br Functional significance Defects of the lysyl
Functional significance Defects of the lysyl hydroxylases LH1, LH2, and LH3 impair collagen secretion and stability in the extracellular matrix, and cause rare connective tissue disorders such as Ehlers-Danlos type-VI , Bruck syndrome , and skeletal dysplasia , respectively. Elucidating the biological significance of collagen glycosylation has remained elusive since the late discovery of the COLGALT1 and COLGALT2 genes. Using molecular modeling and synthetic glycopeptides, the presence of Gal on Hyl has been shown to decrease the interactions of collagen type IV regions with α2β1 and α3β1 integrins , and with CD44 expressed on melanoma L-703,664 succinate weight . Collagen glycosylation might therefore modulate the adhesion and spreading of cells on basement membranes. The inactivation of COLGALT1 in osteosarcoma cells led to intracellular accumulation of collagen type I, yet secreted collagen exhibited a normal thermal stability . Interestingly, the inactivation of COLGALT1 drove a compensatory expression of COLGALT2, which is normally hardly expressed in osteosarcoma cells . In another study, knockdown of COLGALT1 in HEK 293 cells expressing adiponectin resulted in decreased secretion of high-molecular weight adiponectin, confirming the role of Hyl glycosylation in oligomerization through the collagen domain of the hormone  (Figure 3). These works indicated that glycosylation is involved in the control of collagen secretion, possibly in the alignment of collagen fibrils and in protein oligomerization. The process of collagen secretion is not fully understood, even at this stage. Collagen transport out of the ER requires COPII coat proteins, although collagen exceeds by far the size of typical secretory vesicles. The packaging of bulky cargo such as collagen into COPII-like structures and exit from the ER requires the COP subunit Sec23A , the membrane accessory protein TANGO1/Mia3 , and the TRAPP tethering complex . Future work shall clarify whether the disaccharide Glc(α1-2)Gal(β1-O) possibly interacts with such packaging proteins, thereby contributing to the regulation of intracellular collagen transport.
Diseases A disease of collagen glycosylation in humans has only been reported recently. Mutations in the COLGALT1 gene were identified in two children presenting with cerebral small vessel abnormality and porencephaly . Cerebral small vessel diseases are typical for heterozygous mutations in COL4A1  and COL4A2  genes, underlining the importance of basement membrane collagen for the structural integrity of arterioles and venules in the brain. The loss of COLGALT1 activity was found to alter collagen type IV secretion, hence the phenotypic similarity with collagen type IV disorders. Cerebral small vessel diseases are clinically heterogeneous with a broad range of manifestations of variable severity. Besides a common early onset characterized by delayed motor development in infancy and a slowly progressive disease, the two COLGALT1 patients presented different levels of psychomotor and intellectual impairments. Whereas one patient was admitted to a regular elementary school by six years of age, the other one was affected of severe spastic quadriplegia and severe intellectual disability. One patient died at the age of nine years of intracranial hemorrhages following an infection . Collagen glycosylation is also possibly involved in the etiology of auto-immune diseases. Glycosylation plays a role in the recognition of collagen peptides by the adaptive immune system. In mice, immunization with heterologous collagen type II yields T-cells restricted to an immuno-dominant glycopeptide . The contribution of lysyl hydroxylation and glycosylation in shaping the immune response to collagen was confirmed when comparing the pro-arthritic effect of unmodified collagen with hydroxylated and glycosylated collagen in a mouse model of collagen-induced arthritis . Changes in the glycosylation pattern of collagen may therefore influence the onset of auto-immune disorders related to the connective tissue such as rheumatoid arthritis  and systemic sclerosis .