polypeptide, e.g., a polypeptide capable of providing or enhancing protein-protein binding, sequence specific nucleic acid binding (such as GAL4), enhancing stability of the FGE polypeptide under assay conditions, or providing a detectable moiety, such as green fluorescent protein. A polypeptide fused to a FGE polypeptide or fragment may also provide means of readily 20 detecting the fusion protein, e.g., by immunological recognition or by fluorescent labeling. The invention also is useful in the generation of transgenic non-human animals. As used herein, "transgenic non-human animals" includes non-human animals having one or more exogenous nucleic acid molecules incorporated in germ line cells and/or somatic cells. Thus the transgenic animals include "knockout" animals having a homozygous or 25 heterozygous gene disruption by homologous recombination, animals having episomal or chromosomally incorporated expression vectors, etc. Knockout animals can be prepared by homologous recombination using embryonic stem cells as is well known in the art. The recombination may be facilitated using, for example, the cre/lox system or other recombinase systems known to one of ordinary skill in the art. In certain embodiments, the recombinase 30 system itself is expressed conditionally, for example, in certain tissues or cell types, at certain embryonic or post-embryonic developmental stages, is induced by the addition of a compound which increases or decreases expression, and the like. In general, the conditional expression vectors used in such systems use a variety of promoters which confer the desired gene expression pattern (e.g., temporal or spatial). Conditional promoters also can be WO 2004/072275 PCT/US2004/003632 -40 operably linked to FGE nucleic acid molecules to increase expression of FGE in a regulated or conditional manner. Trans-acting negative regulators of FGE activity or expression also can be operably linked to a conditional promoter as described above. Such trans-acting regulators include antisense FGE nucleic acids molecules, nucleic acid molecules which 5 encode dominant negative FGE molecules, ribozyme molecules specific for FGE nucleic acids, and the like. The transgenic non-human animals are useful in experiments directed toward testing biochemical or physiological effects of diagnostics or therapeutics for conditions characterized by increased or decreased FGE expression. Other uses will be apparent to one of ordinary skill in the art. 10 The invention also contemplates gene therapy. The procedure for performing ex vivo gene therapy is outlined in U.S. Patent 5,399,346 and in exhibits submitted in the file history of that patent, all of which are publicly available documents. In general, it involves introduction in vitro of a functional copy of a gene into a cell(s) of a subject which contains a defective copy of the gene, and returning the genetically engineered cell(s) to the subject. 15 The functional copy of the gene is under operable control of regulatory elements which permit expression of the gene in the genetically engineered cell(s). Numerous transfection and transduction techniques as well as appropriate expression vectors are well known to those of ordinary skill in the art, some of which are described in PCT application W095/00654. In vivo gene therapy using vectors such as adenovirus, retroviruses, herpes virus, and targeted 20 liposomes also is contemplated according to the invention. The invention further provides efficient methods of identifying agents or lead compounds for agents active at the level of a FGE or FGE fragment dependent cellular function. In particular, sdch functions include interaction with other polypeptides or fragments. Generally, the screening methods involve assaying for compounds which 25 interfere with FGE activity (such as Cformylglycine generating activity), although compounds which enhance FGE Cc-formylglycine generating activity also can be assayed using the screening methods. Such methods are adaptable to automated, high throughput screening of compounds. Target indications include cellular processes modulated by FGE such as Ca-formylglycine generating activity. 30 A wide variety of assays for candidate (pharmacological) agents are provided, including, labeled in vitro protein-ligand binding assays, electrophoretic mobility shift assays, immunoassays, cell-based assays such as two- or three-hybrid screens, expression assays, etc. The transfected nucleic acids can encode, for example, combinatorial peptide libraries or cDNA libraries. Convenient reagents for such assays, e.g., GAL4 fusion proteins, are known WO 2004/072275 PCT/US2004/003632 -41 in the art. An exemplary cell-based assay involves transfecting a cell with a nucleic acid encoding a FGE polypeptide fused to a GAL4 DNA binding domain and a nucleic acid encoding a reporter gene operably linked to a gene expression regulatory region, such as one or more GAL4 binding sites. Activation of reporter gene transcription occurs when the FGE 5 and reporter fusion polypeptide binds such as to enable transcription of the reporter gene. Agents which modulate a FGE polypeptide mediated cell function are then detected through a change in the expression of reporter gene. Methods for determining changes in the expression of a reporter gene are known in the art. FGE fragments used in the methods, when not produced by a transfected nucleic acid io are added to an assay mixture as an isolated polypeptide. FGE polypeptides preferably are produced recombinantly, although such polypeptides may be isolated from biological extracts. Recombinantly produced FGE polypeptides include chimeric proteins comprising a fusion of a FGE protein with another polypeptide, e.g., a polypeptide capable of providing or enhancing protein-protein binding, sequence specific nucleic acid binding (such as GAL4), 15 enhancing stability of the FGE polypeptide under assay conditions, or providing a detectable moiety, such as green fluorescent protein or Flag epitope. The assay mixture is comprised of a natural intracellular FGE binding target capable of interacting with FGE. While natural FGE binding targets may be used, it is frequently preferred to use portions (e.g., peptides -see e.g., the peptide of SEQ ID NO:33- or nucleic 20 acid fragments) or analogs (i.e., agents which mimic the FGE binding properties of the natural binding target for purposes of the assay) of the FGE binding target so long as the portion or analog provides binding affinity and avidity to the FGE fragment measurable in the assay. The assay mixture also comprises a candidate agent. Typically, a plurality of assay 25 mixtures are run in parallel with different agent concentrations to obtain a different response to the various concentrations. Typically, one of these concentrations serves as a negative control, i.e., at zero concentration of agent or at a concentration of agent below the limits of assay detection. Candidate agents encompass numerous chemical classes, although typically they are organic compounds. Preferably, the candidate agents are small organic compounds, 30 i.e., those having a molecular weight of more than 50 yet less than about 2500, preferably less than about 1000 and, more preferably, less than about 500. Candidate agents comprise functional chemical groups necessary for structural interactions with polypeptides and/or nucleic acids, and typically include at least an amine, carbonyl, hydroxyl or carboxyl group, preferably at least two of the functional chemical groups and more preferably at least three of WO 2004/072275 PCUS2004/003632 -42 the functional chemical groups. The candidate agents can comprise cyclic carbon or heterocyclic structure and/or aromatic or polyaromatic structures substituted with one or more of the above-identified functional groups. Candidate agents also can be biomolecules such as peptides, saccharides, fatty acids, sterols, isoprenoids, purines, pyrimidines, 5 derivatives or structural analogs of the above, or combinations thereof and the like. Where the agent is a nucleic acid, the agent typically is a DNA or RNA molecule, although modified nucleic acids as defined herein are also contemplated. Candidate agents are obtained from a wide variety of sources including libraries of synthetic or natural compounds. For example, numerous means are available for random and 10 directed synthesis of a wide variety of organic compounds and biomolecules, including expression of randomized oligonucleotides, synthetic organic combinatorial libraries, phage display libraries of random peptides, and the like. Alternatively, libraries of natural compounds in the form of bacterial, fungal, plant and animal extracts are available or readily produced. Additionally, natural and synthetically produced libraries and compounds can be 15 modified through conventional chemical, physical, and biochemical means. Further, known (pharmacological) agents may be subjected to directed or random chemical modifications such as acylation, alkylation, esterification, amidification, etc. to produce structural analogs of the agents. A variety of other reagents also can be included in the mixture. These include 20 reagents such as salts, buffers, neutral proteins (e.g., albumin), detergents, etc. which may be used to facilitate optimal protein-protein and/or protein-nucleic acid binding. Such a reagent may also reduce non-specific or background interactions of the reaction components. Other reagents that improve the efficiency of the assay such as protease, inhibitors, nuclease inhibitors, antimicrobial agents, and the like may also be used. 25 The mixture of the foregoing assay materials is incubated under conditions whereby, but for the presence of the candidate agent, the FGE polypeptide specifically binds a cellular binding target, a portion thereof or analog thereof. The order of addition of components, incubation temperature, time of incubation, and other parameters of the assay may be readily determined. Such experimentation merely involves optimization of the assay parameters, not 30 the fundamental composition of the assay. Incubation temperatures typically are between 4"C and 40"C. Incubation times preferably are minimized to facilitate rapid, high throughput screening, and typically are between 0.1 and 10 hours. After incubation, the presence or absence of specific binding between the FGE polypeptide and one or more binding targets is detected by any convenient method available WO 2004/072275 PCT/US2004/003632 -43 to the user. For cell free binding type assays, a separation step is often used to separate bound from unbound components. The separation step may be accomplished in a variety of ways. Conveniently, at least one of the components is immobilized on a solid substrate, from which the unbound components may be easily separated. The solid substrate can be made of s a wide variety of materials and in a wide variety of shapes, e.g., microtiter plate, microbead, dipstick, resin particle, etc. The substrate preferably is chosen to maximum signal to noise ratios, primarily to minimize background binding, as well as for ease of separation and cost. Separation may be effected for example, by removing a bead or dipstick from a reservoir, emptying or diluting a reservoir such as a microtiter plate well, rinsing a bead, 10 particle, chromatograpic column or filter with a wash solution or solvent. The separation step preferably includes multiple rinses or washes. For example, when the solid substrate is a microtiter plate, the wells may be washed several times with a washing solution, which typically includes those components of the incubation mixture that do not participate in specific bindings such as salts, buffer, detergent, non-specific protein, etc. Where the solid 15 substrate is a magnetic bead, the beads may be washed one or more times with a washing solution and isolated using a magnet. Detection may be effected in any convenient way for cell-based assays such as two or three-hybrid screens. The transcript resulting from a reporter gene transcription assay of FGE polypeptide interacting with a target molecule typically encodes a directly or indirectly 20 detectable product, e.g., S-galactosidase activity, luciferase activity, and the like. For cell free binding assays, one of the components usually comprises, or is coupled to, a detectable label. A wide variety of labels can be used, such as those that provide direct detection (e.g., radioactivity, luminescence, optical or electron density, etc), or indirect detection (e.g., epitope tag such as the FLAG epitope, enzyme tag such as horseseradish peroxidase, etc.). 25 The label may be bound to a FGE binding partner, or incorporated into the structure of the binding partner. A variety of methods may be used to detect the label, depending on the nature of the label and other assay components. For example, the label may be detected while bound to the solid substrate or subsequent to separation from the solid substrate. Labels may be directly 3o detected through optical or electron density, radioactive emissions, nonradiative energy transfers, etc. or indirectly detected with antibody conjugates, streptavidin-biotin conjugates, etc. Methods for detecting the labels are well known in the art. The invention provides FGE-specific binding agents, methods of identifying and making such agents, and their use in diagnosis, therapy and pharmaceutical development.

WO 2004/072275 PCT/US2004/00363 2 44 For example, FGE-specific pharmacological agents are useful in a variety of diagnostic and therapeutic applications, especially where disease or disease prognosis is associated with altered FGE binding characteristics such as in Multiple Sulfatase Deficiency. Novel FGE specific binding agents include FGE-specific antibodies, cell surface receptors, and other 5 natural intracellular and extracellular binding agents identified with assays such as two hybrid screens, and non-natural intracellular and extracellular binding agents identified in screens of chemical libraries and the like. In general, the specificity of FGE binding to a specific molecule is determined by binding equilibrium constants. Targets which are capable of selectively binding a FGE 10 polypeptide preferably have binding equilibrium constants of at least about 107 M-, more preferably at least about 108 M-1, and most preferably at least about 10 9 M~. A wide variety of cell based and cell free assays may be used to demonstrate FGE-specific binding. Cell based assays include one, two and three hybrid screens, assays in which FGE-mediated transcription is inhibited or increased, etc. Cell free assays include FGE-protein binding 15 assays, immunoassays, etc. Other assays useful for screening agents which bind FGE polypeptides include fluorescence resonance energy transfer (FRET), and electrophoretic mobility shift analysis (EMSA). According to another aspect of the invention, a method for identifying an agent useful in modulating Ca-formylglycine generating activity of a molecule of the invention, is 20 provided. The method involves (a) contacting a molecule having Ca-formylglycine generating activity with a candidate agent, (b) measuring C-formylglycine generating activity of the molecule, and (c) comparing the measured Ca-formylglycine generating activity of the molecule to a control to determine whether the candidate agent modulates Cc formylglycine generating activity of the molecule, wherein the molecule is an FGE nucleic 25 acid molecule of the invention, or an expression product thereof. "Contacting" refers to both direct and indirect contacting of a molecule having CCrformylglycine generating activity with the candidate agent. "Indirect" contacting means that the candidate agent exerts its effects on the Ca-formylglycine generating activity of the molecule via a third agent (e.g., a messenger molecule, a receptor, etc.). In certain embodiments, the control is Ca-formylglycine 30 generating activity of the molecule measured in the absence of the candidate agent. Assaying methods and candidate agents are as described above in the foregoing embodiments with respect to FGE.

WO 2004/072275 PCT/US2004/00363 2 -45 According to still another aspect of the invention, a method of diagnosing a disorder characterized by aberrant expression of a nucleic acid molecule, an expression product thereof, or a fragment of an expression product thereof, is provided. The method involves contacting a biological sample isolated from a subject with an agent that specifically binds to 5 the nucleic acid molecule, an expression product thereof, or a fragment of an expression product thereof, and determining the interaction between the agent and the nucleic acid molecule or the expression product as a determination of the disorder, wherein the nucleic acid molecule is an FGE molecule according to the invention. The disorder is Multiple Sulfatase Deficiency. Mutations in the FGE gene that cause the aberrant expression of FGE 1o molecules result in the following amino acid changes on SEQ ID NO:2: MetlArg; Met1Val; Leu20Phe; Ser155Pro; Alal77Pro; Cys2l8Tyr; Arg224Trp; Asn259Ile; Pro266Leu; Ala279Val; Arg327Stop; Cys336Arg; Arg345Cys; Ala348Pro; Arg349Gln; Arg349Trp; Arg349Trp; Ser359Stop; or a combination thereof. In the case where the molecule is a nucleic acid molecule, such determinations can be 15 carried out via any standard nucleic acid determination assay, including the polymerase chain reaction, or assaying with labeled hybridization probes as exemplified herein. In the case where the molecule is an expression product of the nucleic acid molecule, or a fragment of an expression product of the nucleic acid molecule, such determination can be carried out via any standard immunological assay using, for example, antibodies which bind to any of the 20 polypeptide expression products. "Aberrant expression" refers to decreased expression (underexpression) or increased expression (overexpression) of FGB molecules (nucleic acids and/or polypeptides) in comparison with a control (i.e., expression of the same molecule in a healthy or "normal" subject). A "healthy subject", as used herein, refers to a subject who, according to standard 25 medical standards, does not have or is at risk for developing Multiple Sulfatase Deficiency. Healthy subjects also do not otherwise exhibit symptoms of disease. In other words, such subjects, if examined by a medical professional, would be characterized as healthy and free of symptoms of a Multiple Sulfatase Deficiency. These include features of metachromatic leukodystrophy and of a mucopolysaccharidosis, such as increased amounts of acid 30 mucopolysaccharides in several tissues, mild 'gargoylism', rapid neurologic deterioration, excessive presence of mucopolysaccharide and sulfatide in the urine, increased cerebrospinal fluid protein, and metachromatic degeneration of myelin in peripheral nerves. The invention also provides novel kits which could be used to measure the levels of the nucleic acids of the invention, or expression products of the invention.

WO 2004/072275 PCT/US2004/003632 -46 In one embodiment, a kit comprises a package containing an agent that selectively binds to any of the foregoing FGB isolated nucleic acids, or expression products thereof, and a control for comparing to a measured value of binding of said agent any of the foregoing FGE isolated nucleic acids or expression products thereof. In some embodiments, the control 5 is a predetermined value for comparing to the measured value. In certain embodiments, the control comprises an epitope of the expression product of any of the foregoing FGE isolated nucleic acids. In one embodiment, the kit further comprises a second agent that selectively binds to a polypeptide selected from the group consisting of Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, 10 Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, and HSulf-6, or a peptide thereof, and a control for comparing to a measured value of binding of said second agent to said polypeptide or peptide thereof. In the case of nucleic acid detection, pairs of primers for amplifying a nucleic acid 15 molecule of the invention can be included. The preferred kits would include controls such as known amounts of nucleic acid probes, epitopes (such as Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, and HSulf-6, expression 20 products) or anti-epitope antibodies, as well as instructions or other printed material. In certain embodiments the printed material can characterize risk of developing a sulfatase deficiency condition based upon the outcome of the assay. The reagents may be packaged in containers and/or coated on wells in predetermined amounts, and the kits may include standard materials such as labeled immunological reagents (such as labeled anti-IgG 25 antibodies) and the like. One kit is a packaged polystyrene microtiter plate coated with FGE protein and a container containing labeled anti-human IgG antibodies. A well of the plate is contacted with, for example, a biological fluid, washed and then contacted with the anti-IgG antibody. The label is then detected. A kit embodying features of the present invention, generally designated by the numeral 11, is illustrated in Figure 25. Kit 11 is comprised of the 30 following major elements: packaging 15, an agent of the invention 17, a control agent 19 and instructions 21. Packaging 15 is a box-like structure for holding a vial (or number of vials) containing an agent of the invention 17, a vial (or number of vials) containing a control agent 19, and instructions 21. Individuals skilled in the art can readily modify packaging 15 to suit individual needs.

WO 2004/072275 PCTIUS2004/003632 -47 The invention also embraces methods for treating Multiple Sulfatase Deficiency in a subject. The method involves administering to a subject in need of such treatment an agent that modulates Ca-formylglycine generating activity, in an amount effective to increase Ca formylglycine generating activity in the subject. In some embodiments, the method further s comprises co-administering an agent selected from the group consisting of a nucleic acid molecule encoding Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf 3, HSulf-4, HSulf-5, and HSulf-6, an expression product of the nucleic acid molecule, and/or 10 a fragment of the expression product of the nucleic acid molecule. "Agents that modulate expression" of a nucleic acid or a polypeptide, as used herein, are known in the art, and refer to sense and antisense nucleic acids, dominant negative nucleic acids, antibodies to the polypeptides, and the like. Any agents that modulate exression of a molecule (and as described herein, modulate its activity), are useful according 15 to the invention. In certain embodiments, the agent that modulates C.-formylglycine generating activity is an isolated nucleic acid molecule of the invention (e.g., a nucleic acid of SEQ ID NO.3). In important embodiments, the agent that modulates Caformylglycine generating activity is a peptide of the invention (e.g., a peptide of SEQ I) NO.2). In some embodiments, the agent that modulates C-formylglycine generating activity is a sense 2o nucleic acid of the invention. According to one aspect of the invention, a method for for increasing C formylglycine generating activity in a subject, is provided. The method involves administering an isolated FGE nucleic acid molecule of the invention, and/or an expression product thereof, to a subject, in an amount effective to increase C,-formylglycine generating 25 activity in the subject. According to still another aspect of the invention, a method for increasing Ca formylglycine generating activity in a cell, is provided. The method involves contacting the cell with an isolated nucleic acid molecule of the invention (e.g., a nucleic acid of SEQ ID NO.1), or an expression product thereof (e.g., a peptide of SEQ I) NO.2), in an amount 30 effective to increase Cc-formylglycine generating activity in the cell. In important embodiments, the method involves activating the endogenous FGE gene to increase Ca formylglycine generating activity in the cell.

