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(The FASEB Journal. 2000;14:761-768.)
© 2000 FASEB

A Bethlem myopathy Gly to Glu mutation in the von Willebrand factor A domain N2 of the collagen {alpha}3(VI) chain interferes with protein folding

TAKAKO SASAKI*, ERHARD HOHENESTER{dagger}, RUI-ZHU ZHANG{ddagger}, SUSAN GOTTA{ddagger}, MARCY C. SPEER§, RUP TANDAN||, RUPERT TIMPL*1 and MON-LI CHU{ddagger}

* Max-Planck-Institut für Biochemie, D-82152 Martinsried, Germany;
{dagger} Biophysics Section, Blackett Laboratory and Division of Medicine, Imperial College, London SW7 2AZ, U.K.;
{ddagger} Department of Dermatology and Cutaneous Biology, and Biochemistry and Molecular Pharmacology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA;
§ Department of Medicine, Section of Medical Genetics, Duke University Medical Center, Durham, North Carolina 27710, USA;
|| Department of Neurology, University of Vermont College of Medicine, Burlington, Vermont 05405, USA

1Correspondence: Max-Planck-Institut für Biochemie, Am Klopferspitz 18A, D-82152 Martinsried, Germany. E-mail: TIMPL{at}biochem.mpg.de


   ABSTRACT
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
A single G1679E mutation in the amino-terminal globular domain N2 of the {alpha}3 chain of type VI collagen was found in a large family affected with Bethlem myopathy. Recombinant production of N2 (~200 residues) in transfected mammalian cells has now been used to examine the possibility that the mutation interfered with protein folding. The wild-type form and a G1679A mutant were produced at high levels and shown to fold into a stable globular structure. Only a small amount of secretion was observed for mutants G1679E and G1679Q, which apparently were efficiently degraded within the cells. Homology modeling onto the related von Willebrand factor A1 structure indicated that substitution of G1679 by the bulky E or Q cannot be accommodated without considerable changes in the folding pattern. This suggests protein misfolding as a molecular basis for this particular mutation in Bethlem myopathy, in agreement with radioimmunoassay data showing reduced levels of domain N2 in cultured fibroblasts from two patients.—Sasaki, T., Hohenester, E., Zhang, R.-Z., Gotta, S., Speer, M. C., Tandan, R., Timpl, R., Chu, M.-L. A Bethlem myopathy Gly to Glu mutation in the von Willebrand factor A domain N2 of the collagen {alpha}3(VI) chain interferes with protein folding.


Key Words: haploin sufficiency • inherited disease • protein misfolding • recombinant production


   INTRODUCTION
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
GLYCINE IS DEVOID of a ß carbon and therefore has a considerable conformational flexibility compared to all other amino acids. It is frequently found at critical conformational sites, and its substitution by bulkier amino acids may confer considerable constraints on protein folding and stability (1) . The collagen triple helix is the most typical case, with an exclusive requirement for glycine at every third sequence position in order to allow the zipper-like folding of the three chains into a rigid structure. Glycine is placed close to the common axis and provides hydrogen bonds to adjacent chains (2 3 4) . It is therefore not surprising that many glycine substitutions of fibril-forming collagen types are considered to cause various dominant and recessive genetic diseases, including osteogenesis imperfecta and chondrodysplasias (5) . These substitutions are likely to introduce flexibility into the triple helix, which causes premature degradation of procollagens or interferes with fibrillogenesis. The same substitutions in the triple-helix of collagen type VII, which forms anchoring fibrils for basement membranes, are found in various forms of dystrophic epidermolysis bullosa and cause skin blistering (6 , 7) .

Substitutions of glycine are found in various other genetic disorders, which do not include the collagen triple helix. They were identified in the globular domains of some collagen types (5 , 8 , 9) and various modules of noncollagenous microfibrils (10) , and are more difficult to interpret in terms of their struction–function relationship. These substitutions are frequently found in calcium binding EG modules of fibrillin in patients with Marfan syndrome and related disorders (11) . A Gly to Ser change in one of these modules was shown to cause defective folding because the Ser side chain interferes with the loop c disulfide bridge (12) . A Gly to Val substitution was identified in the carboxyl-terminal globular domain of collagen type X in a family with Schmid metaphyseal chondrodysplasia. In vitro expression of the mutant collagen demonstrated lack of trimerization, but it was not clear whether this was due to defective globular folding (9) .

