). To ascertain the consequences of the sulfate transport defect on proteoglycan synthesis, we studied the structure and sulfation of proteoglycans in cartilage tissue and in fibroblast and chondrocyte cultures from a fetus with achondrogenesis 1B. Proteoglycans extracted from epiphyseal cartilage and separated on agarose gels migrated more slowly than controls and stained poorly with alcian blue. The patient's cultured cells showed reduced incorporation of [
S]sulfate relative to [3 H]glucosamine, impaired uptake of sulfate, and higher resistance to chromate toxicity compared to control cells. Epiphyseal chondrocytes cultured in alginate beads synthesized proteoglycans of normal molecular size as judged by gel filtration chromatography, but undersulfated as judged by ion exchange chromatography and by the amount of nonsulfated disaccharide. High performance liquid chromatography analysis of chondroitinase-digested proteoglycans showed that sulfated disaccharides were present, although in reduced amounts, indicating that at least in vitro, other sources of sulfate can partially compensate for sulfate deficiency. A t1475c transition causing a L483P substitution in the eleventh transmembrane domain of the sulfate/chloride antiporter was present on both alleles in the patient who was the product of a consanguineous marriage. The results indicate that the defect of sulfate transport is expressed in both chondrocytes and fibroblasts and results in the synthesis of proteoglycans bearing glycosaminoglycan chains which are poorly sulfated but of normal length.Achondrogenesis type 1B (ACG-1B) 1 (1) is an autosomal recessive, lethal chondrodysplasia with severe underdevelopment of the skeleton, extreme micromelia, and death before or immediately after birth because of thoracic hypoplasia (1-8). Both radiological and histological features differentiate ACG-1B from achondrogenesis type 1A and achondrogenesis type 2 (3). In ACG-1B, cartilage matrix contains abnormally coarse collagen fibers and stains poorly with cationic dyes which have affinity for sulfated proteoglycans (toluidine blue or alcian blue) (4,8). Evidence of undersulfation of proteoglycans (PGs) in cartilage on the basis of histological findings and in fibroblast cultures, together with the demonstration of insufficient formation of activated sulfate metabolites, was obtained recently in one patient with ACG-1B (8). Further studies have revealed that ACG-1B is caused not by a defect in the metabolic activation of sulfate, as originally concluded (8), but by a sulfate uptake defect caused by mutations in the sulfate transporter gene (9) originally isolated as the locus responsible for the non-lethal disorder, diastrophic dysplasia (10). The pathogenesis of the severe developmental defect of the skeleton seen in ACG-1B is believed to involve undersulfation of cartilage PGs, as suggested by both the staining properties of cartilage and its markedly reduced sulfate content (9), but direct demonstration of undersulfation of individual cartilage PGs is lacking. We h...