WO 2004/072275 PCT/US2004/003632 -48 In any of the foregoing embodiments the nucleic acid may be operatively coupled to a gene expression sequence which directs the expression of the nucleic acid molecule within a eukaryotic cell such as an HT-1080 cell. The "gene expression sequence" is any regulatory nucleotide sequence, such as a promoter sequence or promoter-enhancer combination, which 5 facilitates the efficient transcription and translation of the nucleic acid to which it is operably linked. The gene expression sequence may, for example, be a mammalian or viral promoter, such as a constitutive or inducible promoter. Constitutive mammalian promoters include, but are not limited to, the promoters for the following genes: hypoxanthine phosphoribosyl transferase (HPTR), adenosine deaminase, pyruvate kinase, a-actin promoter and other 10 constitutive promoters. Exemplary viral promoters which function constitutively in eukaryotic cells include, for example, promoters from the simian virus, papilloma virus, adenovirus, human immunodeficiency virus (HIV), Rous sarcoma virus, cytomegalovirus, the long terminal repeats (LTR) of moloney leukemia virus and other retroviruses, and the thymidine kinase promoter of herpes simplex virus. Other constitutive promoters are known 15 to those of ordinary skill in the art. The promoters useful as gene expression sequences of the invention also include inducible promoters. Inducible promoters are activated in the presence of an inducing agent. For example, the metallothionein promoter is activated to increase transcription and translation in the presence of certain metal ions. Other inducible promoters are known to those of ordinary skill in the art. 20 In general, the gene expression sequence shall include, as necessary, 5' non transcribing and 5' non-translating sequences involved with the initiation of transcription and translation, respectively, such as a TATA box, capping sequence, CAAT sequence, and the like. Especially, such 5' non-transcribing sequences will include a promoter region which includes a promoter sequence for transcriptional control of the operably joined nucleic acid. 25 The gene expression sequences optionally includes enhancer sequences or upstream activator sequences as desired. Preferably, any of the FGE nucleic acid molecules of the invention is linked to a gene expression sequence which permits expression of the nucleic acid molecule in a cell of a specific cell lineage, e.g., a neuron. A sequence which permits expression of the nucleic acid 30 molecule in a cell such as a neuron, is one which is selectively active in such a cell type, thereby causing expression of the nucleic acid molecule in these cells. The synapsin-1 promoter, for example, can be used to express any of the foregoing nucleic acid molecules of the invention in a neuron; and the von Willebrand factor gene promoter, for example, can be used to express a nucleic acid molecule in a vascular endothelial cell. Those of ordinary skill WO 2004/072275 PCT/US2004/00363 2 -49 in the art will be able to easily identify alternative promoters that are capable of expressing a nucleic acid molecule in any of the preferred cells of the invention. The nucleic acid sequence and the gene expression sequence are said to be "operably linked" when they are covalently linked in such a way as to place the transcription and/or 5 translation of the nucleic acid coding sequence (e.g, in the case of FGE, SEQ ID NO. 3) under the influence or control of the gene expression sequence. If it is desired that the nucleic acid sequence be translated into a functional protein, two DNA sequences are said to be operably linked if induction of a promoter in the 5' gene expression sequence results in the transcription of the nucleic acid sequence and if the nature of the linkage between the two 10 DNA sequences does not (1) result in the introduction of a frame-shift mutation, (2) interfere with the ability of the promoter region to direct the transcription of the nucleic acid sequence, and/or (3) interfere with the ability of the corresponding RNA transcript to be translated into a protein. Thus, a gene expression sequence would be operably linked to a nucleic acid sequence if the gene expression sequence were capable of effecting transcription of that is nucleic acid sequence such that the resulting transcript might be translated into the desired protein or polypeptide. The molecules of the invention can be delivered to the preferred cell types of the invention alone or in association with a vector (see also earlier discussion on vectors). In its broadest sense (and consistent with the description of expression and targeting vectors 20 elsewhere herein), a "vector" is any vehicle capable of facilitating: (1) delivery of a molecule to a target cell and/or (2) uptake of the molecule by a target cell. Preferably, the delivery vectors transport the molecule into the target cell with reduced degradation relative to the extent of degradation that would result in the absence of the vector. Optionally, a "targeting ligand" can be attached to the vector to selectively deliver the vector to a cell which expresses 25 on its surface the cognate receptor for the targeting ligand. In this manner, the vector (containing a nucleic acid or a protein) can be selectively delivered to a neuron. Methodologies for targeting include conjugates, such as those described in U.S. Patent 5,391,723 to Priest. Another example of a well--known targeting vehicle is a liposome. Liposomes are commercially available from Gibco BRL. Numerous methods are published 30 for making targeted liposomes. In general, the vectors useful in the invention include, but are not limited to, plasmids, phagemids, viruses, other vehicles derived from viral or bacterial sources that have been manipulated by the insertion or incorporation of the nucleic -acid sequences of the invention, and additional nucleic acid fragments (e.g., enhancers, promoters) which can be attached to WO 2004/072275 PCTUS2004/00363 2 -50 the nucleic acid sequences of the invention. Viral vectors are a preferred type of vector and include, but are not limited to, nucleic acid sequences from the following viruses: adenovirus; adeno-associated virus; retrovirus, such as moloney murine leukemia virus; harvey murine sarcoma virus; murine mammary tumor virus; rouse sarcoma virus; SV40-type viruses; s polyoma viruses; Epstein-Barr viruses; papilloma viruses; herpes virus; vaccinia virus; polio virus; and RNA virus such as a retrovirus. One can readily employ other vectors not named but known in the art. A particularly preferred virus for certain applications is the adeno-associated virus, a double-stranded DNA virus. The adeno-associated virus is capable of infecting a wide range 10 of cell types and species and can be engineered to be replication-deficient. It further has advantages, such as heat and lipid solvent stability, high transduction frequencies in cells of diverse lineages, including hematopoietic cells, and lack of superinfection inhibition thus allowing multiple series of transductions. Reportedly, the adeno-associated virus can integrate into human cellular DNA in a site-specific manner, thereby minimizing the 15 possibility of insertional mutagenesis and variability of inserted gene expression. In addition, wild-type adeno-associated virus infections have been followed in tissue culture for greater than 100 passages in the absence of selective pressure, implying that the adeno-associated virus genomic integration is a relatively stable event. The adeno-associated virus can also function in an extrachromosomal fashion. 20 In general, other preferred viral vectors are based on non-cytopathic eukaryotic viruses in which non-essential genes have been replaced with the gene of interest. Non cytopathic viruses include retroviruses, the life cycle of which involves reverse transcription of genomic viral RNA into DNA with subsequent proviral integration into host cellular DNA. Adenoviruses and retroviruses have been approved for human gene therapy trials. In general, 25 the retroviruses are replication-deficient (i.e., capable of directing synthesis of the desired proteins, but incapable of manufacturing an infectious particle). Such genetically altered retroviral expression vectors have general utility for the high-efficiency transduction of genes in vivo. Standard protocols for producing replication-deficient retroviruses (including the steps of incorporation of exogenous genetic material into a plasmid, transfection of a 30 packaging cell lined with plasmid, production of recombinant retroviruses by the packaging cell line, collection of viral particles from tissue culture media, and infection of the target cells with viral particles) are provided in Kriegler, M., "Gene Transfer and Expression, A Laboratory Manual," W.K Freeman C.O., New York (1990) and Murry, E.J. Ed. "Methods in Molecular Biology," vol. 7, Humana Press, Inc., Cliffton, New Jersey (1991).

WO 2004/072275 PCT/US2004/003632 -51 Another preferred retroviral vector is the vector derived from the moloney Murine leukemia virus, as described in Nabel, B.G., et al., Science,1990, 249:1285-1288. These vectors reportedly were effective for the delivery of genes to all three layers of the arterial wall, including the media. Other preferred vectors are disclosed in Flugelman, et al., 5 Circulation, 1992, 85:1110-1117. Additional vectors that are useful for delivering molecules of the invention are described in U.S. Patent No. 5,674,722 by Mulligan, et. al. In addition to the foregoing vectors, other delivery methods may be used to deliver a molecule of the invention to a cell such as a neuron, liver, fibroblast, and/or a vascular endothelial cell, and facilitate uptake thereby. 10 A preferred such delivery method of the invention is a colloidal dispersion system. Colloidal dispersion systems include lipid-based systems including oil-in-water emulsions, micelles, mixed micelles, and liposomes. A preferred colloidal system of the invention is a liposome. Liposomes are artificial membrane vessels which are useful as a delivery vector in vivo or in vitro. It has been shown that large unilamellar vessels (LUV), which range in size 15 from 0.2 - 4.0 pm can encapsulate large macromolecules. RNA, DNA, and intact virions can be encapsulated within the aqueous interior and be delivered to cells in a biologically active form (Fraley, et al., Trends Biochen. Sci., 1981, 6:77). In order for a liposome to be an efficient gene transfer vector, one or more of the following characteristics should be present: (1) encapsulation of the gene of interest at high efficiency with retention of biological 20 activity; (2) preferential and substantial binding to a target cell in comparison to non-target cells; (3) delivery of the aqueous contents of the vesicle to the target cell cytoplasm at high efficiency; and (4) accurate and effective expression of genetic information. Liposomes may be targeted to a particular tissue, such as the myocardium or the vascular cell wall, by coupling the liposome to a specific ligand such as a monoclonal 25 antibody, sugar, glycolipid, or protein. Ligands which may be useful for targeting a liposome to the vascular wall include, but are not limited to the viral coat protein of the Hemagglutinating virus of Japan. Additionally, the vector may be coupled to a nuclear targeting peptide, which will direct the nucleic acid to the nucleus of the host cell. Liposomes are commercially available from Gibco BRL, for example, as 3o LIPOFECTTNTm and LIPOFECTACETm, which are formed of cationic lipids such as N-[1-(2, 3 dioleyloxy)-propyl]-N, N, N-trimethylammonium chloride (DOTMA) and dirnethyl dioctadecylammonium bromide (DDAB). Methods for making liposomes are well known in the art and have been described in many publications. Liposomes also have been reviewed by Gregoriadis, G. in Trends in Biotechnology, V. 3, p. 235-241 (1985). Novel liposornes for WO 2004/072275 PCT/US2004/003632 -52 the intracellular delivery of macromolecules, including nucleic acids, are also described in PCT International application no. PCT/US96/07572 (Publication No. WO 96/40060, entitled "Intracellular Delivery of Macromolecules"). In one particular embodiment, the preferred vehicle is a biocompatible micro particle 5 or implant that is suitable for implantation into the mammalian recipient. Exemplary bioerodible implants that are useful in accordance with this method are described in PCT International application no. PCT/US/03307 (Publication No. WO 95/24929, entitled "Polymeric Gene Delivery System", claiming priority to U.S. patent application serial no. 213,668, filed March 15, 1994). PCT/US10307 describes a biocompatible, preferably 10 biodegradable polymeric matrix for containing an exogenous gene under the control of an appropriate promoter. The polymeric matrix is used to achieve sustained release of the exogenous gene in the patient. In accordance with the instant invention, the nucleic acids described herein are encapsulated or dispersed within the biocompatible, preferably biodegradable polymeric matrix disclosed in PCT/US/03307. The polymeric matrix 15 preferably is in the form of a micro particle such as a micro sphere (wherein a nucleic acid is dispersed throughout a solid polymeric matrix) or a microcapsule (wherein a nucleic acid is stored in the core of a polymeric shell). Other forms of the polymeric matrix for containing the nucleic acids of the invention include films, coatings, gels, implants, and stents. The size and composition of the polymeric matrix device is selected to result in favorable release 20 kinetics in the tissue into which the matrix device is implanted. The size of the polymeric matrix devise further is selected according to the method of delivery which is to be used, typically injection into a tissue or administration of a suspension by aerosol into the nasal and/or pulmonary areas. The polymeric matrix composition can be selected to have both favorable degradation rates and also to be formed of a material which is bioadhesive, to 25 further increase the effectiveness of transfer when the devise is administered to a vascular surface. The matrix composition also can be selected not to degrade, but rather, to release by diffusion over an extended period of time. Both non-biodegradable and biodegradable polymeric matrices can be used to deliver the nucleic acids of the invention to the subject. Biodegradable matrices are preferred. Such 30 polymers may be natural or synthetic polymers. Synthetic polymers are preferred. The polymer is selected based on the period of time over which release is desired, generally in the order of a few hours to a year or longer. Typically, release over a period ranging from between a few hours and three to twelve months is most desirable. The polymer optionally is WO 2004/072275 PCT/US20041003632 -53 in the form of a hydrogel that can absorb up to about 90% of its weight in water and further, optionally is cross-linked with multi-valent ions or other polymers. In general, the nucleic acids of the invention are delivered using the bioerodible implant by way of diffusion, or more preferably, by degradation of the polymeric matrix. 5 Exemplary synthetic polymers which can be used to form the biodegradable delivery system include: polyamides, polycarbonates, polyalkylenes, polyalkylene glycols, polyalkylene oxides, polyalkylene terepthalates, polyvinyl alcohols, polyvinyl ethers, polyvinyl esters, poly-vinyl halides, polyvinylpyrrolidone, polyglycolides, polysiloxanes, polyurethanes and co-polymers thereof, alkyl cellulose, hydroxyalkyl celluloses, cellulose ethers, cellulose 10 esters, nitro celluloses, polymers of acrylic and methacrylic esters, methyl cellulose, ethyl cellulose, hydroxypropyl cellulose, hydroxy-propyl methyl cellulose, hydroxybutyl methyl cellulose, cellulose acetate, cellulose propionate, cellulose acetate butyrate, cellulose acetate phthalate, carboxylethyl cellulose, cellulose triacetate, cellulose sulphate sodium salt, poly(methyl methacrylate), poly(ethyl methacrylate), poly(butylmethacrylate), poly(isobutyl 15 methacrylate), poly(hexylmethacrylate), poly(isodecyl methacrylate), poly(lauryl methacrylate), poly(phenyl methacrylate), poly(methyl acrylate), poly(isopropyl acrylate), poly(isobutyl acrylate), poly(octadecyl acrylate), polyethylene, polypropylene, poly(ethylene glycol), poly(ethylene oxide), poly(ethylene terephthalate), poly(vinyl alcohols), polyvinyl acetate, poly vinyl chloride, polystyrene and polyvinylpyrrolidone. 20 Examples of non-biodegradable polymers include ethylene vinyl acetate, poly(meth) acrylic acid, polyamides, copolymers and mixtures thereof. Examples of biodegradable polymers include synthetic polymers such as polymers of lactic acid and glycolic acid, polyanhydrides, poly(ortho)esters, polyurethanes, poly(butic acid), poly(valeric acid), and poly(lactide-cocaprolactone), and natural polymers such as 25 alginate and other polysaccharides including dextran and cellulose, collagen, chemical derivatives thereof (substitutions, additions of chemical groups, for example, alkyl, alkylene, hydroxylations, oxidations, and other modifications routinely made by those skilled in the art), albumin and other hydrophilic proteins, zein and other prolamines and hydrophobic proteins, copolymers and mixtures thereof. In general, these materials degrade either by 30 enzymatic hydrolysis or exposure to water in vivo, by surface or bulk erosion. Bioadhesive polymers of particular interest include bioerodible hydrogels described by H.S. Sawhney, C.P. Pathak and J.A. Hubell in Macromolecules, 1993, 26, 581-587, the teachings of which are incorporated herein, polyhyaluronic acids, casein, gelatin, glutin, polyanhydrides, polyacrylic acid, alginate, chitosan, poly(methyl methacrylates), poly(ethyl WO 2004/072275 PCT/US2004/00363 2 -54 methacrylates), poly(butylmethacrylate), poly(isobutyl methacrylate), poly(hexylmethacrylate), poly(isodecyl methacrylate), poly(lauryl methacrylate), poly(phenyl methacrylate), poly(methyl acrylate), poly(isopropyl acrylate), poly(isobutyl acrylate), and poly(octadecyl acrylate). Thus, the invention provides a composition of the above-described 5 molecules of the invention for use as a medicament, methods for preparing the medicament and methods for the sustained release of the medicament in vivo. Compaction agents also can be used in combination with a vector of the invention. A "compaction agent", as used herein, refers to an agent, such as a histone, that neutralizes the negative charges on the nucleic acid and thereby permits compaction of the nucleic acid into 10 a fine granule. Compaction of the nucleic acid facilitates the uptake of the nucleic acid by the target cell. The compaction agents can be used alone, i.e., to deliver an isolated nucleic acid of the invention in a form that is more efficiently taken up by the cell or, more preferably, in combination with one or more of the above-described vectors. Other exemplary compositions that can be used to facilitate uptake by a target cell of 15 the nucleic acids of the invention include calcium phosphate and other chemical mediators of intracellular transport, microinjection compositions, and electroporation. The invention embraces methods for increasing sulfatase activity in a cell. Such methods involve contacting a cell expressing a sulfatase with an isolated nucleic acid molecule of of the invention (e.g., an isolated nucleic acid molecule as claimed in any one of 20 Claims 1-8, an FGE nucleic acid molecule having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87), or an expression product thereof (e.g., a polypeptide as claimed in Claims 11 15, 19, 20, or a peptide having a sequence selected from the group consisting of SEQ UD NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78), in an amount 25 effective to increase sulfatase activity in the cell. "Increasing" sulfatase activity, as used herein, refers to increased affinity for, and/or conversion of, the specific substrate for the sulfatase, typically the result of an increase in FGly formation on the sulfatase molecule. In one embodiment, the cell expresses a sulfatase at levels higher than those of wild type cells. By "increasing sulfatase activity in a cell" also refers to increasing activity of a sulfatase that 30 is secreted by the cell. The cell may express an endogenous and/or an exogenous sulfatase. Said contacting of the FGE molecule also refers to activating the cells's endogenous FGE gene. In important embodiments, the endogenous sulfatase is activated. In certain embodiments, the sulfatase is Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosarnine 6 Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase WO 2004/072275 PCTIUS2004/003632 -55 C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf4, HSulf-5, and/or HSulf-6. In certain embodiments the cell is a mammalian cell. According to another aspect of the invention, a pharmaceutical composition, is 5 provided. The composition comprises a sulfatase that is produced by cell, in a pharmaceutically effective amount to treat a sulfatase deficiency, and a pharmaceutically acceptable carrier, wherein said cell has been contacted with an agent comprising an isolated nucleic acid molecule of the invention (e.g., as claimed in Claims 1-8, or a nucleic acid molecule having a sequence selected from the group consisting of SEQ ID NO: 1, 3, 4, 45, 10 47, 49, 51, 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, and 80-87), or an expression product thereof (e.g., a peptide selected from the group consisting of SEQ ID NO. 2, 5, 46, 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, and 78). In important embodiments, the sulfatase is expressed at higher levels than normal/control cells. The invention also embraces a sulfatase producing cell wherein the ratio of active is sulfatase to total sulfatase produced by the cell is increased. The cell comprises: (i) a sulfatase with an increased activity compared to a control, and (ii) a Formylglycine Generating Enzyme with an increased activity compared to a control, wherein the ratio of active sulfatase to total sulfatase produced by the cell is increased by at least 5% over the ratio of active sulfatase to total sulfatase produced by the cell in the absence of the 20 Formylglycine Generating Enzyme. It is known in the art that overexpression of sulfatases can decrease the activity of endogenous sulfatases (Anson et al., Biochem. J., 1993, 294:657 662). Furthermore, only a fraction of the recombinant sulfatases is active. We have discovered, unexpectedly, that increased expression/activity of FGE in a cell with increased expression/activity of a sulfatase results in the production of a sulfatase that is more active. 25 Since the presence of FGly on a sulfatase molecule is associated with sulfatase activity, "active sulfatase" can be quantitated by determining the presence of FGly on the sulfatase cell product using MALDI-TOF mass spectrometry, as described elsewhere herein. The ratio with total sulfatase can then be easily determined. The invention also provides methods for the diagnosis and therapy of sulfatase 30 deficiencies. Such disorders include, but are not limited to, Multiple Sulfatase Deficiency, Mucopolysaccharidosis II (MPS II; Hunter Syndrome), Mucopolysaccharidosis IA (MPS IIA; Sanfilippo Syndrome A), Mucopolysaccharidosis VIII (MPS VII), Mucopolysaccharidosis IVA (MPS IVA; Morquio Syndrome A), Mucopolysaccharidosis VI (MPS VI; Maroteaux-Lamy Syndrome), Metachromatic Leukodystrophy (MLD), X-linked WO 2004/072275 PCT/US2004/003632 -56 Recessive Chondrodysplasia Punctata 1, and X-linked Ichthyosis (Steroid Sulfatase Deficiency). The methods of the invention are useful in both the acute and the prophylactic treatment of any of the foregoing conditions. As used herein, an acute treatment refers to the 5 treatment of subjects having a particular condition. Prophylactic treatment refers to the treatment of subjects at risk of having the condition, but not presently having or experiencing the symptoms of the condition. In its broadest sense, the terms "treatment" or "to treat" refer to both acute and prophylactic treatments. If the subject in need of treatment is experiencing a condition (or 10 has or is having a particular condition), then treating the condition refers to ameliorating, reducing or eliminating the condition or one or more symptoms arising from the condition. In some preferred embodiments, treating the condition refers to ameliorating, reducing or eliminating a specific symptom or a specific subset of symptoms associated with the condition. If the subject in need of treatment is one who is at risk of having a condition, then 15 treating the subject refers to reducing the risk of the subject having the condition. The mode of administration and dosage of a therapeutic agent of the invention will vary with the particular stage of the condition being treated, the age and physical condition of the subject being treated, the duration of the treatment, the nature of the concurrent therapy (if any), the specific route of administration, and the like factors within the knowledge and 20 expertise of the health practitioner. As described herein, the agents of the invention are administered in effective amounts to treat any of the foregoing sulfatase deficiencies. In general, an effective amount is any amount that can cause a beneficial change in a desired tissue of a subject. Preferably, an effective amount is that amount sufficient to cause a favorable phenotypic change in a 25 particular condition such as a lessening, alleviation or elimination of a symptom or of a condition as a whole. In general, an effective amount is that amount of a pharmaceutical preparation that alone, or together with further doses, produces the desired response. This may involve only slowing the progression of the condition temporarily, although more preferably, it involves 30 halting the progression of the condition permanently or delaying the onset of or preventing the condition from occurring. This can be monitored by routine methods. Generally, doses of active compounds would be from about 0.01 mg/kg per day to 1000 mg/kg per day. It is expected that doses ranging from 50tg-500 mg/kg will be suitable, preferably orally and in one or several administrations per day.

