label: an N-acetyl-alpha-neuraminosyl-(2->8)-N-acetyl-alpha-neuraminosyl-(2->3)-beta-D-galactosyl-(1<->1')-N-acylsphing-4-enine + CMP + H(+) => a ganglioside GM4 (d18:1(4E)) + CMP-N-acetyl-beta-neuraminate
label_lc: an n-acetyl-alpha-neuraminosyl-(2->8)-n-acetyl-alpha-neuraminosyl-(2->3)-beta-d-galactosyl-(1<->1')-n-acylsphing-4-enine + cmp + h(+) => a ganglioside gm4 (d18:1(4e)) + cmp-n-acetyl-beta-neuraminate