“…The synthesis of the ceramide molecule from the sphingosine and the fatty acid takes place in the cytosolic aspects of the endoplasmic reticulum membranes by ceramide synthases (CerS1-6) ( Rizzo et al, 2021 ). The synthesis of the oligosaccharide part of Gb3 takes place in the Golgi apparatus ( Budani et al, 2021 ; Rizzo et al, 2021 ) and is constituted firstly by the synthesis of a glucosylceramide (GlcCer) produced by the enzyme glucosylceramide synthase (GCS), which catalyzes the binding of a glucose molecule to a ceramide; next, the enzyme β-1,4 galactosyltransferase 5 (β4Gal-T5) binds one molecule of galactose to form lactosylceramide (LacCer); in a third and final reaction, the enzyme lactosylceramide α-1,4-galactosyltransferase (Gb3 synthase) catalyzes the addition of α-1,4 galactose to LacCer (galactose β-1,4 glucose 1-1′ Cer) to produce Gb3 (galactose α-1,4 galactose β-1,4 glucose 1,1′ Cer) ( Kojima et al, 2000 ; Okuda and Nakayama, 2008 ; Budani et al, 2021 ; Rizzo et al, 2021 ). Another enzyme, isoglobotriaosylceramide synthase, can produce polygalactosylated species (Galn-Gb3) by adding α-1,3 galactose residues to Gb3 ( Miller et al, 2018 ).…”