WO 2004/072275 PCT/US2004/003632 -57 Such amounts will depend, of course, on the particular condition being treated, the severity of the condition, the individual patient parameters including age, physical condition, size and weight, the duration of the treatment, the nature of concurrent therapy (if any), the specific route of administration and like factors within the knowledge and expertise of the 5 health practitioner. Lower doses will result from certain forms of administration, such as intravenous administration. In the event that a response in a subject is insufficient at the initial doses applied, higher doses (or effectively higher doses by a different, more localized delivery route) may be employed to the extent that patient tolerance permits. Multiple doses per day are contemplated to achieve appropriate systemic levels of compounds. It is preferred 10 generally that a maximum dose be used, that is, the highest safe dose according to sound medical judgment. It will be understood by those of ordinary skill in the art, however, that a patient may insist upon a lower dose or tolerable dose for medical reasons, psychological reasons or for virtually any other reasons. The agents of the invention may be combined, optionally, with a pharmaceutically is acceptable' carrier to form a pharmaceutical preparation. The term "pharmaceutically acceptable carrier" as used herein means one or more compatible solid or liquid fillers, diluents or encapsulating substances which are suitable for administration into a human. The term "carrier" denotes an organic or inorganic ingredient, natural or synthetic, with which the active ingredient is combined to facilitate the application. The components of the 20 pharmaceutical compositions also are capable of being co-mingled with the molecules of the present invention, and with each other, in a manner such that there is no interaction which would substantially impair the desired pharmaceutical efficacy. In some aspects, the pharmaceutical preparations comprise an agent of the invention in an amount effective to treat a disorder. 25 The pharmaceutical preparations may contain suitable buffering agents, including: acetic acid in a salt; citric acid in a salt; boric acid in a salt; or phosphoric acid in a salt. The pharmaceutical compositions also may contain, optionally, suitable preservatives, such as: benzalkonium chloride; chlorobutanol; parabens or thimerosal. A variety of administration routes are available. The particular mode selected will 30 depend, of course, upon the particular drug selected, the severity of the condition being treated and the dosage required for therapeutic efficacy. The methods of the invention, generally speaking, may be practiced using any mode of administration that is medically acceptable, meaning any mode that produces effective levels of the active compounds without causing clinically unacceptable adverse effects. Such modes of administration WO 2004/072275 PCT/US2004/003632 -58 include oral, rectal, topical, nasal, intradermal, transdermal, or parenteral routes. The term "parenteral" includes subcutaneous, intravenous, intraomental, intramuscular, or infusion. Intravenous or intramuscular routes are not particularly suitable for long-term therapy and prophylaxis. As an example, pharmaceutical compositions for the acute treatment of subjects 5 having a migraine headache may be formulated in a variety of different ways and for a variety of administration modes including tablets, capsules, powders, suppositories, injections and nasal sprays. The pharmaceutical preparations may conveniently be presented in unit dosage form and may be prepared by any of the methods well-known in the art of pharmacy. All methods lo include the step of bringing the active agent into association with a carrier which constitutes one or more accessory ingredients. In general, the compositions are prepared by uniformly and intimately bringing the active compound into association with a liquid carrier, a finely divided solid carrier, or both, and then, if necessary, shaping the product. Compositions suitable for oral administration may be presented as discrete units, such 15 as capsules, tablets, lozenges, each containing a predetermined amount of the active compound. Other compositions include suspensions in aqueous liquids or non-aqueous liquids such as a syrup, elixir or an emulsion. Compositions suitable for parenteral administration conveniently comprise a sterile aqueous preparation of an agent of the invention, which is preferably isotonic with the blood 20 of the recipient This aqueous preparation may be formulated according to known methods using suitable dispersing or wetting agents and suspending agents. The sterile injectable preparation also may be a sterile injectable solution or suspension in a non-toxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butane diol. Among the acceptable vehicles and solvents that may be employed are water, Ringer's solution, and 25 isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose any bland fixed oil may be employed including synthetic mono-or di-glycerides. In addition, fatty acids such as oleic acid may be used in the preparation of injectables. Formulations suitable for oral, subcutaneous, intravenous, intramuscular, etc. administrations can be found in Remington's Pharmaceutical 30 Sciences, Mack Publishing Co., Easton, PA. According to one aspect of the invention, a method for increasing Cc-formylglycine generating activity in a cell, is provided. The method involves contacting the cell with an isolated nucleic acid molecule of the invention (e.g., a nucleic acid of SEQ ID NO.1), or an expression product thereof (e.g., a peptide of SEQ ID NO.2), in an amount effective to WO 2004/072275 PCrUS2004/003632 -59 increase C.-formylglycine generating activity in the cell. In important embodiments, the method involves activating the endogenous FOE gene to increase Ccrformylglycine generating activity in the cell. In some embodiments, the contacting is performed under conditions that permit entry of a molecule of the invention into the cell. 5 The term "permit entry" of a molecule into a cell according to the invention has the following meanings depending upon the nature of the molecule. For an isolated nucleic acid it is meant to describe entry of the nucleic acid through the cell membrane and into the cell nucleus, where upon the "nucleic acid transgene" can utilize the cell machinery to produce functional polypeptides encoded by the nucleic acid. By "nucleic acid transgene" it is meant io to describe all of the nucleic acids of the invention with or without the associated vectors. For a polypeptide, it is meant to describe entry of the polypeptide through the cell membrane and into the cell cytoplasm, and if necessary, utilization of the cell cytoplasmic machinery to functionally modify the polypeptide (e.g., to an active form). Various techniques may be employed for introducing nucleic acids of the invention is into cells, depending on whether the nucleic acids are introduced in vitro or in vivo in a host. Such techniques include transfection of nucleic acid-CaPO 4 precipitates, transfection of nucleic acids associated with DEAE, transfection with a retrovirus including the nucleic acid of interest, liposome mediated transfection, and the like. For certain uses, it is preferred to target the nucleic acid to particular cells. In such instances, a vehicle used for delivering a 20 nucleic acid of the invention into a cell (e.g., a retrovirus, or other virus; a liposome) can have a targeting molecule attached thereto. For example, a molecule such as an antibody specific for a surface membrane protein on the target cell or a ligand for a receptor on the target cell can be bound to or incorporated within the nucleic acid delivery vehicle. For example, where liposomes are employed to deliver the nucleic acids of the invention, proteins which bind to a 25 surface membrane protein associated with endocytosis may be incorporated into the liposome formulation for targeting and/or to facilitate uptake. Such proteins include capsid proteins or fragments thereof tropic for a particular cell type, antibodies for proteins which undergo internalization in cycling, proteins that target intracellular localization and enhance intracellular half life, and the like. Polymeric delivery systems also have been used 30 successfully to deliver nucleic acids into cells, as is known by those skilled in the art. Such systems even permit oral delivery of nucleic acids. Other delivery systems can include time-release, delayed release or sustained release delivery systems. Such systems can avoid repeated administrations of an agent of the present invention, increasing convenience to the subject and the physician. Many types of release WO 2004/072275 PCT/US2004/003632 -60 delivery systems are available and known to those of ordinary skill in the art. They include polymer base systems such as poly(lactide-glycolide), copolyoxalates, polycaprolactones, polyesteramides, polyorthoesters, polyhydroxybutyric acid, and polyanhydrides. Microcapsules of the foregoing polymers containing drugs are described in, for example, U.S. 5 Patent 5,075,109. Delivery systems also include non-polymer systems that are: lipids including sterols such as cholesterol, cholesterol esters and fatty acids or neutral fats such as mono- di- and tri-glycerides; hydrogel release systems; sylastic systems; peptide based systems; wax coatings; compressed tablets using conventional binders and excipients; partially fused implants; and the like. Specific examples include, but are not limited to: (a) 10 erosional systems in which an agent of the invention is contained in a form within a matrix such as those described in U.S. Patent Nos. 4,452,775, 4,675,189, and 5,736,152, and (b) diffusional systems in which an active component permeates at a controlled rate from a polymer such as described in U.S. Patent Nos. 3,854,480, 5,133,974 and 5,407,686. In addition, pump-based hardware delivery systems can be used, some of which are adapted for 15 implantation. Use of a long-term sustained release implant may be desirable. Long-term release, as .used herein, means that the implant is constructed and arranged to deliver therapeutic levels of the active ingredient for at least 30 days, and preferably 60 days. Long-term sustained release implants are well-known to those of ordinary skill in the art and include some of the 20 release systems described above. Specific examples include, but are not limited to, long-term sustained release implants described in U.S. Patent No. 4,748,024, and Canadian Patent No. 1330939. The invention also involves the administration, and in some embodiments co administration, of agents other than the FGE molecules of the invention that when 25 administered in effective amounts can act cooperatively, additively or synergistically with a molecule of the invention to: (i) modulate Ccrformylglycine generating activity, and (ii) treat any of the conditions in which Ca-formylglycine generating activity of a molecule of the invention is involved (e.g., a sulfatase deficiency including MSD). Agents other than the molecules of the invention include Iduronate 2-Sulfatase, Sulfamidase, N 30 Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, or HSulf-6, (nucleic acids and polypeptides, and/or fragments thereof), and/or combinations thereof.

WO 2004/072275 PCTIUS2004/003632 -61 "Co-administering," as used herein, refers to administering simultaneously two or more compounds of the invention (e.g., an FGE nucleic acid and/or polypeptide, and an agent known to be beneficial in the treatment of, for example, a sulfatase deficiency -e.g., Iduronate 2-Sulfatase in the treatment of MPSfl-), as an admixture in a single composition, or 5 sequentially, close enough in time so that the compounds may exert an additive or even synergistic effect. The invention also embraces solid-phase nucleic acid molecule arrays. The array consists essentially of a set of nucleic acid molecules, expression products thereof, or fragments (of either the nucleic acid or the polypeptide molecule) thereof, each nucleic acid 10 molecule selected from the group consisting of FGE, Iduronate 2-Sulfatase, Sulfamidase, N Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf4, HSulf-5, and HSulf-6, fixed to a solid substrate. In some embodiments, the solid-phase array further comprises at least one control 15 nucleic acid molecule. In certain embodiments, the set of nucleic acid molecules comprises at least one, at least two, at least three, at least four, or even at least five nucleic acid molecules, each selected from the group consisting of FGE, Iduronate 2-Sulfatase, Sulfamidase, N Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, 20 Arylsulfatase G, HSulf-1, HSulf-2, HSulf-3, HSulf-4, HSulf-5, and HSulf-6. In preferred embodiments, the set of nucleic acid molecules comprises a maximum number of 100 different nucleic acid molecules. In important embodiments, the set of nucleic acid molecules comprises a maximum number of 10 different nucleic acid molecules. According to the invention, standard hybridization techniques of microarray 25 technology are utilized to assess patterns of nucleic acid expression and identify nucleic acid expression. Microarray technology, which is also known by other names including: DNA chip technology, gene chip technology, and solid-phase nucleic acid array technology, is well known to those of ordinary skill in the art and is based on, but not limited to, obtaining an array of identified nucleic acid probes (e.g., molecules described elsewhere herein such as of 30 FGE, Iduronate 2-Sulfatase, Sulfamidase, N-Acetylgalactosamine 6-Sulfatase, N Acetylglucosamine 6-Sulfatase, Arylsulfatase A, Arylsulfatase B, Arylsulfatase C, Arylsulfatase D, Arylsulfatase E, Arylsulfatase F, Arylsulfatase G, HSulf-1, HSulf-2, HSulf 3, HSulf-4, HSulf-5, and/or HSulf-6) on a fixed substrate, labeling target molecules with reporter molecules (e.g., radioactive, chemiluminescent, or fluorescent tags such as WO 2004/072275 PCT/US2004/003632 -62 fluorescein, Cye3-dUTP, or Cye5-dUTP), hybridizing target nucleic acids to the probes, and evaluating target-probe hybridization. A probe with a nucleic acid sequence that perfectly matches the target sequence will, in general, result in detection of a stronger reporter molecule signal than will probes with less perfect matches. Many components and s techniques utilized in nucleic acid microarray technology are presented in The Chipping Forecast, Nature Genetics, Vol.21, Jan 1999, the entire contents of which is incorporated by reference herein. According to the present invention, microarray substrates may include but are not limited to glass, silica, aluminosilicates, borosilicates, metal oxides such as alumina and 10 nickel oxide, various clays, nitrocellulose, or nylon. In all embodiments a glass substrate is preferred. According to the invention, probes are selected from the group of nucleic acids including, but not limited to: DNA, genomic DNA, cDNA, and oligonucleotides; and may be natural or synthetic. Oligonucleotide probes preferably are 20 to 25-mer oligonucleotides and DNA/cDNA probes preferably are 500 to 5000 bases in length, although other lengths 15 may be used. Appropriate probe length may be determined by one of ordinary skill in the art by following art-known procedures. In one embodiment, preferred probes are sets of two or more of the nucleic acid molecules set forth as SEQ ID NOs: 1, 3, 4, 6, 8, 10, and/or 12. Probes may be purified to remove contaminants using standard methods known to those of ordinary skill in the art such as gel filtration or precipitation. 20 In one embodiment, the microarray substrate may be coated with a compound to enhance synthesis of the probe on the substrate. Such compounds include, but are not limited to, oligoethylene glycols. In another embodiment, coupling agents or groups on the substrate can be used to covalently link the first nucleotide or olignucleotide to the substrate. These agents or groups may include, but are not limited to: amino, hydroxy, bromo, and carboxy 25 groups. These reactive groups are preferably attached to the substrate through a hydrocarbyl radical such as an alkylene or phenylene divalent radical, one valence position occupied by the chain bonding and the remaining attached to the reactive groups. These hydrocarbyl groups may contain up to about ten carbon atoms, preferably up to about six carbon atoms. Alkylene radicals are usually preferred containing two to four carbon atoms in the principal 30 chain. These and additional details of the process are disclosed, for example, in U.S. Patent 4,458,066, which is incorporated by reference in its entirety. In one embodiment, probes are synthesized directly on the substrate in a predetermined grid pattern using methods such as light-directed chemical synthesis, WO 2004/072275 PCT/US2004/003632 -63 photochemical deprotection, or delivery of nucleotide precursors to the substrate and subsequent probe production. In another embodiment, the substrate may be coated with a compound to enhance binding of the probe to the substrate. Such compounds include, but are not limited to: s polylysine, amino silanes, amino-reactive silanes (Chipping Forecast, 1999) or chromium (Gwynne and Page, 2000). In this embodiment, presynthesized probes are applied to the substrate in a precise, predetermined volume and grid pattern, utilizing a computer-controlled robot to apply probe to the substrate in a contact-printing manner or in a non-contact manner such as ink jet or piezo-electric delivery. Probes may be covalently linked to the substrate 10 with methods that include, but are not limited to, UV-irradiation. In another embodiment probes are linked to the substrate with heat. Targets are nucleic acids selected from the group, including but not limited to: DNA, genomic DNA, cDNA, RNA, mRNA and may be natural or synthetic. In all embodiments, nucleic acid molecules from subjects suspected of developing or having a sulfatase 15 deficiency, are preferred. In certain embodiments of the invention, one or more control nucleic acid molecules are attached to the substrate. Preferably, control nucleic acid molecules allow determination of factors including but not limited to: nucleic acid quality and binding characteristics; reagent quality and effectiveness; hybridization success; and analysis thresholds and success. Control nucleic acids may include, but are not limited to, 20 expression products of genes such as housekeeping genes or fragments thereof. To select a set of sulfatase deficiency disease markers, the expression data generated by, for example, microarray analysis of gene expression, is preferably analyzed to determine which genes in different categories of patients (each category of patients being a different sulfatase deficiency disorder), are significantly differentially expressed. The significance of 25 gene expression can be determined using Permax computer software, although any standard statistical package that can discriminate significant differences is expression may be used. Permax performs permutation 2-sample t-tests on large arrays of data. For high dimensional vectors of observations, the Permax software computes t-statistics for each attribute, and assesses significance using the permutation distribution of the maximum and minimum 30 overall attributes. The main use is to determine the attributes (genes) that are the most different between two groups (e.g., control healthy subject and a subject with a particular sulfatase deficiency), measuring "most different" using the value of the t-statistics, and their significance levels.

WO 2004/072275 PCT/US2004/003632 -64 Expression of sulfatase deficiency disease related nucleic acid molecules can also be determined using protein measurement methods to determine expression of SEQ ID NOs: 2, e.g., by determining the expression of polypeptides encoded by SEQ ID NOs: 1, and/or 3. Preferred methods of specifically and quantitatively measuring proteins include, but are not s limited to: mass spectroscopy-based methods such as surface enhanced laser desorption ionization (SELDI; e.g., Ciphergen ProteinChip System), non-mass spectroscopy-based methods, and immunohistochemistry-based methods such as 2-dimensional gel electrophoresis. SELDI methodology may, through procedures known to those of ordinary skill in the 1o art, be used to vaporize microscopic amounts of protein and to create a "fingerprint" of individual proteins, thereby allowing simultaneous measurement of the abundance of many proteins in a single sample. Preferably SELDI-based assays may be utilized to characterize multiple sulfatase deficiency as well as stages of such conditions. Such assays preferably include, but are not limited to the following examples. Gene products discovered by RNA 15 microarrays may be selectively measured by specific (antibody mediated) capture to the SELDI protein disc (e.g., selective SELDI). Gene products discovered by protein screening (e.g., with 2-D gels), may be resolved by "total protein SELDr optimized to visualize those particular markers of interest from among SEQ ID NOs: 1, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, and/or 28. Predictive models of a specific sulfatase deficiency from SELDI measurement 20 of multiple markers from among SEQ ID NOs: 1, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, and/or 28, may be utilized for the SELDI strategies. The use of any of the foregoing microarray methods to determine expression of a sulfatase deficiency disease related nucleic acids can be done with routine methods known to those of ordinary skill in the art and the expression determined by protein measurement 25 methods may be correlated to predetermined levels of a marker used as a prognostic method for selecting treatment strategies for sulfatase deficiency disease patients. The invention also embraces a sulfatase-producing cell wherein the ratio of active sulfatase to total sulfatase produced (i.e., the specific activity) by the cell is increased The cell comprises: (i) a sulfatase with an increased expression, and (ii) a Formylglycine 30 Generating Enzyme with an increased expression, wherein the ratio of active sulfatase to total sulfatase produced by the cell is increased by at least 5% over the ratio of active sulfatase to total sulfatase produced by the cell in the absence of the Formylglycine Generating Enzyme. A "sulfatase with an increased expression," as used herein, typically refers to increased expression of a sulfatase and/or its encoded polypeptide compared to a control.

WO 2004/072275 PCTfJS2004/003632 -65 Increased expression refers to increasing (i.e., to a detectable extent) replication, transcription, and/or translation of any of the sulfatase nucleic acids (sulfatase nucleic acids of the invention as described elsewhere herein), since upregulation of any of these processes results in concentration/amount increase of the polypeptide encoded by the gene (nucleic 5 acid). This can be accomplished using a number of methods known in the art, also described elsewhere herein, such as transfection of a cell with the sulfatase cDNA, and/or genomic DNA encompassing the sulfatase locus, activating the endogenous sulfatase gene by placing, for example, a strong promoter element upstream of the endogenous sulfatase gene genomic locus using homologous recombination (see, e.g., the gene activation technology described in 10 detail in U.S. Patents Nos. 5,733,761, 6,270,989, and 6,565,844, all of which are expressly incorporated herein by reference), etc. A typical control would be an identical cell transfected with a vector plasmid(s). Enhancing (or increasing) sulfatase activity also refers to preventing or inhibiting sulfatase degradation (e.g., via increased ubiquitinization), downregulation, etc., resulting, for example, in increased or stable sulfatase molecule t% 15 (half-life) when compared to a control. Downregulation or decreased expression refers to decreased expression of a gene and/or its encoded polypeptide. The upregulation or downregulation of gene expression can be directly determined by detecting an increase or decrease, respectively, in the level of mRNA for the gene (e.g, a sulfatase), or the level of protein expression of the gene-encoded polypeptide, using any suitable means known to the 20 art, such as nucleic acid hybridization or antibody detection methods, respectively, and in comparison to controls. Upregulation or downregulation of sulfatase gene expression can also be determined indirectly by detecting a change in sulfatase activity. Similarily, a "Formylglycine Generating Enzyme with an increased expression," as used herein, typically refers to increased expression of an FGE nucleic acid of the invention 25 and/or its encoded polypeptide compared to a control. Increased expression refers to increasing (i.e., to a detectable extent) replication, transcription, and/or translation of any of the FGE nucleic acids of the invention (as described elsewhere herein), since upregulation of any of these processes results in concentration/amount increase of the polypeptide encoded by the gene (nucleic acid). This can be accomplished using the methods described above (for 30 the sulfatases), and elsewhere herein. In certain embodiments, the ratio of active sulfatase to total sulfatase produced by the cell is increased by at least 10%, 15%, 20%, 50%, 100%, 200%, 500%, 1000%, over the ratio of active sulfatase to total sulfatase produced by the cell in the absence of the Formylglycine Generating Enzyme.

