The supplementation of the sialic acid biosynthetic pathway with exogenously supplied N-acetylmannosamine (ManNAc) analogs has many potential biomedical and biotechnological applications. In this work, we explore the structure-activity relationship of ManNAc analogs on cell viability and metabolic flux into the sialic acid biosynthetic pathway to gain a better understanding of the fundamental biology underlying "glycosylation engineering" technology. A panel of ManNAc analogs bearing various modifications on the hydroxyl groups as well as substitutions at the N-acyl position was investigated. Increasing the carbon chain length of ester derivatives attached to the hydroxyl groups increased the metabolic efficiency of sialic acid production, whereas similar modification to the N-acyl group decreased efficiency. In both cases, increases in chain length decreased cell viability; DNA ladder formation, Annexin V-FITC two-dimensional flow cytometry assays, caspase-3 activation, and down-regulation of sialoglycoconjugate-processing enzymes established that the observed growth inhibition and toxicity resulted from apoptosis. Two of the panel of 12 analogs tested, specifically Ac 4 ManNLev and Ac 4 ManNHomoLev, were highly toxic. Interestingly, both of these analogs maintained a ketone functionality in the same position relative to the core monosaccharide structure, and both also inhibited flux through the sialic acid pathway (the remainder of the less toxic analogs either increased or had no measurable impact on flux). These results provide fundamental insights into the role of sialic acid metabolism in apoptosis by demonstrating that ManNAc analogs can modulate apoptosis both indirectly via hydroxylgroup effects and directly through N-acyl-group effects.The term "sialic acid engineering" refers to a technique where non-natural N-acetylmannosamine (ManNAc) 1 analogs intercept the sialic acid biosynthetic pathway and are incorporated into cellular sialoglycoconjugates in the place of sialic acid residues (Fig. 1) (1, 2). The impetus behind this strategy is to mimic nature, which uses ÏŸ50 different forms of sialic acid to modulate the structure and function of sialic acid-bearing glycoproteins and lipids (3). By using synthetic N-acyl-modified ManNAc analogs, the surfaces of living cells can be endowed with novel properties not found in nature (4) that, depending on the exact analog used to perform this "submolecular microsurgery" (5), have the potential to elicit a variety of changes in the behavior of the host cell. Theoretically, the ability to modify the cell surface and recombinant sialoglycoconjugates with molecular precision has the potential to regulate any biological process governed by sialic acid, such as cell growth and differentiation, communication among different cells, recognition of soluble factors, and attachment to, or disengagement from, the extracellular matrix (6). In practice, sialic acid engineering methods have already been demonstrated to regulate cellular responses ranging from adhesion to prolif...