Blood group A/B glycosyltransferases (AT/BTs) and Forssman glycolipid synthase (FS) are encoded by the evolutionarily related (A/B alleles) and genes, respectively. AT/BT and FS catalyze the biosynthesis of A/B and Forssman (FORS1) oligosaccharide antigens that are responsible for the distinct blood group systems of ABO and FORS. Using genetic engineering, DNA transfection, and immunocytochemistry and immunocytometry, we have previously shown that the eukaryotic expression construct encoding human AT, whose LeuGlyGly tripeptide at codons 266 to 268 was replaced with FS-specific GlyGlyAla tripeptide, induced weak appearance of FORS1 antigen. Recently, we have shown that the human AT complementary DNA constructs deleting exons 3 or 4, but not exons 2 or 5, induced moderate expression of FORS1 antigen. The constructs containing both the GlyGlyAla substitution and the exon 3 or 4 deletion exhibited an increased FS activity. Here, we report another molecular mechanism in which an amino acid substitution at codon 69 from methionine to threonine or serine (Met69Thr/Ser) also modified enzymatic specificity and permitted FORS1 biosynthesis. Considering that codon 69 is the first amino acid of exon 5 and that the cointroduction of Met69Thr and GlyGlyAla substitutions also enhanced FS activity, the methionine substitutions may affect enzyme structure in a mode similar to the exon 3 or 4 deletion but distinct from the GlyGlyAla substitution.