WO 2004/072275 PCT/US2004/003632 -66 The invention further embraces an improved method for treating a sulfatase deficiency in a subject. The method involves administering to a subject in need of such treatment a sulfatase in an effective amount to treat the sulfatase deficiency in the subject, wherein the sulfatase is contacted with a Formylglycine Generating Enzyme in an amount 5 effective to increase the specific activity of the sulfatase. As described elsewhere herein, "specific activity" refers to the ratio of active sulfatase to total sulfatase produced. "Contacted," as used herein, refers to FGE post-translationally modifying the sulfatase as described elsewhere herein. It would be apparent to one of ordinary skill in the art that an FGE can contact a sulfatase and modify it if nucleic acids encoding FGE and a sulfatase are 10 co-expressed in a cell, or even if an isolated FGE polypeptide contacts an isolated sulfatase polypeptide in vivo or in vitro. Even though an isolated FGE polypeptide can be co administered with an isolated sulfatase polypeptide to a subject to treat a sulfatase deficiency in the subject, it is preferred that the contact between FGE and the sulfatase takes place in vitro prior to administration of the sulfatase to the subject. This improved method of is treatment is beneficial to a subject since lower amounts of the sulfatase need to be administered, and/or with less frequency, since the sulfatase is of higher specific activity. The invention will be more fully understood by reference to the following examples. These examples, however, are merely intended to illustrate the embodiments of the invention and are not to be construed to limit the scope of the invention. 20 Examples Example 1: Multiple Sulfatase Deficiency is caused by mutations in the gene encoding the human Ca formylglycine generating enzyme (FGE) 25 Experimental Procedures Materials and Methods In vitro assay for FGE For monitoring the activity of FGE, the N-acetylated and C-amidated 23mer peptide 30 P23 (MTDFYVPVSLCTPSRAALLTGRS) (SEQ ID NO:33) was used as substrate. The conversion of the Cysteine residue in position 11 to FGly was monitored by MALDI-TOF mass spectrometry. A 6piM stock solution of P23 in 30% acetonitrile and 0.1% trifluoroacetic acid (TFA) was prepared. Under standard conditions 6 pmol of P23 were incubated at 37*C with up to 10 pl enzyme in a final volume of 30 pl 50 mM Tris/HCl, pH 35 9.0, containing 67 mM NaCl, 15 AM CaCl 2 , 2 mM DTT, and 0.33 mg/ml bovine serum WO 2004/072275 PCT/US2004/003632 -67 albumin. To stop the enzyme reaction 1.5 pl 10% TFA were added. P23 then was bound to ZipTip C18 (Millipore), washed with 0.1% TFA and eluted in 3pl 50% acetonitrile, 0.1% TFA. 0.5 pl of the eluate was mixed with 0.5 pl of matrix solution (5 mg/ml a-cyano-4 hydroxy-cinnamic acid (Bruker Daltonics, Billerica, MA) in 50% acetonitrile, 0.1% TFA) on 5 a stainless steel targeL MALDI-TOF mass spectrometry was performed with a Reflex IM (Broker Daltonics) using reflectron mode and laser energy just above the desorption/ionization threshold. All spectra were averages of 200-300 shots from several spots on the target. The mass axis was calibrated using peptides of molecular masses ranging from 1000 to 3000 Da as external standards. Monoisotopic MH of P23 is 2526.28 and of the la FGly containing product 2508.29. Activity (pmol product / h) was calculated on the basis of the peak height of the product divided by the sum of the peak heights of P23 and the product. Purfication of FGE from bovine testis Bovine testes were obtained from the local slaughter house and stored for up to 20 h on ice. The parenchyme was freed from connective tissue and homogenized in a waring 15 blendor and by three rounds of motor pottering. Preparation of rough microsomes (RM) by cell fractionation of the obtained homogenate was performed as described (Meyer et al., J. Biol. Chem., 2000, 275:14550-14557) with the following modifications. Three differential centrifugation steps, 20 minutes each at 4*C, were performed at 500 g (JA1O rotor), 3000 g (JA10) and 10000 g (JA20). From the last supernatant the RM membranes were sedimented 20 (125000 g, Ti45 rotor, 45 min, 4*C), homogenized by motor pottering and layered on a sucrose cushion (50 mM Hepes, pH 7.6, 50 mM KAc, 6 mM MgAc 2 , 1 mM EDTA, 1.3 M sucrose, 5 mM P-mercaptoethanol). RMs were recovered from the pellet after spinning for 210 minutes at 45000 rpm in a Ti45 rotor at 4*C. Usually 100000-150000 equivalents RM, as defined by Walter and Blobel (Methods Enzymol.,1983, 96:84-93), were obtained from 1 kg 25 of testis tissue. The reticuloplasm, i.e. the luminal content of the RM, was obtained by differential extraction at low concentrations of deoxy Big Chap, as described (Fey et al., J. Biol. Chem., 2001, 276:47021-47028). For FGE purification, 95 ml of reticuloplasm were dialyzed for 20 h at 4 *C against 20 mM Tris/HCl, pH 8.0, 2.5 mM DTT, and cleared by centrifugation at 125000 g for 1 h. 32 ml-aliquots of the cleared reticuloplasm were loaded on 30 a MonoQ HR1O/10 column (Amersham Biosciences, Piscataway, NJ) at room temperature, washed and eluted at 2 ml/min with a linear gradient of 0 to 0.75 M NaCl in 80 ml of the Tris buffer. The fractions containing FGE activity, eluting at 50-165 mM NaCl, of three runs were pooled (42 ml) and mixed with 2 ml of Concanavalin A-Sepharose (Amersham Biosciences) that had been washed with 50 mM Hepes buffer, pH 7.4, containing 0.5 M KCl, 1 mM WO 2004/072275 PCT/US2004/003632 -68 MgC 2 , 1 mM MnCI 2 , 1 mM CaC1 2 , and 2.5 mM DTT. After incubation for 16 h at 4 "C, the Concanavalin A-Sepharose was collected in a column and washed with 6 ml of the same Hepes buffer. The bound material was eluted by incubating the column for 1 h at room temperature with 6 ml 0.5 M a-methylmannoside in 50 mM Hepes, pH 7.4, 2.5 mM DTT. 5 The elution was repeated with 4 ml of the same eluent. The combined eluates (10 ml) from Concanavalin A-Sepharose were adjusted to pH 8.0 with 0.5 M Tris/HC1, pH 9.0, and mixed with 2 ml of Affigel 10 (Bio-Rad Laboratories, Hercules, CA) that had been derivatized with 10 mg of the scrambled peptide (PVSLPTRSCAALLTGR) (SEQ ID NO:34) and washed with buffer A (50 mM Hepes, pH 8.0, containing 0.15 M potassium acetate, 0.125 M sucrose, 10 1 mM MgCl 2 , and 2.5 mM DTT). After incubation for 3 h at 4 "C the affinity matrix was collected in a column. The flow through and a wash fraction with 4 ml of buffer A were collected, combined and mixed with 2 ml of Affigel 10 that had been substituted with 10 mg of the Ser69 peptide (PVSLSTPSRAALLTGR) (SEQ ID NO:35) and washed with buffer A. After incubation overnight at 4"C, the affinity matrix was collected in a column, washed 3 is times with 6 ml of buffer B (buffer A containing 2 M NaCI and a mixture of the 20 proteinogenic amino acids, each at 50 mg/ml). The bound material was eluted from the affinity matrix by incubating the Affigel twice for 90 min each with 6 ml buffer B containing 25 mM Ser69 peptide. An aliqout of the eluate was substituted with 1 mg/ml bovine serum albumin, dialyzed against buffer A and analyzed for activity. The remaining part of the 20 activity (11.8 ml) was concentrated in a Vivaspin 500 concentrator (Vivascience AG, Hannover, Germany), and solubilized at 95 'C in Laemmli SDS sample buffer. The polypeptide composition of the starting material and preparations obtained after the chromatographic steps were monitored by SDSPAGE (15% acrylamide, 0.16% bisacrylamide) and staining with SYPRO Ruby (Bio-Rad Laboratories). 25 Identification of FGE by mass spectrometry For peptide mass fingerprint analysis the purified polypeptides were in-gel digested with trypsin (Shevchenko et al., Anal. Chem., 1996, 68:850-855), desalted on C18 ZipTip and analyzed by MALDI-TOF mass spectrometry using dihydrobenzoic acid as matrix and two autolytic peptides from trypsin (m/z 842.51 and 2211.10) as internal standards. For tandem 30 mass spectrometry analysis selected peptides were analyzed by MALDI-TOF post-source decay mass spectrometry. Their corresponding doubly charged ions were isolated and fragmented by offline nano-ESI ion trap mass spectrometry (EsquireLC, Bruker Daltonics). The mass spectrometric data were used by Mascot search algorithm for protein identification in the NCBInr protein database and the NCBI EST nucleotide database.

WO 2004/072275 PCTUS2004/00363 2 -69 Bioinformatics Signal peptides and clevage sites were described with the method of von Heijne (von Heijne, Nucleic Acids Res., 1986, 14:4683-90) implemented in EMBOSS (Rice et al., Trends in Genetics, 2000, 16:276-277). N-glycosylation sites were predicted using the algorithm of 5 Bnmnak (Gupta and Brunak, Pac. Symp. Biocomput., 2002, 310-22). Functional domains were detected by searching PFAM-Hidden-Markov-Models (version 7.8) (Sonnhammer et al., Nucleic Acids Res., 1998, 26:320-322). To search for FGE homologs, the databases of the National Center for Biotechnology Information (Wheeler et al., Nucleic Acids Res., 2002, 20:13-16) were queried with BLAST (Altschul et al., Nucleic Acids Res., 1997, 25:3389 10 3402). Sequence similarities were computed using standard tools from EMBOSS. Genomic loci organisation and synteny were determined using the NCBI's human and mouse genome resources and the Human-Mouse Homology Map also form NCBI, Bethesda, MD). Cloning of human FGE cDNA Total RNA, prepared from human fibroblasts using the RNEASYN Mini kit (Qiagen, is Inc., Valencia, CA) was reverse transcribed using the OMNISCRIPT RTm kit (Qiagen, Inc., Valencia, CA) and either an oligo(dT) primer or the FGE-specific primer 1199nc (CCAATGTAGGTCAGACACG) (SEQ ID NO:36). The first strand cDNA was amplified by PCR using the forward primer lc (ACATGGCCCGCGGGAC) (SEQ ID NO:37) and, as reverse primer, either 1199nc or 1182nc (CGACTGCTCCTTGGACTGG) (SEQ ID NO:38). 20 The PCR products were cloned directly into the pCR4-TOPOm vector (Invitrogen Corporation, Carlsbad, CA). By sequencing multiple of the cloned PCR products, which had been obtained from various individuals and from independent RT and PCR reactions, the coding sequence of the FGE cDNA was determined (SEQ ID NOs:1 and 3). Mutation detection, genomic sequencing, site-directed mutagenesis and Northern blot 25 analysis Standard protocols utilized in this study were essentially as described in LUbke et al. (Nat. Gen., 2001, 28:73-76) and Hansske et al. (J. Clin. Invest., 2002, 109:725-733). Northern blots were hybridized with a cDNA probe covering the entire coding region and a p-actin cDNA probe as a control for RNA loading. 30 Cell lines and cell culture The fibroblasts from MSD patients 1-6 were obtained from E. Christenson (Rigshospitalet Copenhagen), M. Beck (Universitatskinderklinik Mainz), A. KohlschUtter (Universitatskrankenhaus Eppendorf, Hamburg), E. Zammarchi (Meyer Hospital, University of Florence), K. Harzer (Institut fuir Himforschung, UniversitAt Tubingen), and A. Fensom WO 2004/072275 PCT/US2004/003632 -70 (Guy's Hospital, London), respectively. Human skin fibroblasts, HT-1080, BHK21 and CHO cells were maintained at 37"C under 5% CO2 in Dulbecco's modified Eagle's medium containing 10% fetal calf serum. Transfection, indirect immunofluorescence, Western blot analysis and detection of FGE 5 activity The FGE cDNA was equipped with a 5' EcoRI-site and either a 3' HA-, c-Myc or RGS-His6-tag sequence, followed by a stop-codon and a HindiII site, by add-on PCR using Pfu polymerase (Stratagene, La Jolla, CA) and the following primers: GGAATICGGGACAACATGGCTGCG (EcoRI) (SEQ ID NO:39), CCCAAGCTTATGC 10 GTAGTCAGGCACATCATACGGATAGTCCATGGTGGGCAGGC(HA)(SEQ ID NO:40), CCCAAGCTrACAGGTCTTCTCAGAAATCAGCI G'ITCGTCCATGGTGGGCAG GC (c-Myc) (SEQ ID NO:41), CCCAAGCTTAGTGATGGTGATGGTGATGCGATC CTCTGTCCATGGTGGGCAGGC (RGS-His 6 ) (SEQ ID NO:42). The resulting PCR products were cloned as EcoRi/HindII fragments into pMPSVEH (Artelt et al., Gene, 1988, is 68:213-219). The plasmids obtained were transiently transfected into HT-1080, BHK21 and CHO cells, grown on cover slips, using EFFECTENETm (Qiagen) as transfection reagent. 48h after transfection the cells were analyzed by indirect immunofluorescence as described previously (Ltibke et al., Nat. Gen., 2001, 28:73-76; Hansske et al., J. Clin. Invest., 2002, 109:725-733), using monoclonal IgGI antibodies against HA (Berkeley Antibody Company, 20 Richmond, CA), c-Myc (Santa Cruz Biotechnology, Inc., Santa Cruz, CA) or RGS-His (Qiagen) as primary antibodies. The endoplasmic reticulum marker protein proteindisulfide isomerase (PDI) was detected with a monoclonal antibody of different subtype (IgG2A, Stressgen Biotech., Victoria BC, Canada). The pimary antibodies werde detected with isotype-specific goat secondary antibodies coupled to CY2 or CY3, respectively (Molecular 25 Probes, Inc., Eugene, OR). Immunofluorescence images were obtained on a Leica TCS Sp2 AOBS laser scan microscope. For Western blot analysis the same monoclonal antibodies and a HRP-conjugated anti-mouse IgG as secondary antibody were used. For determination of FGE activity, the trypsinised cells were washed with phosphate buffered saline containing a mixture of proteinase inhibitors (208 pM 4-(2- aminoethyl)benzene sulfonyl fluoride 30 hydrochloride, 0.16 AM aprotinin, 4.2 pM leupeptin, 7.2 pM bestatin, 3 pM pepstatin A, 2.8 pM E-64), solubilized in 10 mM Tris, pH 8.0, containing 2.5 mM DTI, the proteinase inhibitors and 1% Triton X-100, and cleared by centrifugation at 125,000 g for lh. The supernatant was subjected to chromatography on a MonoQ PC 1.6/5 column using the conditions described above. Fractions eluting at 50-200 mM NaCl were pooled, lyophilised WO 2004/072275 PCT/US2004/003632 -71 and reconstituted in one tenth of the original pool volume prior determination of FGE activity with peptide P23. Retroviral transduction cDNAs of interest were cloned into the Moloney murine leukemia virus based vector 5 pLPCX and pLNCX2 (BD Biosciences Clontech, Palo Alto, CA). The transfection of ecotropic FNX-Eco cells (ATCC, Manassas, VA) and the transduction of amphotropic

