Mutations in ABCG5 (G5) or ABCG8 (G8) cause sitosterolemia, an autosomal recessive disease characterized by sterol accumulation and premature atherosclerosis. G5 and G8 are ATP-binding cassette (ABC) half-transporters that must heterodimerize to move to the apical surface of cells. We examined the role of N-linked glycans in the formation of the G5/G8 heterodimer to gain insight into the determinants of folding and trafficking of these proteins. Site-directed mutagenesis revealed that two asparagine residues (Asn 585 and Asn 592 ) are glycosylated in G5 and that G8 has a single N-linked glycan attached to Asn 619 . N-Linked glycosylation of G8 was required for efficient trafficking of the G5/G8 heterodimer, but mutations that abolished glycosylation of G5 did not prevent trafficking of the heterodimer. Both G5 and G8 are bound by the lectin chaperone, calnexin, suggesting that the calnexin cycle may facilitate folding of the G5/G8 heterodimer. To determine the effects of 13 disease-causing missense mutations in G5 and G8 on formation and trafficking of the G5/G8 heterodimer, mutant forms of the half-transporters were expressed in CHO-K1 cells. All 13 mutations reduced trafficking of the G5/G8 heterodimer from the endoplasmic reticulum to the Golgi complex, and most prevented the formation of stable heterodimers between G5 and G8. We conclude that the majority of the molecular defects in G5 and G8 that cause sitosterolemia impair transport of the sterol transporter to the cell surface.Mutations in either ABCG5 (G5) or ABCG8 (G8) cause sitosterolemia, an autosomal recessive disorder characterized by the accumulation of both plant-derived (primarily sitosterol) and animal-derived sterols (cholesterol) in plasma and tissues (1-3). In mice, G5 and G8 are located on the apical surfaces of enterocytes and hepatocytes, where they limit the absorption of dietary sterols and promote the excretion of cholesterol into bile, respectively (4 -8). Individuals with sitosterolemia have a generalized increase in the absorption of dietary neutral sterols and a defect in the excretion of these sterols into bile (8 -10). This impairment in sterol trafficking results in the deposition of neutral sterols in the skin as xanthomas and in the walls of the coronary arteries, causing premature atherosclerosis.G5 and G8 are both glycoproteins (11). If G5 or G8 is expressed alone in cultured cells it is retained in the ER, 1 and its glycans remain sensitive to endoglycosidase H, an enzyme that removes immature, high mannose N-linked glycans that have not been processed to mature oligosaccharides in the Golgi complex. If both proteins are expressed in the same cell, the N-linked sugars become insensitive to endoglycosidase H and sensitive to neuraminidase, which cleaves sialic acid residues added in the trans-Golgi complex. As G5 and G8 transit from the ER to the cell surface, the changes in glycan structure result in an increase in the apparent molecular mass of each protein when analyzed by immunoblotting.ABC half-transporters must homodime...