The complex series of events in collagen maturation provide a model that illustrates the biologic consequences of incomplete polypeptide maturation. The best-known defect in collagen biosynthesis is scurvy, a result of a dietary deficiency of vitamin C required by prolyl and lysyl hydroxylases. The resulting deficit in the number of hydroxyproline and hydroxylysine residues undermines the conformational stability of collagen fibers, leading to bleeding gums, swelling joints, poor wound healing, and ultimately to death. Menkes' syndrome, characterized by kinky hair and growth retardation, reflects a dietary deficiency of the copper required by lysyl oxidase, which catalyzes a key step in formation of the covalent cross-links that strengthen collagen fibers.
Genetic disorders of collagen biosynthesis include several forms of osteogenesis imperfecta, characterized by fragile bones. In Ehlers-Dahlos syndrome, a group of connective tissue disorders that involve impaired integrity of supporting structures, defects in the genes that encode a collagen-1, procollagen V-peptidase, or lysyl hydroxylase result in mobile joints and skin abnormalities.
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