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m PT67 cells (BD Biosciences Clontech) and human fibroblasts was performed as described (LUbke et al., Nat. Gen., 2001, 28:73-76; Thiel et al., Biochem. J., 2002, 376, 195-201). For some experiments pLPCX-transduced PT67 cells were selected 10 with puromycin prior determination of sulfatase activities. Sulfatase assays Activity of ASA, STS and GalNAc6S were determined as described in Rommerskirch and von Figura, Proc. Nati. Acad. Sci., USA, 1992, 89:2561-2565; GlLssl and Kresse, Cln. Chim. Acta, 1978, 88:111-119. 15 Results A rapid peptide based assay for FGE activity We had developed an assay for determining FGE activity in microsome extracts using in vitro synthesized [3S] ASA fragments as substrate. The fragments were added to the assay mixture as ribosome-associated nascent chain complexes. The quantitation of the product 20 included tryptic digestion, separation of the peptides by RP-HPLC and identification and quantitation of the [ 5 S]-labeled FGly containing tryptic peptide by a combination of chemical derivatization to hydrazones, RP-HPLC separation and liquid scintillation counting (Fey et al., J. Biol. Chem., 2001, 276:47021-47028). For monitoring the enzyme activity during purification, this cumbersome procedure needed to be modified. A synthetic 16mer 25 peptide corresponding to ASA residues 65-80 and containing the sequence motif required for FGly formation inhibited the FGE activity in the in vitro assay. This suggested that peptides such as ASA65-80 may serve as substrates for FGE. We synthesized the 23mer peptide P23 (SEQ ID NO:33), which corresponds to ASA residues 60-80 with an additional N-acetylated methionine and a C-amidated seine residue to protect the N- and C-terminus, respectively. 30 The cysteine and the FGly containing forms of P23 could be identified and quantified by matrix-assisted laser desorption/ionisation time of flight (MALDI-TOF) mass spectrometry. The presence of the FGly residue in position 11 of P23 was verified by MALDI-TOF post source decay mass spectrometry (see Peng et al., J. Mass Spec., 2003, 38:80-86). Incubation of P23 with extracts from microsomes of bovine pancreas or bovine testis converted up to WO 2004/072275 PCT/US2004/003632 -72 95% of the peptide into a FGly containing derivative (Fig. 1). Under standard conditions the reaction was proportional to the amount of enzyme and time of incubation as long as less than 50% of the substrate was consumed and the incubation period did not exceed 24 h. The k. for P23 was 13 nM. The effects of reduced and oxidized glutathione, Ca 2 + and pH were s comparable to those seen in the assay using ribosome-associated nascent chain complexes as substrate (Fey et al., J. Biol. Chem., 2001, 276:47021-47028). Purification of FGE For purification of FGE the soluble fraction (reticuloplasm) of bovine testis microsomes served as the starting material. The specific activity of FGE was 10-20 times io higher than that in reticuloplasm from bovine pancreas microsomes (Fey et al., J. Biol. Chem., 2001, 276:47021-47028). Purification of FGE was achieved by a combination of four chromatographic steps. The first two steps were chromatography on a MonoQ anion exchanger and on Concanavalin A-Sepharose. At pH 8 the FGE activity bound to MonoQ and was eluted at 50-165 mM NaCl with 60-90% recovery. When this fraction was mixed 15 with Concanavalin A-Sepharose, FGE was bound. 30-40% of the starting activity could be eluted with 0.5 M a-methyl mannoside. The two final purification steps were chromatography on affinity matrices derivatized with 16mer peptides. The first affinity matrix was Affigel 10 substituted with a variant of the ASA65-80 peptide, in which residues Cys69, Pro7l and Arg73, critical for FGly formation, were scrambled (scrambled peptide 20 PVSLPTRSCAALLTGR -SEQ ID NO:34). This peptide did not inhibit FGE activity when added at 10 mM concentration to the in vitro assay and, when immobilized to Affigel 10, did not retain FGE activity. Chromatography on the scrambled peptide affinity matrix removed peptide binding proteins including chaperones of the endoplasmic reticulum. The second affinity matrix was Affigel 10 substituted with a variant of the ASA65-80 peptide, in which 25 the Cys69 was replaced by a serine (Ser69 peptide PVSLSTPSRAALLTGR-SEQ ID NO:35). The Ser69 peptide affinity matrix efficiently bound FGE. The FGE activity could be eluted with either 2 M KSCN or 25 mM Ser69 peptide with 20-40% recovery. Prior to activity determination the KSCN or Ser69 peptide had to be removed by dialysis. The substitution of Cys69 by serine was crucial for the elution of active FGE. Affigel 10 substituted with the 30 wildtype ASA65-80 peptide bound FGE efficiently. However, nearly no activity could be recovered in eluates with chaotropic salts (KSCN, MgCl2), peptides (ASA65-80 or Ser69 peptide) or buffers with low or high pH. In Fig. 2 the polypeptide pattern of the starting material and of the active fractions obtained after the four chromatographic steps of a typical WO 2004/072275 PCT/US2004/003632 -73 purification is shown. In the final fraction 5% of the starting FGE activity and 0.0006% of the starting protein were recovered (8333-fold purification). The purified 39.5 and 41.5 kDa polypeptides are encoded by a single gene The 39.5 and 41.5 kDa polypeptides in the purified FGE preparation were subjected 5 to peptide mass fingerprint analysis. The mass spectra of the tryptic peptides of the two polypeptides obtained by MALDI-TOF mass spectrometry were largely overlapping, suggesting that the two proteins originate from the same gene. Among the tryptic peptides of both polypeptid6s two abundant peptides MH* 1580.73, SQNTPDSSASNLGFR (SEQ ID NO:43), and Mf 2049.91, MVPIPAGVFrMGTDDPQIK -SEQ ID NO:44 plus two jo methionine oxidations) were found, which matched to the protein encoded by a cDNA with GenBank Acc. No. AK075459 (SEQ ID NO:4). The amino acid sequence of the two peptides was confirmed by MALDI-TOF post source decay spectra and by MS/MS analysis using offline nano-electrospray ionisation (ESI) iontrap mass spectrometry. An EST sequence of the bovine ortholog of the human cDNA covering the C-terminal part of the FGE and 15 matching the sequences of both peptides provided additional sequence information for bovine FGE. Evolutionary conservation and domain structure of FGE The gene for human FGE is encoded by the cDNA of (SEQ ID NOs: 1 and/or 3) and located on chromosome 3p26. It spans -105 kb and the coding sequence is distributed over 9 20 exons. Three orthologs of the human FGE gene are found in mouse (87% identity), Drosophila melanogaster (48% identity), and Anopheles gambiae (47% identity). Orthologous EST sequences are found for 8 further species including cow, pig, Xenopus laevis, Silurana tropicalis, zebra fish, salmon and other fish species (for details see Example' 2). The exon-intron structure between the human and the mouse gene is conserved and the 25 mouse gene on chromosome 6E2 is located within a region syntenic to the human chromosome 3p2 6 . The genomes of S. cerevisiae and C. elegans lack FGE homologs. In prokaryotes 12 homologs of human FGE were found. The cDNA for human FGE is predicted to encode a protein of 374 residues (Fig. 3 and SEQ ID NO:2). The protein contains a cleavable signal sequence of 33 residues, which indicates translocation of FGE into the 30 endoplasmic reticulum, and contains a single N-glycosylation site at Asnl41. The binding of FGE to concanavalin A suggests that this N-glycosylation site is utilized. Residues 87-367 of FGE are listed in the PFAM protein motif database as a domain of unknown function (PFAM: DUF323). Sequence comparison analysis of human FGE and its eukaryotic WO 2004/072275 PCT/US2004/003632 -74 orthologs identified in data bases indicates that this domain is composed of three distinct subdomains. The N-terminal subdomain (residues 91-154 in human FGE) has a sequence identity of 46% and a similarity of 79% within the four known eukaryotic FGE orthologs. In human s FGE, this domain carries the N-glycosylation site at Asn. 141, which is conserved in the other orthologs. The middle part of FGE (residues 179-308 in human FGE) is represented by a tryptophan-rich subdomain (12 tryptophans per 129 residues). The identity of the eukaryotic orthologs within this subdomain is 57%, the similarity is 82%. The C-terminal subdomain (residues 327-366 in human FGE) is the most highly conserved sequence within the FGE 10 family. The sequence identity of the human C-terminal subdomain with the eukaryotic orthologs (3 full length sequences and 8 ESTs) is 85%, the similarity 97%. Within the 40 residues of the subdomain 3 four cysteine residues are fully conserved. Three of cysteins are also conserved in the prokaryotic FGE orthologs. The 12 prokaryotic members of the FGE family (for details see Example 2) share the subdomain structure with eukaryotic FGEs. The 15 boundaries between the three subdomains are more evident in the prokaryotic FGE family due to non-conserved sequences of variable length separating the subdomains from each other. The human and the mouse genome encode two closely related homologs of FGE (SEQ ID NOs:43 and 44, GenBank Acc. No. NM_015411, in man, and SEQ ID NOs:45 and 46, GenBank Acc. No. AK076022, in mouse). The two paralogs are 86% identical. Their genes 20 are located on syntenic chromosome regions (7q 11 in human, 5G1 in mouse). Both paralogs share with the FGE orthologs the subdomain structure and are 35% identical and 47% similar to human FGE. In the third subdomain, which is 100% identical in both homologs, the cysteine containing undecamer sequence of the subdomain 3 is missing. Expression, subcellular localization and molecular forms 25 A single transcript of 2.1 kb is detectable by Northern blot analysis of total RNA from skin fibroblasts and poly A' RNA from heart, brain, placenta, lung, liver, skeletal muscle, kidney and pancreas. Relative to f-actin RNA the abundance varies by one order of magnitude and is highest in pancreas and kidney and lowest in brain. Various eukaryotic cell lines stably or transiently expressing the cDNA of human FGE or FGE derivatives C 30 terminally extended by a HA-, Myc- or His6-tag were assayed for FGE activity and subcellular localization of FGE. Transient expression of tagged and non-tagged FGE increased the FGE activity 1.6 - 3.9-fold. Stable expression of FGE in PT67 cells increased the activity of FGE about 100-fold. Detection of the tagged FGE form by indirect immunofluorescence in BHK 21, CHO, and HT1080 cells showed a colocalization of the WO 2004/072275 PCT/US2004/003632 -75 variously tagged FGE forms with proteindisulfide isomerase, a lumenal protein of the endoplasmic reticulum. Western blot analysis of extracts from BHK 21 cells transiently transfected with cDNA encoding tagged forms of FGE showed a single immunoreactive band with an apparent size between 42 to 44 kDa. 5 The FGE gene carries mutations in MSD MSD is caused by a deficiency to generate FGly residues in sulfatases (Schmidt, B., et al., Cell, 1995, 82:271-278). The FGE gene is therefore a candidate gene for MSD. We amplified and sequenced the FGE encoding cDNA of seven MSD patients and found ten different mutations that were confirmed by sequencing the genomic DNA (Table 1). io Table 1: Mutations in MSD patients Mutation Effect on Protein Remarks Patient 1076C>A S359X Truncation of the C-terminal 16 1* residues IVS3+5-8 del Deletion of residues In-frame deletion of exon 3 1, 2 149-173 979C>T R327X Loss of subdomain 3 2 1045C>T R349W Substitution of a conserved 3,7 residue in subdomain 3 1046G>A R349Q Substitution of a conserved 4 residue in subdomain 3 1006T>C C336R Substitution of a conserved 4 residue in subdomain 3 836C>T A279V Substitution of a conserved 5 residue in subdomain 2 243delC frameshift and Loss of all three subdomains 5 truncation 661delG frameshift and Loss of the C-terminal third of 6** truncation FGE including subdomain 3 IVS6-1G>A Deletion of residues In-frame deletion of exon 7 5 1281-318 *Patient 1 is the MSD patient Mo. in Schmidt, B., et al., Cell, 1995, 82:271-278 and Rommerskirch and von Figura, Proc. Natl. Acad. Sci, USA, 1992, 89:2561-2565. 15 **Patient 6 is the MSD patient reported by Burk et al., J. Pediatr., 1984, 104:574-578. The other patients represent unpublished cases. The first patient was heterozygous for a 1076C>A substitution converting the codon for serine 359 into a stop codon (S359X) and a mutation causing the deletion of the 25 20 residues 149-173 that are encoded by exon 3 and space the first and the second domain of the protein. Genomic sequencing revealed a deletion of nucleotides +5-8 of the third intron (IVS3+5-8 del) thereby destroying the splice donor site of intron 3. The second patient was heterozygous for the mutation causing the loss of exon 3 (IVS3+5-8 del) and a 979C>T WO 2004/072275 PCT/US2004/003632 -76 substitution converting the codon for arginine 327 into a stop codon (R327X). The truncated FGE encoded by the 979C>T allele lacks most of subdomain 3. The third patient was homozygous for a 1045C>T substitution replacing the conserved arginine 349 in subdomain 3 by tryptophan (R349W). The fourth patient was heterozygous for two missense mutations 5 replacing conserved residues in the FGE domain: a 1046>T substitution replacing arginine 349 by glutamine (R349Q) and a 1006T>C substitution replacing cysteine 336 by arginine (C336R). The fifth patient was heterozygous for a 836 C>T substitution replacing the conserved alanine 279 by valine (A279V). The second mutation is a single nucleotide deletion (243delC) changing the sequence after proline 81 and causing a translation stop 10 after residue 139. The sixth patient was heterozygous for the deletion of a single nucleotide (661deIG) changing the amino acid sequence after residue 220 and introducing a stop codon after residue 266. The second mutation is a splice acceptor site mutation of intron 6 (IVS6 1G>A) causing an in-frame deletion of exon 7 encoding residues 281-318. In the seventh patient the same 1045C>T substitution was found as in the third patient. In addition we 15 detected two polymorphisms in the coding region of 18 FGE alleles from controls and MSD patients. 22% carried a 188G>A substitution, replacing serine 63 by asparagine (S63N) and 28% a silent 11 16C>T substitution. Transduction of MSD fibroblasts with wild type and mutant FGE cDNA In order to confirm the deficiency of FGE as the cause of the inactivity of sulfatases 20 synthesized in MSD, we expressed the FGE cDNA in MSD fibroblasts utilizing retroviral gene transfer. As a control we transduced the retroviral vector without cDNA insert. To monitor the complementation of the metabolic defect the activity of ASA, steroid sulfatase (STS) and N-acetylgalactosamine 6-sulfatase (GaINAc6S) were measured in the transduced fibroblasts prior or after selection. Transduction of the wild type FGE partially restored the 25 catalytic activity of the three sulfatases in two MSD-cell lines (Table 2) and for STS in a third MSD cell line. It should be noted that for ASA and GalNAc6S the restoration was only partial after selection of the fibroblasts reaching 20 to 50% of normal activity. For STS the activity was found to be restored to that in control fibroblasts after selection. Selection increased the activity of ASA and STS by 50 to 80%, which is compatible with the earlier 30 observation that 15 to 50% of the fibroblasts become transduced (Lilbke et al., Nat. Gen., 2001, 28:73-76). The sulfatase activities in the MSD fibroblasts transduced with the retroviral vector alone (Table 2) were comparable to those in non-transduced MSD fibroblasts (not shown). Transduction of FGE cDNA carrying the IVS3+5-8del mutation failed to restore the sulfatase activities (Table 2).

WO 2004/072275 PCT/US2004/003632 -77 Table 2: Complementation of MSD fibroblasts by transduction of wild type or mutant FGE cDNA Fibroblasts FGE-insert Sulfatase ASA' STS . GalNAc6S 1 MSD3* - 1.9±0.2 <3 56.7 ± 32 FGE+ 7.9 13.5 n. d. FGE* 12.2±0.2 75.2 283 ± 42 FGE-IVS3+5-8del* 1.8 < 3 n. d. FGE-IVS3+5-8del* 2.1 < 3 98.5 MSD 40 1.1±0.3 < 3 n. d. FGE* 4.7 17.0 n. d. Control fibroblasts 58 i11 66± 31 828 ± 426 'The values give the ratio between ASA (mU/ig cell protein), STS (pU/mg cell protein), GalNAc6S (pU/mg 5 cell protein) and that of P-hexosaminidase (U/mg cell protein). For control fibroblasts the mean and the variation of 6-11 cell lines is given. Where indicated the range of two cultures transduced in parallel is given for MSD fibroblasts. * The number of MSD fibroblasts refers to that of the patient in Table 1. + Activity determination prior to selection. 10 ++ Activity determination after selection. n.d.: not determined Discussion FGE is a highly conserved glycoprotein of the endoplasmic reticulum. 15 Purification of FGE from bovine testis yielded two polypeptides of 39,5 and 41.5 kDa which originate from the same gene. The expression of three differently tagged versions of FGE in three different eukaryotic cell lines as a single form suggests that one of the two forms observed in the FGE preparation purified from bovine testis may have been generated by limited proteolysis during purification. The substitution of Cys69 in ASA65-80 peptide 20 by serine was critical for the purification of FGE by affinity chromatography. FGE has a cleavable signal sequence that mediates translocation across the membrane of the endoplasmic reticulum. The greater part of the mature protein (275 residues out of 340) defines a unique domain, which is likely to be composed of three subdomains (see Example 2), for none of the three subdomains homologs exist in proteins with known function. The 25 recognition of the linear FGly modification motif in newly synthesized sulfatase polypeptides (Dierks et al., EMBO J., 1999, 18:2084-2091) could be the function of a FGE subdomain. The catalytic domain could catalyse the FGly formation in several ways. It has been proposed that FGE abstracts electrons from the thiol group of the cysteine and transfers them to an acceptor. The resulting thioaldehyde would spontaneously hydrolyse to FGly and H 2

S

WO 2004/072275 PCT/US20041003632 -78 (Schmidt, B., et al., Cell, 1995, 82:271-278). Alternatively FGE could act as a mixed function oxygenase (monooxygenase) introducing one atom of 02 into the cysteine and the other in H 2 0 with the help of an electron donor such as FADH 2 . The resulting thioaldehyde hydrate derivative of cysteine would spontaneously react to FGly and H 2 S. Preliminary 5 experiments with a partially purified FGE preparation showed a critical dependence of the FGly formation on molecular oxygen. This would suggest that FGE acts as a mixed-function oxygenase. The particular high conservation of subdomain 3 and the presence of three fully conserved cysteine residues therein make this subdomain a likely candidate for the catalytic site. It will be interesting to see whether the structural elements mediating the recognition of 1o the FGly motif and the binding of an electron acceptor or electron donor correlate with the domain structure of FGE. Recombinant FGE is localized in the endoplasmic reticulum, which is compatible with the proposed site of its action. FGly residues are generated in newly synthesized sulfatases during or shortly after their translocation into the endoplasmic reticulum (Dierks et 15 al., Proc. Nati. Acad. Sci. U.S.A., 1997, 94:11963-11968; Dierks et al., FEBS Lett., 1998, 423:61-65). FGE itself does not contain an ER-retention signal of the KDEL type. Its retention in the endoplasmic reticulum may therefore be mediated by the interaction with other ER proteins. Components of the translocation/ N-glycosylation machinery are attractive candidates for such interacting partners. 20 Mutations in FGE cause MSD We have shown that mutations in the gene encoding FGE cause MSD. FGE also may interact with other components, and defects in genes encoding the latter could equally well cause MSD. In seven MSD patients we indeed found ten different mutations in the FGE gene. All mutations have severe effects on the FGE protein by replacing highly conserved 25 residues in subdomain 3 (three mutations) or subdomain 2 (one mutation) or C-terminal truncations of various lengths (four mutations) or large inframe deletions (two mutations). For two MSD-cell lines and one of the MSD mutations it was shown that transduction of the wild type, but not of the mutant FGE cDNA, partially restores the sulfatase activities. This clearly identifies the FGE gene as the site of mutation and the disease causing nature of the 30 mutation. MSD is both clinically and biochemically heterogenous. A rare neonatal form presenting at birth and developing a hydrocephalus, a common form resembling initially to an infantile metachromatic leukodystrophy and subsequently developing ichthyosis- and mucopolysaccharidosis-like features, and a less frequent mild form in which the clinical features of a mucopolysaccharidosis prevail, have been differentiated. Biochemically it is WO 2004/072275 PCT/US2004/00363 2 -79 characteristic that a residual activity of sulfatases can be detected, which for most cases in cultured skin fibroblasts is below 10% of controls (Burch et al., Clin. Genet., 1986, 30:409 15; Basner et al., Pediatr. Res., 1979, 13:1316-1318). However, in some MSD cell lines the activity of selected sulfatases can reach the normal range (Yutaka et al., Clin. Genet., 1981, 5 20:296-303). Furthermore, the residual activity has been reported to be subject to variations depending on the cell culture conditions and unknown factors. Biochemically, MSD has been classified into two groups. In group I the residual activity of sulfatases is below 15% including that of ASB. In group II the residual activity of sulfatases is higher and particularly that of ASB may reach values of up to 50-100% of control. All patients reported here fall io into group I except patient 5, which falls into group 11 (ASB activity in the control range) of the biochemical phenotype. Based on clinical criteria patients 1 and 6 are neonatal cases, while patients 2-4 and 7 have the common and patient 5 the mucopolysaccharidosis-like form of MSD. The phenotypic heterogeneity suggests that the different mutations in MSD patients 15 are associated with different residual activities of FGE. Preliminary data on PT67 cells stably expressing FGE IVS3+5-8del indicate that the in-frame deletion of exon 3 abolishes FGE activity completely. The characterization of the mutations in MSD, of the biochemical properties of the mutant FGE and of the residual content of FGly in sulfatases using a recently developed highly sensitive mass spectrometric method (Peng et al., J. Mass Spec., 20 2003, 38:80-86) will provide a better understanding of the genotype-phenotype correlation in MSD. Example 2: The human FGE gene defines a new gene family modifying sulfatases which is conserved 25 from prokaryotes to eukaryotes Bioinformatics Signal peptides and cleavage sites were described with the method of von Heijne (Nucleic Acids Res., 1986, 14:4683) implemented in EMBOSS (Rice et al., Trends in 30 Genetics, 2000, 16:276-277), and the method of Nielsen et al. (Protein Engineering, 1997, 10:1-6). N-glycosylation sites were predicted using the algorithm of Brunak (Gupta and Brunak, Pac. Symp. Biocomput., 2002, 310-22). Functional domains were detected by searching PFAM-Hidden-Markov-Models (version 7.8) (Sonnhammer et al., Nucleic Acids Res., 1998, 26:320-322). Sequences from the 35 PFAM DUF323 seed were obtained from TrEMBL (Bairoch, A. and Apweiler, R., Nucleic Acids Res., 2000, 28:45-48). Multiple alignments and phylogenetic tree constructions were WO 2004/072275 PCTfUS2004/003632 -80 performed with Clustal W (Thompson, J., et al., Nucleic Acids Res., 1994, 22:4673-4680). For phylogenetic tree computation, gap positions were excluded and multiple substitutions were corrected for. Tree bootstraping was performed to obtain significant results. Trees were visualised using Njplot (Perriere, G. and Gouy, M., Biochinzie, 1996, 78:364-369). 5 Alignments were plotted using the pret- typlot command from EMBOSS. To search for FGE homologs, the databases NR, NT and EST of the National Center for Biotechnology Information (NCBI) (Wheeler et al., Nucleic Acids Res., 2002, 20:13-16), were queried with BLAST (Altschul et al., Nucleic Acids Res., 1997, 25:3389-3402). For protein sequences, the search was performed using iterative converging Psi-Blast against the io current version of the NR database using an expectation value cutoff of 104, and default parameters. Convergence was reached after 5 iterations. For nucleotide sequences, the search was performed with Psi-TBlastn: using NR and the protein sequence of human FGE as input, a score matrix for hFGE was built with iterative converging Psi-Blast. This matrix was used as input for blastall to query the nucleotide databses NT and EST. For both steps, an 15 expectation value cutoff of 10-20 was used. Protein secondary structure prediction was done using Psipred (Jones, D., JMol Biol., 1999, 292:1950-202; McGuffin, L., et al., Bioinformatics, 2000, 16:404-405). Similarity scores of the subdomains were computed from alignments using the cons algorithm form EMBOSS with default parameters. The metaalignments were generated by 20 aligning consensus sequences of the FGE-family subgroups. Genomic loci organisation and synteny were determined using the NCBI's human and mouse genome resources at NCBI (Bethesda, MD) and Softberry's (Mount Kisco, NY) Human- Mouse-Rat Synteny. Bacterial genome sequences were downloaded from the NCBI-FTP-server. The NCBI microbial genome annotation was used to obtain an overview of the genomic loci of bacterial FGE 25 genes. Results and Discussion Basic features and motifs of human FGE and related proteins The human FGE gene (SEQ ID NOs:1, 3) encodes the FGE protein (SEQ ID NO:2) which is predicted to have 374 residues. A cleavage signal between residues 22-33 (Heijne 30 Score of 15.29) and a hydropathy-score (Kyte, J. and Doolittle, R., J Mol Biol., 1982, 157:105-132) of residues 17-29 between 1.7 and 3.3 indicate that the 33 N-terminal residues are cleaved off after ER-translocation. However with the algorithm of Nielsen et al. (Protein Engineering, 1997, 10:1-6), cleavage of the signal sequence is predicted after residue 34. The protein has a single potential N-glycosylation site at Asn 141.

