In both the healthy and cancer glycocalyx, MGAT1, COSMC, and UGCG are critical chain initiating enzymes that synthesize N-linked glycans (complex and hybrid), O-linked glycans, and GSLs, respectively, and may play a crucial role in cell signaling, immune evasion, and cancer metastasis (138, 225–227). The gene discussed is C1GALT1C1; the disease is cancer.