AMACO (VWA2 protein) is an extracellular matrix protein of unknown function associated with certain basement membranes in skin, lung, and kidney. AMACO is a member of the von Willebrand factor A-like (VWA) domain containing protein superfamily and in addition to three VWA domains it also contains two epidermal growth factor-like domains. One of these contains the rare, overlapping consensus sequences for both O-glucosylation and O-fucosylation. In earlier studies of other proteins the attachment of either core glucose and fucose moieties or of the respective elongated glycans starting with these monosaccharides has been described. By a detailed mass spectrometric analysis we show that both elongated O-glucosylated (Xyl1-3Xyl1-3Glc) and elongated O-fucosylated glycan chains (NeuAc2-3Gal1-4GlcNAc1-3Fuc) can be attached to AMACO in close proximity on the same epidermal growth factor-like domain. It has been reported that the lack of O-fucosylation can markedly decrease secretion of proteins. However, the secretion of AMACO is not significantly affected when the glycosylation sites are mutated. The number of extracellular matrix proteins carrying the overlapping consensus sequence is very limited and it could be that these modifications have a new, yet unknown function.AMACO (VWA2 protein) is a recently discovered member of the protein superfamily containing von Willebrand factor A-like (VWA) 3 domains of the type found in matrilins and collagens (1). AMACO consists of an N-terminal VWA-like domain, which is followed by a cysteine-rich region that has no obvious similarity to any other known domain. Toward the C terminus, an epidermal growth factor-like (EGF) domain, two additional VWA-like domains, and a second EGF-like domain follow (Fig. 1A). Electron microscopy and nonreducing SDS-PAGE show both monomers and higher aggregates, indicating a partial cross-linking of native AMACO via unpaired cysteines. AMACO is specifically expressed in skin, lung, and kidney. The protein is deposited in the extracellular matrix and appears to be associated with certain basement membranes that underlie epithelial cells. The function of AMACO still remains unclear. However, the localization may indicate that AMACO is either a structural component of some basement membranes or part of the anchoring structures formed on a scaffold of, e.g. collagen VII or fibrillin. Recently, in a microarray AMACO was identified as a candidate marker of colon neoplasia and found to be induced by an average of 78-fold in stage II, III, and IV colon cancers, as well as in colon adenomas and colon cancer cell lines. Epitope-tagged AMACO was detectable in the blood of mice bearing transfected human cancer xenografts indicating a potential role as a diagnostic serum marker of early stage colon cancer. Therefore, AMACO was alternatively named CCSP-2, colon cancer secreted protein-2 (2). In addition, polymorphisms in the AMACO gene were shown to be associated with dominant protection against type 1A diabetes, although a functional relevance for this linkage...