WO 2004/072275 PCT/US2004/003632 -81 A search with the FGE protein sequence against the protein motif database PFAM (Sonnhammer et al., Nucleic Acids Res., 1998, 26:320-322) revealed that residues 87-367 of human FGE can be classified as the protein domain DUF323 ("domain of unknown function", PF03781) with a highly significant expectation value of 7:9.10- 1 4 . The PFAM 5 seed defining DUF323 consists of 25 protein sequences, of which the majority are hypothetical proteins derived from sequencing data. To analyse the relationship between human FGE and DUF323, a multiple alignment of FGE with the sequences of the DUF323 seed was performed. Based on this, a phylogenetic tree was constructed and bootstraped. Four of the hypothetical sequences (TrEMBL-IDs Q9CK12, Q91761, 094632 and Q9Y405) 10 had such a strong divergence from the other members of the seed that they prevented successfull bootstraping and had to be removed from the set. Figure 2 shows the bootstraped tree displaying the relationship between human FGE and the remaining 21 DUF323 seed proteins. The tree can be used to subdivide the seed members into two categories: homologs closely related to human FGE and the remaining, less related genes. 15 The topmost 7 proteins have a phylogenetic distance between 0.41 and 0.73 to human FGE. They only contain a single domain, DUF323. The homology within this group extends over the whole amino acid sequence, the greater part of which consists of the DUF323 domain. The DUF323 domain is strongly conserved within this group of homologs, while the other 15 proteins of the seed are less related to human FGE (phylogenetic distance between 20 1.14 and 1.93). Their DUF323 domain diverges considerably from the highly conserved DUF323-domain of the first group (cf. section "Subdomains of FGE and mutations in the FGE gene"). Most of these 15 proteins are hypothetical, six of them have been further investigated. One of them, a serine/threonine kinase (TrEMBL:084147) from C. trachomatis contains other domains in addition to DUF323: an ATP-binding domain and a kinase domain. 25 The sequences from R. sphaeroides (TrEMBL: Q9ALV8) and Pseudomonas sp.(TrEMBL: 052577) encode the protein NirV, a gene cotranscribed with the copper-containing nitrite reductase nirK (Jain, R. and Shapleigh, J., Microbiology, 2001, 147:2505-2515). CarC (TrEMBL: Q9XB56) is an oxygenase involved in the synthesis of a p-lactam antibiotic from E. carotovora (McGowan, S., et al., Mol Microbiol., 1996, 22:415-426; Khaleeli N, T. C., 30 and Busby RW, Biochemistry, 2000,39:8666-8673). XylR (TrEMBL: 031397) and BH0900 (TrEMBL: Q9KEF2) are enhancer binding proteins involved in the regulation of pentose utilisation (Rodionov, D., et al., FEMS Microbiol Lett., 2001, 205:305-314) in bacillaceae and clostridiaceae. The comparison of FGE and DUF323 led to the establishment of a homology threshold differentiating the FGE family from distant DUF323-containing WO 2004/072275 PCT/US2004/003632 -82 homologs with different functions. The latter include a serine/threonine kinase and XylR, a transcription enhancer as well as FGE, a FGly generating enzyme and CarC, an oxygenase. As discussed in elsewhere herein, FGE might also exert its cysteine modifying function as an oxygenase, suggesting that FGE and non-FGE members of the DUF323 seed may share an 5 oxygenase function. Homologs of FGE The presence of closely related homologs of human FGE in the DUF323 seed directed us to search for homologs of human FGE in NCBrs NR database (Wheeler et al., Nucleic Acids Res., 2002, 20:13-16). The threshold of the search was chosen in such a way that all 6 io homologs present in the DUF323 seed and other closely related homologs were obtained without finding the other seed members. This search led to the identification of three FGE orthologs in eukaryotes, 12 orthologs in prokaryotes and two paralogs in man and mouse (Table 3). Table 3: The FGE gene family in eukaryotes and prokaryotes SEQ ID NOs: SPECIES LENGTH [AA SUBGROUP NA,AA [GI) 1/3, 2 Homo sapiens 374 El 49,50 Mus musculus 372f El [221223611 51,52 Drosophila melanogaster 336 El [201303971 53,54 Anopheles gambiae 290 El [21289310] 47,48 Mus musculus 308 E2 [263449561 45,46 Homo sapiens 301 E2 [24308053] 55,56 Streptomyces coelicolor A3(2) 314 P1 [212258121 57, 58 Corynebacterium efficiens YS-314 334 P1 [25028125) 59,60 Novosphingobium aromaticivorans 338 P2 [23108562] 61,62 Mesorhizobium loti 372 P2 [13474559] 63,64 Burkholderia fungorum 416 P2 [22988809] 65,66 Sinorhizobium meliloti 303 P2 [16264068] 67,68 Microscilla sp. 354 P2 [14518334] 69,70 Pseudomonas putida KT2440 291 P2 [26990068] 71,72 Ralstonia metallidurans 259 P2 WO 2004/072275 PCT/US2004/003632 -83 [22975289] 73, 74 Prochlorococcus marinus 291 P2 [23132010 75,76 Caulobacter crescentus CB 15 338 P2 [16125425] 77,78 Mycobacterium tuberculosis Ht37Rv 299 P2 [15607852] GI- GenBank protein identifier NA- nucleic acid AA - amino acids, El - eukaryotic orthologs E2 - eukaryotic paralogs P1 - closely related prokaryotic orthologs P2- other prokaryotic orthologs S f- protein sequence mispredicted in GenBank Note that the mouse sequence GI 22122361 is predicted in GenBank to encode a protein of 284 aa, although the cDNA sequence NM 145937 encodes for a protein of 372 residues. This misprediction is based on the omission of the first exon of the murine FGE gene. All sequences found in the NR database are from higher eukaryotes or prokaryotes. 10 FGE-homologs were not detected in archaebacteriae or plants. Searches with even lowered thresholds in the fully sequenced genomes of C. elegans and S. cerevisiae and the related ORF databases did not reveal any homologs. A search in the eukaryotic sequences of the NT and EST nucleotide databases led to the identification of 8 additional FGE orthologous ESTs with 3'-terminal cDNA sequence fragments showing a high degree of conservation on the 15 protein level which are not listed in the NR database. These sequences do not encompass the full coding part of the mRNAs and are all from higher eukaryotes (Table 4). Table 4: FGE ortholog EST fragments in eukaryotes SEQ ID NOs: SPECIES NA [GB] 80 Oncorhynchus mykiss [CA379852] 81 Danio rerio [AI721440] 82 Oryzias latipes [BJ505402] 83 Xenopus laevis [BJ054666] 84 Silurana tropicalis [AL8924191 85 Salmo salar [CA064079] 86 Sus scrofa [BF189614] 87 Bos taurus [AV609121] 20 GB- GenBank Accession No; NA- nucleic acid WO 2004/072275 PCT/US2004/003632 -84 Multiple alignment and construction of a phylogenetic tree (using ClustalW) of the coding sequences from the NR database allowed the definition of four subgroups of homologs: eukaryotic orthologs (human, mouse, mosquito and fruitfly FGE, eukaryotic paralogs (human and mouse FGE paralog), prokaryotic orthologs closely related to FGE s (Streptomyces and Corynebacterium and other prokaryotic orthologs (Caulobacter, Pseudomonas, Mycobacterium, Prochlorococcus, Mesorhizobium, Sinorhizobium, Novosphingobium, Ralstonia, Burkholderia, and Microscilla) . The eukaryotic orthologs show an overall identity to human FGE of 87% (mouse), 48% (fruitfly) and 47% (anopheles). While FGE orthologs are found in prokaryotes and higher eukaryotes, they are missing in the 10 completely sequenced genomes of lower eukaryotes phylogenetically situated between S. cerevisiae and D. melanogaster. In addition, FGE homologs are absent in the fully sequenced genomes of E. coli and the pufferfish. As discussed elsewhere herein, the FGE paralogs found in human and mouse may have a minor FGly-generating activity and contribute to the residual activities of sulfatases 15 found in MSD patients. Subdomains of FGE The members of the FGE gene family have three highly conserved parts/domains (as described elsewhere herein). In addition to the two non-conserved sequences separating the former, they have non-conserved extensions at the N- and C- terminus. The three conserved 20 parts are considered to represent subdomains of the DUF323 domain because they are spaced by non-conserved parts of varying length. The length of the part spacing subdomains 1 and 2 varies between 22 and 29 residues and that spacing subdomains 2 and 3 between 7 to 38 amino acids. The N- and C-terminal non-conserved parts show an even stronger variation in length (N-terminal: 0-90 AA, Cterminal: 0-28 AA). The sequence for the FGE gene from 25 Ralstonia metallidurans is probably incomplete as it lacks the first subdomain. To verify the plausibility of defining subdomains of DUF323, we performed a secondary structure prediction of the human FGE protein using Psipred. The hydrophobic ER-signal (residues 1-33) is predicted to contain helix-structures confirming the signal prediction of the von-Heijne algorithm. The N-terminal non-conserved region (aa 34-89) and 30 the spacing region between subdomains 2 and 3 (aa 308-327) contain coiled sections. The region spacing subdomains 1 and 2 contains a coil. The cc-helix at aa 65/66 has a low prediction confidence and is probably a prediction artefact. The subdomain boundaries are situated within coils and do not interrupt a-helices or 0-strands. The first subdomain is made up of several p-strands and an a-helix, the second subdomain contains two Q-strands and four WO 2004/072275 PCT/IUS2004/003632 -85 a-helices. The third subdomain has a a-helix region flanked by a sheet a the beginning and the end of the subdomain. In summary, the secondary structure is in agreement with the proposed subdomain structure as the subdomain boundaries are situated within coils and the subdomains contain structural elements a-helices and p-strands). 5 It should be noted that none of the subdomains exists as an isolated module in sequences listed in databases. Within each of the four subgroups of the FGE family, the subdomains are highly conserved, with the third subdomain showing the highest homology (Table 5). This subdomain shows also the strongest homology across the subgroups. Table 5: Homology (% similarity) of the FGE family subdomains Subfamily Members Subdomain 1 2 3 El 4 79 82 100 E2 2 90 94 100 P1 2 70 79 95 P2 10 59 79 80 10 El - eukaryotic orthologs; E2 - eukaryotic paralogs P1 - closely related prokaryotic orthologs; P2 - other prokaryotic orthologs The first subdomain of the FGE-family shows the weakest homology across the subgroups. In the eukaryotic orthologs it carries the N-glycosylation site: at residue Asn 141 15 in human, at Asn 139 in the mouse and Asn 120 in the fruit fly. In anopheles, no asparagine is found at the residue 130 homologous to D. melanogaster Asn 120. However, a change of two nucleotides would create an N-glycosylation site Asn 130 in anopheles. Therefore, the sequence encompassing residue 130 needs to be resequenced. The second subdomain is rich in tryptophans with 12 Trp in 129 residues of human FGE. Ten of these tryptophans are 20 conserved in the FGE family. High conservation of subdomain 3: subdomain 3 between eukaryotic orthologs are 100% similar and 90% identical. The importance of the third subdomain for the function of the protein is underlined by the observation that this subdomain is a hot spot for disease causing mutations in MSD patients. Seven of nine mutations identified in six MSD patients 25 described in Example 1 are located in sequences that encode the 40 residues of subdomain 3. The residues contain four cysteines, three of which are conserved among the pro- and eukaryotic orthologs. The two eukaryotic paralogs show the lowest homology to the other members of the FGE-family, e.g. they lack two of the three conserved cysteines of subdomain 3. Features conserved between subdomain 3 sequences of orthologs and paralogs WO 2004/072275 PCT/US2004/003632 -86 are the initial RVXXGG(A)S motif (SEQ ID NO:79), a heptamer containing three arginines (residues 19-25 of the subdomain consensus sequence) and the terminal GFR motif. A comparison with the DUF323 domain of the 15 seed sequences that are no close homologs of FGE shows marked sequence differences: the 15 seed sequences have a less conserved first 5 and second subdornain, although the overall subdomain structure is also visible. Subdomain 3, which is strongly conserved in the FOE family, is shorter and has a significantly weaker homology to the eukaryotic subdomain 3 (similarity of about 20%) as compared to the prokaryotic FGE family members (similarity of about 60%). Thus they lack all of the conserved cysteine residues of subdomain 3. The only conserved features are the initial 10 RVXXGG(A)S motif (SEQ ID NO:79) and the terminal GFR motif. Genomic organisation of the human and murine FGE gene The human FGE gene is located on chromosome 3p26. It encompasses 105 kb and 9 exons for the translated sequence. The murine FGE gene has a length of 80 Kb and is located on chromosome 6E2. The 9 exons of the murine FGE gene have nearly the same size as the 15 human exons (Figure 3). Major differences between the human and the mouse gene are the lower conservation of the 3'-UTR in exon 9 and the length of exon 9, which is 461 bp longer in the murine gene. Segment 6E2 of mouse chromosome 6 is highly syntenic to the human chromosome segment 3p26. Towards the telomere, both the human and the murine FGE loci are flanked by the genes coding for LMCD1, KIAA0212, ITPR1, AXCAM, and IL5RA. In 20 the centromeric direction, both FGE loci are flanked by the loci of CAV3 and OXTR. Genomic organisation of the prokaryotic FGE genes In prokaryotes the sulfatases are classified either as cysteine- or serine-type sulfatases depending on the residue that is converted to FGly in their active center (Miech, C., et al., J Biol Chem., 1998, 273:4835-4837; Dierks, T., et al., J Biol Chem., 1998, 273:25560-25564). 25 In Klebsiella pneumoniae, E. coli and Yersinia pestis, the serine-type sulfatases are part of an operon with AtsB, which encodes a cytosolic protein containing iron-sulfur cluster motifs and is critical for the generation of FGly from serine residues (Marquordt, C., et al., JBiol Chen., 2003, 278:2212-2218; Szameit, C., et al., JBiol Chem., 1999, 274:15375-15381). It was therefore of interest to examine whether prokaryotic FGE genes are localized in 30 proximity to cysteine-type sulfatases that are the substrates of FGE. Among the prokaryotic FGE genes shown in Table 3, seven have fully sequenced genomes allowing a neighbourhood analysis of the FGE loci. Indeed, in four of the 7 genomes (C. efficiens: PID 25028125, P. putida: PD 26990068, C. crescentus: PD 16125425 and M. tuberculosis: PD 15607852) a cysteine-type sulfatase is found in direct vicinity of FGE compatible with a cotranscription of WO 2004/072275 PCT/US2004/003632 -87 FGE and the sulfatase. In two of them (C. efficiens and P. putida), FGE and the sulfatase have even overlapping ORFs, strongly pointing to their coexpression. Furthermore, the genomic neighbourhood of FGE and sulfatase genes in four prokaryotes provides additional evidence for the assumption that the bacterial FGEs are functional orthologs. 5 The remaining three organisms do contain cysteine-type sulfatases (S. coelicolor: PID 24413927, M. loti: PID 13476324, S. meliloti: PIDs 16262963, 16263377, 15964702), however, the genes neighbouring FGE in these organisms neither contain a canonical sulfatase signature (Dierks, T., et al., J Biol Chem., 1998, 273:25560-25564) nor a domain that would indicate their function. In these organims the expression of FGE and cysteine-type 10 sulfatases is therefore likely to be regulated in trans. Conclusions The identification of human FGE whose deficiency causes the autosomal-recessively transmitted lysosomal storage disease Multiple Sulfatase Deficiency, allows the definition of a new gene family which comprises FGE orthologs from prokaryotes and eukaryotes as well 15 as an FGE paralog in mouse and man. FGE is not found in the fully sequenced genomes of E. coli, S. cerevisiae, C. elegans and Fugu rubripes. In addition, there is a phylogenetic gap between prokaryotes and higher eukaryotes with FGE lacking in any species phylogenetically situated between prokaryotes and D. melanogaster. 'However, some of these lower eukaryotes, e.g. C. elegans, have cysteine-type sulfatase genes. This points to the existence 20 of. a second FGly generating system acting on cysteine-type sulfatases. This assumption is supported by the observation that E. coli, which lacks FGE, can generate FGly in cysteine type sulfatases (Dierks, T., et al., JBiol Chem., 1998, 273:25560-25564). Example 3: FGE expression causes significant increases in sulfatase activity in cell lines that overexpress 25 a sulfatase We wanted to examine the effects of FGE on cells expressing/overexpressing a sulfatase. To this end, HT-1080 cells expressing human sulfatases Iduronate 2-Sulfatase (I2S) or N-Acetylgalactosamine 6-Sulfatase (GALNS) were transfected in duplicate with either a FGE expression construct, pXMG.1.3 (Table 7 and Fig. 4) or a control plasinid, 30 pXMG.1.2 (FGE in antisense orientation incapable of producing functional FGE, Table 7). Media samples were harvested 24, 48, and 72 hours following a 24 hour post-electroporation medium change. The samples of medium were tested for respective sulfatase activity by activity assay and total sulfatase protein level estimated by ELISA specific for either Iduronate 2-Sulfatase or N-Acetylgalactosamine 6-Sulfatase.

WO 2004/072275 PCT/US2004/003632 -88 Table 6. Transfected Cell Lines Expressing Sulfatases Used as Substrates for Transfection Cell Strain Plasmid Sulfatase Expressed 36F pXFM4A.1 N-Acetylgalactosamine 6-Sulfatase 30C6 pXI2S6 Iduronate 2-Sulfatase Table 7. FGE and Control Plasmids Used to Transfect Iduronate 2-Sulfatase and N-Acetylgalactosamine 6-Sulfatase Expressing HIT-1080 Cells Plasmid Configuration of Major DNA Sequence Elements* pXMG.1.3 >1.6 kb CMV enhancer/promoter > 1.1 kb FGE cDNA>hGH3' (FGE expression) untranslated sequence <amp <DHFR cassette < Cdneo cassette (neomycin (FGE xpresion) phosphotransferase) pXMG.1.2 (control, >1.6 kb CMV enhancer/promoter < 1.1 kb FGE cDNA<hGH3' FGE reverse untranslated sequence <amp <DHFR cassette < Cdneo cassette (neomycin orientation) phosphotransferase) 5 * > denotes orientation 5' to 3' Experimental Procedures Materials and Methods Transfection of HT-1080 cells producing Iduronate 2-Sulfatase and N 10 Acetylgalactosamine 6-Sulfatase HT-1080 cells were harvested to obtain 9-12 x 106 cells for each electroporation. Two plasmids were transfected in duplicate: one to be tested (FGE) and a control; in this case the control plasmid contained the FGE cDNA cloned in the reverse orientation with respect to 15 the CMV promoter. Cells were centrifuged at approximately 1000 RPM for 5 minutes. Cells were suspended in IX PBS at 16x10 6 cells/mL. To the bottom of electroporation cuvette, 100 pig of plasmid DNA was added, 750 lL of cell suspension (12x10 6 cells) was added to the DNA solution in the cuvette. The cells and DNA were mixed gently with a plastic transfer pipette, being careful not to create bubbles. The cells were electroporated at 450 V, 250 pF 20 (BioRad Gene Pulser). The time constant was recorded. The electroporated cells were allowed to sit undisturbed for 10-30 minutes. 1.25 mL of DMEM/10% calf serum was then added to each cuvette, mixed, and all the cells transferred to a fresh 175 flask containing 20 rL DMEM/10. After 24 hours, the flask was re-fed with 20 mL DMEM/10 to remove dead cells. 48-72 hours after transfection, media 25 samples were collected and the cells harvested from duplicate T75 flasks.

WO 2004/072275 PCT/US2004/003632 -89 Medium Preparation 1L DMEM/I0 (contains: 23m] of 2mM L Glutamine,1l5mL calf serum) Cells were transfected in media without methotrexate (MTX). 24 hours later cells were re fed with media containing the appropriate amounts of MIX (36F = 1.0 pM MTX, 30C6 5 0.1M MTX). Medium was harvested and cells collected 24,48, and 72 hours after re-feed. Activity Assays Iduronate 2-Sulfatase (12S). NAP5 Desalting columns (Amersham Pharmacia Biotech AB, Uppsala, Sweden) were equilibrated with Dialysis Buffer (5 mM sodium acetate, 5 mM tris, pH 7.0). I2S-containing sample was applied to the column and allowed to enter the bed. The i sample was eluted in 1 mL of Dialysis Buffer. Desalted samples were further diluted to approximately 100 ng/mL 12S in Reaction Buffer (5 mM sodium acetate, 0.5 mg/L BSA, 0.1 % Triton X-100, pH 4.5). 10 iL of each I2S sample was added to the top row of a 96-well Fluormetric Plate (Perkin Elmer, Norwalk, CT) and pre-incubated for 15 minutes at 37'C. Substrate was prepared by dissolving 4-methyl-umbelliferyl sulfate (Fluka, Buchs, 15 Switzerland) in Substrate Buffer (5 mM sodium acetate, 0.5 mg/mL BSA, pH 4.5) at a final concentration of 1.5 mg/mL. 100 piL of Substrate was added to each well containing I2S sample and the plate was incubated for 1 hour at 37'C in the dark. After the incubation 190 pL of Stop Buffer (332.5 mM glycine, 207.5 mM sodium carbonate, pH 10.7) was added to each well containing sample. Stock 4-methylumbelliferone (4-MUF, Sigma, St. Louis, MO) 20 was prepared as the product standard in reagent grade water to a final concentration of 1 pLM. 150 pAL of 1 1 M 4-MUF Stock and 150 p4L Stop Buffer were added to one top row well in the plate. 150 pL of Stop Buffer was added to every remaining well in the 96-well plate. Two fold serial dilutions were made from the top row of each column down to the last row of the plate. The plate was read on a Fusion Universal Microplate Analyzer (Packard, Meriden, CT) 25 with an excitation filter wavelength of 330 nrm and an emission filter wavelength of 440 nm. A standard curve of moles of 4-MUF stock versus fluorescence was generated, and unknown samples have their fluorescence extrapolated from this curve. Results are reported as Units/mL where one Unit of activity was equal to 1 mole of 4-MUF produced per minute at 37"C. 30 N-Acetylgalactosamine 6-Sulfatase (GALNS). The GALNS activity assay makes use of the fluorescent substrate, 4-methylumbelliferyl-p-D-galactopyranoside- 6 -sulfate (Toronto Research Chemicals Inc., Catalogue No. M33448). The assay was comprised of two-steps. At the first step, 75 pL of the 1.3 mM substrate prepared in reaction buffer (0.1M sodium acetate, 0.1M sodium chloride, pH 4.3) was incubated for 4 hours at 37 0 C with 10 pzL of WO 2004/072275 PCT/US2004/003632 -90 media/protein sample or its corresponding dilutions. The reaction was stopped by the addition of 5 pL of 2M monobasic sodium phosphate to inhibit the GALNS activity. Following the addition of approximately 500 U of p-galactosidase from Aspergillus oryzae (Sigma, Catalogue No. G5160), the reaction mixture was incubated at 37*C for an additional 5 hour to release the fluorescent moiety of the substrate. The second reaction was stopped by the addition of 910 pL of stop solution (1% glycine, 1% sodium carbonate, pH 10.7). The fluorescence of the resultant mixture was measured by using a measurement wavelength of 359 run and a reference wavelength of 445 rnm with 4-methylumbelliferone (sodium salt from Sigma, Catalogue No. M1508) serving as a reference standard. One unit of the activity io corresponds to moles of released 4-methylumbelliferone pier hour. Immunoassays (ELISA) Iduronate 2-Sulfatase (12S). A 96-well flat bottom plate was coated with a mouse monoclonal anti-I2S antibody diluted to 10 pg/mL in 50 nM sodium bicarbonate pH 9.6 for 1 hour at 37'C. The mouse monoclonal anti-12S antibody was developed under contract by Maine 15 Biotechnology Services, Inc. (Portland, ME) to a purified, recombinantly-produced, full length, human I2S polypeptide using standard hybridoma-producing technology. The plate was washed 3 times with 1X PBS containing 0.1% Tween-20 and blocked for 1 hour with 2% BSA in wash buffer at 37'C. Wash buffer with 2% BSA was used to dilute samples and standards. 12S standard was diluted and used from 100 ng/mL to 1.56 ng/mL. After removal 20 of the blocking buffer, samples and standards were applied to the plate and incubated for 1 hour at 37*C. Detecting antibody, horseradish peroxidase-conjugated mouse anti-I 2 S antibody, was diluted to 0.15 pig/mL in wash buffer with 2% BSA. The plate was washed 3 times, detecting antibody added to the plate, and it was incubated for 30 minutes at 37'C. To develop the plate, TMB substrate (Bio-Rad, Hercules, CA) was prepared. The plate was 25 washed 3 times, 100 pzL of substrate was added to each well and it was incubated for 15 minutes at 37'C. The reaction was stopped with 2 N sulfuric acid (100 pUwell) and the plate was read on a microtiter plate reader at 450 rnm, using 655 nm as the reference wavelength. N-Acetylgalactosamine 6-Sulfatase (GALNS). Two mouse monoclonal anti-GALNS antibodies provided the basis of the GALNS ELISA. The mouse monoclonal anti- GALNS 3o antibodies were also developed under contract by Maine Biotechnology Services, Inc. (Portland, ME) to a purified, recombinantly-produced, full-length, human GALNS polypeptide using standard hybridoma-producing technology. The first antibody, for capture of GALNS was used to coat a P96 MaxiSorp Nunc-Immuno Plate (Nalge Nunc, Catalogue No. 442404) in a coating buffer (50 mM sodium bicarbonate, pH 9.6). After incubation for WO 2004/072275 PCT/US2004/003632 -91 one hour at 37"C and washing with a wash buffer, the plate was blocked with blocking buffer (PBS, 0.05% Tween-20, 2% BSA) for one hour at 37C. Experimental and control samples along with GALNS standards were then loaded onto the plate and further incubated for one hour at 37*C. After washing with a wash buffer, the second, detection antibody conjugated to 5 HRP was applied in blocking buffer followed by 30 minute incubation at 37 0 C. After washing the plate again, the Bio-Rad TIMB substrate reagent was added and incubated for 15 minutes. 2N' sulfuric acid was then added to stop the reaction and results were scored spectrophotometrically by using a Molecular Device plate reader at 450 nm wavelength. Discussion 10 Effect of FGE on Sulfatase Activity GALNS. An approximately 50-fold increase in total GALNS activity was observed over the control levels (Figure 5). This level of increased activity was observed with all three medium sampling time points. Moreover, the GALNS activity was accumulated linearly over time with a four-fold increase between 24 and 48 hours and a two-fold increase between the 15 48 hour and 72 hour timepoints. 12S. Although of smaller absolute magnitude, a similar effect was observed for total I2S activity where an approximately 5-fold increase in total I2S activity was observed over the control levels. This level of increased activity was sustained for the duration of the experiment. 12S activity accumulated in the medium linearly over time, similar to the results 20 seen with GALNS (2.3-fold between 24 and 48 hours, and 1.8-fold between 48 and 72 hours). Effect of FGE on Sulfatase Specific Activity GALNS. Expression of FGE in 36F cells enhanced apparent specific activity of GALNS (ratio of enzyme activity to total enzyme estimated by ELISA) by 40-60 fold over the control 25 levels (Figure 6). The increase in specific activity was sustained over the three time points in the study and appeared to increase over the three days of post-transfection accumulation. I2S. A similar effect was seen with I2S, where a 6-7-fold increase in specific activity (3-5 U/mg) was observed over the control values (0.5-0.7 U/mg). The ELISA values for both GALNS (Figure 7) and I2S were not significantly affected 30 by transfection of FGE. This indicates that expression of FGE does not impair translational and secretory pathways involved in sulfatase production. In sum, all of these results for both sulfatases indicate that FGE expression dramatically increases sulfatase specific activity in cell lines that overexpress GALNS and 12S.

WO 2004/072275 PCT/US2004/00363 2 -92 Co-expression of FGE (SUMFI) and other sulfatase genes To test the effect of FGE (SUMFL1) on additional sulfatase activities in normal cells we overexpressed ARSA (SEQ ID NO:14), ARSC (SEQ ID NO:18) and ARSE (SEQ ID NO:22) cDNAs in various cell lines with and without co-transfection of the FGE (SUMF1) s cDNA and measured sulfatase activities. Overexpression of sulfatase cDNAs in Cos-7 cells resulted in a moderate increase of sulfatase activity, while a striking synergistic increase (20 to 50 fold) was observed when both a sulfatase gene and the FGE (SUMF1) gene were co expressed. A similar, albeit lower, effect was observed in three additional cell lines, HepG2, LE293, and U2OS. Simultaneous overexpression of multiple sulfatase cDNAs resulted in a i lower increase of each specific sulfatase activity as compared to overexpression of a single sulfatase, indicating the presence of competition of the different sulfatases for the modification machinery. To test for functional conservation of the FGE (SUMF1) gene during evolution we overexpressed ARSA, ARSC and ARSE cDNAs in various cell lines with and without co 1s transfection of the MSD cDNA and measured sulfatase activities. Both the murine and the Drosophila FGE (SUMFI) genes were active on all three human sulfatases, with the Drosophila FGE (SUMFI) being less efficient. These data demonstrate a high degree of functional conservation of FGE (SUMF1) during evolution implicating significant biological importance to cellular function and survival. A similar and consistent, albeit much weaker, 20 effect was observed by using the FGE2 (SUMF2) gene, suggesting that the protein encoded by this gene also has a sulfatase modifying activity. These data demonstrate that the amount of the FGE (SUMFl1)-encoded protein is a limiting factor for sulfatase activities, a finding with important implications for the large scale production of active sulfatases to be utilized in enzyme replacement therapy. 25 Example 4: Identification of the gene mutated in MSD by means of functional complementation using microcell mediated chromosome transfer. In a separate experiment using microcell mediated chromosome transfer by means of 30 functional complementation we confirmed that the gene mutated in MSD is FGE. Our findings provide further insight into a novel biological mechanism affecting an entire farnily of proteins in distantly related organisms. In addition to identifying the molecular basis of a rare genetic disease, our data further confirms a powerful enhancing effect of the FGE gene product on the activity of sulfatases. The latter finding has direct clinical implications for the 35 therapy of at least eight human diseases caused by sulfatase deficiencies.

WO 2004/072275 PCT[US2004/003632 -93 The gene for MSD maps to chromosome 3 p 2 6 To identify the chromosomal location of the gene mutated in MSD we attempted to rescue the deficient sulfatase enzymes by functional complementation via microcell mediated chromosome transfer. A panel of human/mouse hybrid cell lines, containing individual 5 normal human chromosomes tagged with the dominant selectable marker HyTK, was used as the source of donor human chromosomes and fused to an immortalized cell line from a patient with MSD. All 22 human autosomes were transferred one by one to the patient cell line and hybrids were selected in hygromycin. Approximately 25 surviving colonies were picked in each of the 22 transfer experiments. These were grown separately and harvested for 10 subsequent enzymatic testing. ArylsulfataseA (ARSA) (SEQ ID NO:15), ArylsulfataseB (ARSB) (SEQ ID NO:17), and ArylsulfataseC (ARSC) (SEQ ID NO:19) activities were tested for each of the approximately 440 clones (20 x 22). This analysis clearly indicated that sulfatase activities of several clones deriving from the chromosome 3 transfer was significantly higher compared to that of all the other clones. A striking variability was 15 observed when analyzing the activities of each individual clone from the chromosome 3 transfer. To verify whether each clone had an intact human chromosome 3 from the donor cell line, we used a panel of 23 chromosome 3 polymorphic genetic markers, evenly distributed along the length of the chromosome and previously selected on the basis of having different alleles between the donor and the patient cell lines. This allowed us to examine for 20 the presence of the donor chromosome and to identify possible loss of specific regions due to incidental chromosomal breakage. Each clone having high enzymatic activity retained the entire chromosome 3 from the donor cell line, whereas clones with low activities appeared to have lost the entire chromosome on the basis of the absence of chromosome 3 alleles from the donor cell line. The latter clones probably retained a small region of the donor 25 chromosome containing the selectable marker gene that enabled them to survive in hygromycin containing medium. These data indicate that a normal human chromosome 3 was able to complement the defect observed in the MSD patient cell line. To determine the specific chromosomal region containing the gene responsible for the complementing activity we used Neo-tagged chromosome 3 hybrids which were found to 30 have lost various portions of the chromosome. In addition, we performed irradiated microcell-mediated chromosome transfer of HyTK-tagged human chromosomes 3. One hundred and fifteen chromosome 3 irradiated hybrids were tested for sulfatase activities and genotyped using a panel of 31 polymorphic microsatellite markers spanning the entire chromosome. All clones displaying high enzymatic activities appeared to have retained WO 2004/072275 PCT/US2004/00363 2 -94 chromosome 3p26. A higher resolution analysis using additional markers from this region mapped the putative location for the complementing gene between markers D3S3630 and D3S2397. Identification of the gene mutated in MSD 5 We investigated genes from the 3p26 genomic region for mutations in MSD patients. Each exon including splice junctions were PCR-amplified and analyzed by direct sequencing. Mutation analysis was performed on twelve unrelated affected individuals; five previously described MSD patients and seven unpublished cases. Several mutations were identified from our MSD cohort in the expressed sequence tag (EST) AK075459 (SEQ ID NOs:4,5), 1o corresponding to a gene of unknown function, strongly suggesting that this was the gene involved in MSD. Each mutation was found to be absent in 100 control individuals, thus excluding the presence of a sequence polymorphism. . Additional confirmatory mutation analysis was performed on reverse transcribed patients' RNAs, particularly in those cases in which genomic DNA analysis revealed the presence of a mutation in or near a splice site, 15 possibly affecting splicing. Frameshift, nonsense, splicing, and missense mutations were also identified, suggesting that the disease is caused by a loss of function mechanism, as anticipated for a recessive disorder. This is also consistent with the observation that almost all missense mutations affect amino acids that are highly conserved throughout evolution (see below). 20 Table 8: Additional MSD Mutations identified Case reference phenotype exon nucleotide amino acid change change 1. BA426 Conary et al, 1988 moderate 3 463T>C S155P 3 463T>C S155P 2. BA428 Burch et al, 1986 severe neonatal 5 661delG frameshift 3. BA431 Zenger et al, 1989 moderate 1 2T>GI M iR 2 276delC frameshift 4. BA799 Burk et al, 1981 mild-moderate 3 463T>C S155P 3 463T>C S155P 5. BA806 unpublished severe neonatal 9 1045T>C R349W 6. BA807 Schmidt et al, 1995 unknown 3 c519+4delGTAA ex 3 skipping 9 1076C>A S359X 7. BA809 Couchot et al, 1974 mild-moderate I 2A>G M3V 9 10420>C A348P 8. BA8l0 unpublished severe 8 1006T>C C336R WO 2004/072275 PCT/US2004/003632 -95 9 1046G>A R349Q 9. BA811 unpublished severe neonatal 3 c519+4deIGTAA ex 3 skipping 8 979C>T R327X 10. BA815 unpublished moderate 5 c.603-6delC ex 6 skipping 6 836C>T A279V 11. BA919 unpublished mild-moderate 9 1033C>T R345C 9 1033C>T R345C 12. BA920 unpublished moderate 5 6530>A C218Y 9 1033C>T R345C Mutations were identified in each MSD patient tested, thus excluding locus heterogeneity. No obvious correlation was observed between the types of mutations identified and the severity of the phenotype reported in the patients, suggesting that clinical variability 5 is not caused by allelic heterogeneity. In three instances different patients (case 1 and 4, case 6 and 9, and case 11 and 12 in Table 6) were found to carry the same mutation. Two of these patients (case 11 and 12) originate from the same town in Sicily, suggesting the presence of a founder effect that was indeed confirmed by haplotype analysis. Surprisingly, most patients were found to be compound heterozygotes, carrying different allelic mutations, while only a 1o few were homozygous. Albeit consistent with the absence of consanguinity reported by the parents, this was a somehow unexpected finding for a very rare recessive disorder such as MSD. The FGE gene and protein The consensus cDNA sequence of the human FGE (also used interchangeably herein 15 as SJMF1) cDNA (SEQ I]D NO:1) was assembled from several expressed sequence tag (EST) clones and partly from the corresponding genomic sequence. The gene contains nine exons and spans approximately 105 kb (see Example 1). Sequence comparison also identified the presence of a FGE gene paralog located on human chromosome 7 that we designated FGE2 (also used interchangeably herein as SUMF2) (SEQ ID NOs: 45, 46). 20 Functional complementation of sulfatase deficiencies Fibroblasts from two patients (case 1 and 12 in Table 8) with MSD in whom we identified mutations of the FGE (SUTMF1) gene (cell lines BA426 and BA920) were infected with HSV viruses containing the wild type and two mutated forms of the FGE (SUMF1) cDNA (R327X and Aex3). ARSA, ARSB, and ARSC activities were tested 72 hrs after 25 infection. Expression of the wild type FGE (SUMFI) cDNA resulted in functional complementation of all three activities, while mutant FGE (SUMFI) cDNAs did not (Table 9). These data provide conclusive evidence for the identity of FGE (SUMFL1) as the MSD WO 2004/072275 PCT/US2004/003632 -96 gene and they prove the functional relevance of the mutations found in patients. The disease associated mutations result in sulfatase deficiency, thus demonstrating that FGE (SUMF1) is an essential factor for sulfatase activity. Table 9: Functional complementation of sulfatase deficiencies 5 Recipient construct ARSA(') ARSB(') ARSCo MSD cell line i BA426 HSV amplicon 24.0 22.5 0.15 SUMF1-Aex3 42.0 23.8 0.29 SUMF1-R327X 33.6 24.2 0.16 SUMF1 119.5 (4.9 x) 37.8 (1.7 x) 0.62(4.1 x) is BA920 HSV amplicon 16.6 11.3 0.15 SUMF1-Aex3 17.2 14.4 0.07 SUNF1-R327X 36.0 13.5 0.13 SUMF1 66.5 (4.0 x) 21.6 (1.9 x) 0.42(2.8 x) 20 Control range 123.7-394.6 50.6-60.7 1.80-1.58 ('All enzymatic activities are expressed as nmoles 4-methylumbelliferone liberated mg protein ~' 3 hrs. MSD cell lines BA426 and BA920 were infected with the HSV amplicon alone, and with constructs carrying either mutant or wild-type SUMF1 cDNAs. The increase of single arylsulfatase 25 activities in fibroblasts infected with the wild-type SUMF1 gene, as compared to those of cells infected with the vector alone, is indicated in parentheses. Activities measured in uninfected control fibroblasts are indicated. Molecular basis of MSD Based on the hypothesis that the disease gene should be able to complement the 3o enzymatic deficiency in a patient cell line, we performed microcell-mediated chromosome transfer to an immortalized cell line from a patient with MSD. This technique has been successfully used for the identification of genes whose predicted function could be assessed in cell lines (e.g. by measuring enzymatic activity or by detecting morphologic features). To address the problem of stochastic variability of enzyme activity we measured the activities of 35 three different sulfatases (ARSA, ARSB and ARSC) in the complementation assay. The results of chromosome transfer clearly indicated mapping of the complementing gene to chromosome 3. Subregional mapping was achieved by generating a radiation hybrid panel for chromosome 3. Individual hybrid clones were characterized both at the genomic level, by typing 31 microsatellite markers displaying different alleles between donor and recipient cell 40 lines, and at the functional level by testing sulfatase activities. The analysis of 130 such hybrids resulted in the mapping of the complementing region to chromosome 3p2 6

.

WO 2004/072275 PCTIUS2004/003632 -97 Once the critical genomic region was defined, the FGE (SUMF1) gene was also identified by mutation analysis in patients' DNA. Mutations were found in all patients tested, proving that a single gene is involved in MSD. The mutations found were of different types, the majority (e.g. splice site, start site, nonsense, frameshift) putatively result in a loss 5 function of the encoded protein, as expected for a recessive disease. Most missense mutations affect codons corresponding to amino acids that have been highly conserved during evolution, suggesting that also these mutations cause a loss of function. No correlations could be drawn between the type of mutation and the severity of the phenotype, indicating that the latter is due to unrelated factors. Unexpectedly for a rare genetic disease, many patients were i found to be compound heterozygotes, carrying two different mutations. However, a founder effect was identified for one mutation originating from a small town in Sicily. FGE (SUMF1) gene function The identity of the FGE (SUMFI) gene as the "complementing factor" was demonstrated definitively by rescuing the enzymatic deficiency of four different sulfatases 15 upon expression of exogenous FGE (SUMF1) cDNA, inserted into a viral vector, in two different patient cell lines. In each case a consistent, albeit partial, restoration of all sulfatase activities tested was observed, as compared to control patient cell lines transfected with empty vectors. On average, the increase of enzyme activities ranged between 1.7 to 4.9 fold and reached approximately half of the levels observed in normal cell lines. Enzyme activity 20 correlates with the number of virus particles used in each experiment and with the efficiency of the infection as tested by marker protein (GFP) analysis. In the same experiments vectors containing FGE (SUMF1) cDNAs carrying two of the mutations found in the patients, R327X and Aex3, were used and no significant increase of enzyme activity was observed, thus demonstrating the functional relevance of these mutations. 25 As mentioned elsewhere herein, Schmidt et al. first discovered that sulfatases undergo a post-translational modification of a highly conserved cysteine, that is found at the active site of most sulfatases, to Cct-fonnylglycine. They also showed that this modification was defective in MSD (Schmidt, B., et al., Cell, 1995, 82:271-278). Our mutational and functional data provide strong evidence that FGE (SUMF1) is responsible for this 30 modification. The FGE (SUMIF1) gene shows an extremely high degree of sequence conservation across all distantly related species analyzed, from bacteria to man. We provide evidence that that the Drosophila homologue of the human FGE (SUMF1) gene is able to activate overexpressed human sulfatases, proving that the observed high level of sequence similarity WO 2004/072275 PCT/US20041003632 -98 of the FGE (SUMFI) genes of distantly related species correlates with a striking functional conservation. A notable exception is yeast, which appears to lack the FGE (SUMP1) gene as well as any sulfatase encoding genes, indicating that sulfatase function is not required by this organism and suggesting the presence of a reciprocal influence on the evolution of FGE s (SUMFI) and sulfatase genes. Interestingly, there are two homologous genes, FGE (SUMFI) and FGE2 (SUMF2), in the genomes of all vertebrates analyzed, including humans. As evident from the phylogenetic tree, the FGE2 (SUMF2) gene appears to have evolved independently from the FGE (SUMFI) gene. In our assays the FGE2 (SUMF2) gene is also able to activate i sulfatases, however it does it in a much less efficient manner compared to the FGE (SUMFI) gene. This may account for the residual sulfatase activity found in MSD patients and suggests that a complete sulfatase deficiency would be lethal. At the moment we cannot rule out the possibility that the FGE2 (SUMF2) gene has an additional, yet unknown, function. Impact on the therapy of diseases due to sulfatase deficiencies is A strong increase, up to 50 fold, of sulfatase activities was observed in cells overexpressing FGE (SUMFI) cDNA together with either ARSA, ARSC, or ARSE cDNAs, compared to cells overexpressing single sulfatases alone. In all cell lines a significant synergic effect was found, indicating that FGE (SUMF1) is a limiting factor for sulfatase activity. However, variability was observed among different sulfatases, possibly due to 20 different affinity of the FGE (SUMFl)-encoded protein with the various sulfatases. Variability was also observed between different cell lines which may have different levels of endogenous formylglycine generating enzyme. Consistent with these observations, we found that the expression of the MSD gene varies among different tissues, with significantly high levels in kidney and liver. This may have important implications as tissues with low FGE 25 (SUMF1) gene expression levels may be less capable of effectively modifying exogenously delivered sulfatase proteins (see below). Together these data suggest that the function of the FGE (SUMF1) gene has evolved to achieve a dual regulatory system, with each sulfatase being controlled by both an individual mechanism, responsible for the mRNA levels of each structural sulfatase gene, and a common mechanism shared by all sulfatases. In addition, 30 FGE2 (SUMF2) provides partial redundancy for sulfatase modification. These data have profound implications for the mass production of active sulfatases to be utilized in enzyme replacement therapy. Enzyme replacement studies have been reported on animal models of sulfatase deficiencies, such as a feline model of mucopolysaccharidosis VI, and proved to be effective in preventing and curing several symptoms. Therapeutic trials WO 2004/072275 PCT/US2004/003632 -99 in humans are currently being performed for two congenital disorders due to sulfatase deficiencies, MPSII (Hunter syndrome) and MPSVI (Maroteaux-Lamy syndrome) and will soon be extended to a large number of patients. Example 5: s Enzyme Replacement Therapy with FGE-activated GA LNS for Morquio Disease MPS IVA The primary cause of skeletal pathology in Morquio patients is keratan sulfate (KS) accumulation in epiphyseal disk (growth plate) chondrocytes due to deficiency of the lysosomal sulfatase, GALNS. The primary objective of in vivo research studies was to determine whether intravenously (IV) administered FGE-activated GALNS was able to 1o penetrate chondrocytes of the growth plate as well as other appropriate cell types in normal mice. Notwithstanding a general lack of skeletal abnormalities, a GALNS deficient mouse model (Morquio Knock-In -MKI, S. Tomatsu, St. Louis University, MO) was also used to demonstrate in vivo biochemical activity of repeatedly administered FGE-activated GALNS. The lack of skeletal pathology in mouse models reflects the fact that skeletal KS is either 15 greatly reduced or absent in rodents (Venn G, & Mason RM., Biochem J., 1985, 228:443 450). These mice did, however, demonstrate detectable accumulation of GAG and other cellular abnormalities in various organs and tissues. Therefore, the overall objective of the studies was to demonstrate that FGE-activated GALNS penetrates into the growth plate (biodistribution study) and show functional GAILNS enzyme activity directed towards 20 removal of accumulated GAG in affected tissues (pharmacodynanic study). The results of these studies demonstrated that IV injected FGE-activated GALNS was internalized by chondrocytes of the growth plate, albeit at relatively low levels compared to other tissues. In addition, FGE-activated GALNS injection over the course of 16 weeks in MKI mice effectively cleared accumulated GAG and reduced lysosomal biomarker staining 25 in all soft tissues examined. In sum, the experiments successfully demonstrated GALNS delivery to growth plate chondrocytes and demonstrated biochemical activity in terms of GAG clearance in multiple tissues. Biodistribution Study Four-week-old ICR (normal) mice were given a single IV injection of 5 mg/kg FGE 30 activated GALNS. Liver, femur (bone), heart, kidney and spleen were collected two hours after injection and prepared for histological examination. A monoclonal anti-human GALNS antibody was used to detect the presence of injected GALNS in the various tissues. GALNS was detected in all tissues examined as compared to the vehicle controls. Moreover, GALNS was readily observed in all tissues examined using a horseradish-peroxidase reporter system, WO 2004/072275 PCT/US2004/003632 -100 with the exception of bone. Demonstration of GAINS uptake in the growth plate required the use of a more sensitive fluorescein-isothiocyanate (FITC) reporter system and indicates that although GAINS penetrates the growth plate, it is less readily available to growth plate chondrocytes than to cells of soft tissues. Notwithstanding the requirement of a more s sensitive fluorescent detection method, GALNS delivery to bone growth plate chondrocytes was observed in all growth plate sections examined as compared to the vehicle controls. Pharmacodynamic Study in MKI Mice Four-week-old MKI or wild-type mice were given weekly IV injections (n= 8 per group) through 20 weeks of age. Each weekly injection consisted of either 2 mg/kg FGE 10 activated GALNS or vehicle control (no injection for wild-type mice). All mice were sacrificed for histological examination at 20 weeks of age and stained using the following methods: hematoxylin and eosin for cellular morphology, alcian blue for detection of GAGs. Clearance of accumulated GAG was demonstrated by reduced or absent alcian blue staining in all soft tissues examined (liver, heart, kidney and spleen). This was observed only 15 in the GALNS injected mice. Although the growth plate in the MKI mice functioned normally as evidenced by normal skeletal morphology, there were more subtle cellular abnormalities observed (including vacuolization of chondrocytes without apparent pathological effect). The vacuolized chondrocytes of the hypertrophic and proliferating zones of the growth plate were unaffected by GAINS administration. This was in contrast to the 20 chondrocytes in the calcification zone of the growth plate where a reduction of vacuolization was observed in GALNS injected mice. The vacuolization of chondrocytes and accumulation of presumed non-KS GAG in the growth plate in MKI mice was, in general, surprising and unexpected due to the known lack of KS in the growth plate of mice. These particular observations likely reflect the fact that, in the knock-in mice, high levels of mutant GAINS 25 are present (as opposed to knock-out mice where there is no residual mutant GALNS, no growth plate chondrocyte vacuolization and no GAG accumulation- Tomatsu S. et al., Human Molecular Genetics, 2003, 12:3349-3358). The vacuolization phenomenon in the growth plate may be indicative of a secondary effect on a subset of cells expressing mutant GALNS. Nonetheless, enzyme injection over the course of 16 weeks demonstrated strong 30 evidence of multiple tissue FGE-activated GALNS delivery and in vivo enzymatic activity. Detailed Description of the Drawings Fig. 1: MALDI-TOF mass spectra of P23 after incubation in the absence (A) or presence (B) of a soluble extract from bovine testis microsomes. 6 pmol of P23 were incubated under standard conditions for 10 min at 37 0 C in the absence or presence of 1 pl WO 2004/072275 PCT/US2004/003632 -101 microsomal extract. The samples were prepared for MALDI-TOF mass spectrometry as described in Experimental Procedures. The monoisotopic masses MWr of P23 (2526.28) and its FGly derivative (2508.29) are indicated. Fig. 2: Phylogenetic tree derived from an alignment of human FGE and 21 proteins of 5 the PFAM-DUF323 seed. The numbers at the branches indicate phylogenetic distance. The proteins are designated by their TrEMBL ID number and the species name. hFGE - human FGE. Upper right: scale of the phylogenetic distances. A asterisk indicates that the gene has been further investigated. The top seven genes are part of the FGE gene family. Fig. 3: Organisation of the human and murine FGE gene locus. Exons are shown to scale 10 as dark boxes (human locus) and bright boxes urinee locus). The bar in the lower right comer shows the scale. The lines between the exons show the introns (not to scale). The numbers above the intron lines indicate the size of the introns in kilobases. Fig. 4: Diagram showing a map of FGE Expression Plasmid pXMG.1.3 Fig. 5: Bar graph depicting N-Acetylgalactosamine 6-Sulfatase Activity in 36F Cells 15 Transiently Transfected with FGE Expression Plasmid. Cells were transfected with either a control plasmid, pXMG.1.2, with the FGE cDNA in the reverse oreintation, or a FGE expression plasmid, pXMG.1.3 in media without methotrexate (MTX). 24 hours later cells were re-fed with media containing 1.0 pM MTX. Medium was harvested and cells collected 24, 48, and 72 hours after re-feed. N-Acetylgalactosamine 6-Sulfatase activity was 20 determined by activity assay. Each value shown is the average of two separate transfections with standard deviations indicated by error bars. Fig. 6:- Bar graph depicting N-Acetylgalactosamine 6-Sulfatase Specific Activity in 36F Cells Transiently Transfected with FGE Expression Plasmid. Cells were transfected with either a control plasmid, pXMG.1.2, with the FGE cDNA in the reverse oreintation, or a FGE 25 expression plasmid, pXMG.l.3 in media without methotrexate (MTX). 24 hours later cells were re-fed with media containing 1.0 pM MTX. Medium was harvested and cells collected 24, 48, and 72 hours after re-feed. N-Acetylgalactosamine 6-Sulfatase specific activity was determined by activity assay and ELISA and is represented as a ratio of N Acetylgalactosamine 6-Sulfatase activity per mg of ELISA-reactive N-Acetylgalactosamine 30 6-Sulfatase. Each value shown is the average of two separate transfections. Fig. 7: Bar graph depicting N-Acetylgalactosamine 6-Sulfatase Production in 36F Cells Transiently Transfected with FGE Expression Plasmid. Cells were transfected with either a control plasmid, pXMG.1.2, with the FGE cDNA in the reverse oreintation, or a FGE expression plasmid, pXMG.1.3 in media without methotrexate (MTX). 24 hours later cells CNPorbeDCCY5 I 14364_1.DO-9/0201 0 -102 were re-fed with media containing 1.0 FM MTX. Medium was harvested and cells collected 24, 48, and 72 hours after re-feed. N-Acetylgalactosamine 6-Sulfatase total protein was determined by ELISA. Each value shown is the average of two separate transfections with standard deviations indicated by error bars. 5 Fig. 8: Graph depicting Iduronate 2-Sulfatase Activity in 30C6 Cells Transiently Transfected with FGE Expression Plasmid. Cells were transfected with either a control plasmid, pXMG.1.2, with the FGE cDNA in the reverse orientation, or a FGE expression plasmid, pXMG.1.3 in media without methotrexate (MTX). 24 hours later cells were re 10 fed with media containing 0.1 pM MTX. Medium was harvested and cells collected 24, 48, and 72 hours after re-feed. Iduronate 2-Sulfatase activity was determined by activity assay. Each value shown is the average of two separate transfections. Fig. 9: Depicts a kit embodying features of the present invention. 15 All references disclosed herein are incorporated by reference in their entirety. What is claimed is presented below and is followed by a Sequence Listing. Throughout this specification and the claims which follow, unless the context requires 20 otherwise, the word "comprise", and variations such as "comprises" and "comprising", will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps. The reference in this specification to any prior publication (or information derived from it), 25 or to any matter which is known, is not, and should not be taken as an acknowledgment or admission or any form of suggestion that that prior publication (or information derived from it) or known matter forms part of the common general knowledge in the field of endeavour to which this specification relates.

Claims (28)

1. A composition comprising a sulfatase produced by mammalian cells co-expressing the sulfatase and a formylglycine generating enzyme (FGE), wherein the sulfatase has increased ratio percentage of active sulfatase as compared to a control sulfatase produced by the same mammalian cells in the absence of the FGE.

2. The composition of Claim 1. wherein the ratio of active sul fatase to total su] flftase is increased by at least 5% as compared to the control sulfatase produced in the absence of the FGE.

3. The composition of Claim 1, wherein the ratio of active sulfIatase to total sul fatase is increased by at least 10% as compared to the control sulfatase produced in the absence of the IG .

4. The composition of Claim 1, wherein the ratio of active sul fatase to total su]lfatase is increased by at least 20% as compared to the control sulfatase produced in the absence of the [G E.

5. The composition of any one of the preceding claims, wherein the mammalian cells over-express the FGE.

6. The composition of Claim 5, wherein the mammalian cells over-express the [GE by activating the endogenous FGE.

7. The composition of Claim 5, wherein the mammalian cells over-express the FGl by o\cr-expressing an exOgCnOus FGE.

8. A composition comprising a sulfatase produced by mammalian cells with enhanced Ca-formylglycine generating activity relative to wild-type cells, wherein the sulfatase has C\;NICkoibl'lW(V\ARU iidCI'l IX)C-7/lW)2. -104 increased formation of formylglycine on the sulfatase as compared to a control sullatase produced by the wild-type cells.

9. The composition of Claim 8, wherein the mammalian cells comprise an activated endogcnous formylglycine generating enzyme (FGE).

10. The composition of Claim 8, wherein the mammalian cells comprise an exogenous formylglycinc generating enzyme (FGE). I 1. The composition of any one of the preceding claims, wherein the sulfiatasc is selected from the group consisting of Iduronate 2-Sulfatase, Sulfamidase, N Acetylgalactosamine 6-Sulfatase, N-Acetylglucosamine 6-Sulfatase, A rylsulfatase A, Arylsul fatase 13. Arylsulfatase C, Arylsulfatase ), Arylsulfatase E. Arylsul fatase F. Ary3sulfatase G ISulf-1, HISulf-2. ISulf-3 , HISulf-4, I-ISulf-5, and HISulf-6.

12. Ihe composition of Claim 1 1. whcrcin the sulfitasc is IduironatC 2-Sul fatasc.

13. The composition of' Claim 12, wherein the Iduronate 2-Sul fatase comprises SEQ 1D NO:7.

14. The composition of' Claim I1. wherein the sulfatase is Arylsul fatase A.

15. The composition of any one of the preceding claims, wherein the mammalian cells are CHO cells.

16. The composition of any one of the preceding claims, wherein the mammalian cells are human cells. 1 7. A method of treating a sulfatase deficiency in a subject. comprising administering intO the subject a pharmaceutical composition comprising a sul fatase produced by mammalian cells co-expressing the sulfatase and a formylglycine generating enzyme - 105 (IFGE), wherein the sulfatase has increased ratio percentage of active sulfatase as compared to a control sulfatase produced by the same mammalian cells in the absence of the FGE.

18. A method of treating a sulfatase deficiency in a subject, comprising administering into the subject a pharmaceutical composition comprising a suIfatase produced by mammalian cells with enhanced Ca-formylglycine generating activity relative to wild-typc cells, wherein the sulfatase has increased formation of formylglycine on the sulfatase as compared to a control sulfatase produced by the wild-type cells.

19. The method of Claim 17 or 18, wherein the sul fatase deficiency is selected from the group consisting of M ucopolysaccharidosi s II (MPS ll; HI-Iunter S yndrorme), NI ucopo lysaccharidosis IllA (MPS IllA; Sanfilippo Syndrome A), M ucopolysaccharidosis Vill (MPS Vill), Mucopolysaccharidosis IVA (MPS IVA; Morquio Syndrome A), Mucopolysaccharidosis VI (MPS VI; Maroteaux-Lamy Syndrome), Mctachromatic ILeukodystrophy (MLD), X-linked Recessive Chondrodysplasia Punctata 1, and X-linked lchthyosis (Steroid Sul fatase Deficiency).

20. The method of Claim 19, wherein the sulfatase deficiency is M ucopolysaccharidosis II (MPS 11; Hunter Syndrome).

21. The method of Claim 19, wherein the sulfatase deficiency is Metachromatic Leukodystrophy (MLD).

22. The method of Claim 19. wherein the sulIatase deficiency is M ucopolysaccharidosis lIlA (MPS IIIA; Sanlilippo Syndrome A).

23. The method of Claim 17 or 18, wherein the sulfatase is selected from the group consisting ol Iduronate 2-Sulfatase, Sul famidase, N-Acetylgalactosamine 6-Sulfatase, N Acetylglucosamine 6-Sul fatase, Arylsulfatase A, ArylsulfIatase 13, Arylsul fatase C. A ry Isulf[ase D1, Arylsulfitase F, Arylsul fatase F, Arylsul fatase G. ISulf-l, ISulf-2, H-Sulf-3. ISulf-4, HLSulf-5, and H-Sulf-6. - 106

24. The method of Claim 23, wherein the sulfatase is Iduronate 2-Sulfatase.

25. The method of Claim 23, wherein the sulfatase is ArylsuIfatase A.

26. A sulIatase-producing cell, the cell co-expresses: (i) a sulfatase. and (ii) a Formylglycine Generating Enzyme (FG E); wherein the cell has increased Ca-formylyglycine generating activity as compared to a wild-type cell resulting in an increased ratio of active sulfatase to total sulfatase produced by the cell.

27. The sul fatase-producing cell of Claim 26, wherein the cell comprises an exogenous FGE.

28. The sul fatase-producing cell of Claim 26, wherein the cell comprises an activated endogenous FGE.

29. The sul latase-producing cell of any one of Claims 26 to 28. wherein the [GE comprises an amino acid sequence selected from the group consisting ol amino acids 34 374 of S EQ I) NO:2, SEQ 11) NO:2, 5. 46, 48, 50, 52. 54, 56, 58. 60, 62, 64, 66, 68. 70.

72. 74, 76, and 78. 30. The sulfatase-producing cell of Claim 29, wherein the [GE comprises amino acids 34-374 of SEQ ID NO:2. 31. The sulfIatase-producing cell of Claim 29, wherein the [GE comprises an amino acid sequence of SEQ ID NO:2. NR~abliMAAuix291I X)C-2/1/200I - 107 32. The sulftatase-producing cell of any one of Claims 26 to 31, wherein the ratio of acti vC sulflatase to total sul fatase produced by the cell is increased by at least 5% relative to the ratio in the absence of' the FGE. 33. The sulIatase-producing cell of any one of Claims 26 to 32, wherein the ratio ol active solfatase to total sulfatase produced by the cell is increased by at least 10% relative to the ratio in the absence of the FGE1. 34. 'The sulfatase-producing cell of any one of Claims 26 to 33. wherein the ratio oF active sul I atase to total sul fatase produced by the cell is increased by at least 20% relative to the ratio in the absence of the FGE. 35. The sulf'atase-producing cell of any one of Claims 26 to 34, wherein the sul fatase is selected from the group consisting of Iduronate 2-Sul fatase. Sulfamidase, N !\cetylgalactosamine 6-Sul fatase. N-Acctvllucosaminc 6-Sul fatase. Arylsul fatase A. A\Islatase B. Arylsulf'atase C. Arylsul fatase D. ArylsulfaItase 1E. ArVlsul fatase F. A ryl IsI fmatase G. I-ISuIt'-l -ISulf-2, l-Sulf'-3. lSulf-4, -lSulf-5. and -ISulf'-6. 36. The sulfatase-producing cell of any one of Claims 26 to 35, wherein the sulfatase is an endogenous sul fatase. 37. The sulfatase-producing cell of any one of Claims 26 to 35, wherein the sulfatase is an exogenous solfatase. 38. The sul fatase-producing cell of any one of' Claims 26 to 37, wherein the FGE is an activated endogenous FGE. 39. The sul fatase-producing cell of any one of Claims 26 to 37, wherein the FGE is an exoCenous FGE. NH .L.. (i('e l i .ll'''AR\:Ix .- , _I D l(-la. 'l,2, - 108 40. The sulfatasc-producing cell of any one of Claims 26 to 39. wherein the cell s a mammalian cell. 41. The sulfaItase-producing cell of Claim 40, wherein the mammalian cell is a human cell. 42. The sulfatase-producing cell of Claim 40, wherein the mammalian cell is a Cl-O cell. 43. A sulfatase produced by a sulf'atase-producing cell of any one of' Claims 26 to 42. 44. A pharmaceutical composition comprising a sul fatase of Claim 43. 45. A method of producing activated sulf'atase, comprising cultivating a sulfatase producing cell of'any one of Claims 26 to 42. 46. A polypeptide for preparing a medicament that is for use in treating a sulfatase deficiency, wherein the polypeptide has C,-lormylglycine generating activity and: a) has a sequence selected from the group consisting of SEQ I.) NO. 2. 5. 46. 48, 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72, 74, 76, 78, oi amino acids 34-374 of SFQ ID NC). 2: or b) has at least 50% sequence identity with SEQ ID No 2; or c) has one or more conservative amino acid mutations relative to a polypeptidc as described in a) or b) above; or d) is a fI'agment of a polypeptide as described in a) above; c) is a fusion protein of any of a) to d) above. 47. The polypeptide of Claim 46, wherein the degree of sequence identity in b) is at least 75%. -109 48. The polypeptide of Claim 46, wherein the degree of sequence identity in b) is at least 95%. 49. The polypeptide of Claims 46 to 48, wherein the FGE is a polypeptide that has CQ formylglycinc generating activity and has a subdomain 3 that comprises at least one of the follow.ing: (i) a GFR mlotif; (ii) an RVXXGG(A)S motif; (iii) a heptamer containing three arginines; (iv) three cysteine residues. 50. A nucleic acid encoding a polypeptide as described in any of Claims 46 to 49 or a vector comprising said nucleic acid. 51. A nucleic acid of Claim 50. wherein the vector is a viral vector. 52. A nucleic acid of Claim 51, wherein the viral vector comprises nucleic acid sequences from adenovirus, adeno-associated virus, or retrovirus. 53. A nucleic acid of any one of Claims 50 to 52. wvherein the nucleic acid is operably linked to an gene expression regulatory sequence. 54. A nucleic acid of Claim 53, wherein the gene regulatory sequence is a mammalian or viral prololter. 55. A composition or a kit comprising a polypeptide as described in any of Claims 46 to 49 and a sulfatase. 56. A composition or a kit comprising a nucleic acid as described in any of Claims 50 to 54. -110 57. The composition or a kit of Claim 56, wherein the composition or kid further compriseS a nucleic acid encoding a sulfatase. 58. The composition or a kit of Claim 55 or 57, wherein the sul latase is selected Irom the group consisting of Iduronate 2-Sulfatase, Sul famidase, N-Acetylgalactosaminc 6 Sulfatase, N-Acetylglucosamine 6-Sulfatase, AryIsul fatase A, Arylsulfatase 13, Arylsulfatase C. Arylsulfatase D, Arylsulfatase E., AryIsulfatase F, Arylsulfatase G. HSulf 1. I ISulf-2. lH-Sulf-3, I-Sulf-4, HISulf-5, and H-lSulf-6. 59. A composition or kid of Claim 57 or 58, wherein the nucleic acid encoding the sulfatase is encoded by a separate vector. 60. A method comprising modifying a substrate so as to introduce an aldehyde group using a lormylglycine generating enzyme (FGE). 61. The method of Claim 60, wherein the substrate is a sul fatase comprising the sequence of I JV-FGly-X-P-S-R (SEQ I) NO:32). 62. The method according to Claim 60 or 61, wherein the aldehyde group replaces a thiomethyl group. 63. The method according to Claim 61 or 62. wherein the cysteine or shrine is oxidized. 64, The method of any one of Claims 60 to 63, wherein the FGE is provided as a polypeptide and further wherein the polypeptide has C(,-formylglycine generating activity and: a) has a sequence selected from the group consisting of SE.Q ID NO. 2. 5. 46. 48. 50. 52. 54. 56. 58, 60. 62, 64. 66, 68, 70. 72, 74. 76, 78. or amino acids 34-374 o f S EQ ID NO. 2: or b) has at least 50% sequence identity with SEQ ID No 2; or - 111 c) has one or more conservative amino acid mutations relative to a polVpeptidC as dcscribcd in a) or b) above; or d) is a fragment of a polypeptide as described in a) above; C) is a lusion protein of any of a) to d) above. 65. The method of any one of Claims 60 to 63, wherein the FGE is provided as a nucleic acid encoding a polypeptide described in Claim 64. 66. The method according to any of Claims 60 to 65, wherein the modified substrate is combined with a carrier. 67. A composition according to an) one ol Claims I to 16 or 44 or a method according to any one of Claims 17 to 25, 45 or 60 to 66 or a sulfIatase-producing cell according to any one of Claims 26 to 43 or a polypeptide according to any one of Claims 46 to 49 oi a nucleic acid according to any one of Claims 50 to 54 a composition or kit according to any one of Claims 55 to 59 substantially as herein described with reference to the Figures and/or Examples.