Several missense and deletion mutations have also been reported for the triple helical domains of the three chains that constitute the microfibrillar collagen type VI (13 14 15 16) . Patients involved suffer from Bethlem myopathy, a dominantly inherited, childhood-onset mild muscular dystrophy with joint constructures (17) . A further mutation in such patients was a Gly1679Glu change in domain N2 from the large amino-terminal globular structure N9-N1 of the {alpha}3(VI) chain (8) . Each individual N domain corresponds to a von Willebrand factor domain A-like (VWA) module of ~200 residues (18) .

A recombinant fragment corresponding to N9-N2 was shown to fold into eight small globular domains, which can take up different arrangements relative to one another (19) . Fragment N9-N2 or its subdomains were also shown to bind heparin and hyaluronan. Thus, the Bethlem myopathy mutation could have affected either binding properties or protein folding. The latter appeared more likely based on the recently elucidated structure of von Willebrand factor domain A1 (20 , 21) .

In the present study, we approached these questions by recombinant production in mammalian cells of domain N2 and several mutants of the critical Gly. These cell systems would immediately degrade a product not properly designed to represent an autonomously folding unit, as shown in previous studies (22 23 24 25) . The data demonstrated autonomous folding properties for domain N2, which could accommodate an Ala substitution but not amino acids at position 1679 with a bulkier side chain. These observations were rationalized by homology modeling of the domain N2 structure.


   MATERIALS AND METHODS
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
Expression vectors and cell transfection
To express the wild-type N2 domain of the {alpha}3(VI) collagen chain, F019 cDNA (18) was amplified by polymerase chain reaction (PCR) with primers HCOL6A3–41 (GTC AGC TAG CCG AGA AGA AGA AAG CAG AC) and HCOL6A3–42C GTC ACT CGA GTC AAA GGG TTT CAT GCA TCG C), which introduced an Nhel and Xhol site at the 5'- and 3'- end, respectively. N2 with the Gly to Glu mutation was prepared by RT-PCR amplification of total RNA from fibroblasts of the patient carrying this mutation, using the same primer pairs (8) . N2 domains with Gly to Ala and Gly to Gln mutations were prepared by two sequential PCR reactions with the above primers and two internal primers containing the mutations, as described (26) . The internal primers for the Ala mutant were HCOL6A3-N2AF (CCA AGT GGC GCT TGT CCA G) and HCOL6A3-N2AR (CTG GAC AAG CGC CAC TTG G), and for the Gln mutant were HCOL6A3-N2QF (CCA AGT GCA GCT TGT CCA G) and HCOL6A3-N2QR (CTG GAC AAG CTG CAC TTG G).

Total RNA was reverse transcribed with Superscript II reverse transcriptase (Life Technologies, Gaithersburg, Md.) and PCR amplification was performed with the Ampli Taq PCR kit (Perkin Elmer, Foster City, Calif.) following the manufacturer’s instructions. The PCR products were digested with Nhel and Xhol, then cloned into the corresponding sites of the expression vector pCEP-Pu, which contains the signal sequence for BM-40 (27) . The expression vectors were sequenced to ensure no other mutations were introduced by PCR. These vectors were then used to transfect 293-EBNA cells (Invitrogen, San Diego, Calif.) for episomal production (27) . Efficiency of transfections were analyzed by Northern blots of total mRNA prepared from puromycin-resistant cells using cDNA encoding N2, following standard protocols.

Protein purification
Serum-free conditioned medium (0.5–1l) was collected from transfected cells, dialyzed against 0.05M Tris-HCl, pH 8.6, and passed over a DEAE cellulose column (2.5x15 cm) equilibrated in the same buffer. Elution with a linear 0–0.4M NaCl gradient (300/300 ml) displaced the fragments at ~0.2M NaCl. They were concentrated by ultrafiltration and passed over a Superose 12 column (HR16/50, Pharmacia, Piscataway, N.J.) equilibrated in 0.2M ammonium acetate, pH 6.8. Purified fragments were lyophilized and dissolved in 0.2M ammonium bicarbonate.

Protein analysis
Protein concentrations were determined after hydrolysis with 6M HCl (16 h, 110°C) on a Biotronik LC 3000 analyzer. Sodium dodecyl sulfate (SDS) gel electrophoresis followed standard protocols. Edman degradation on a 473 sequencer was performed according to the manufacturer’s instructions. Electron microscopy was done after rotary shadowing of protein samples (28) and circular dichroism spectroscopy followed previous methods (19) . Chymotrypsin digestions were carried out at an enzyme-substrate ratio of 1:50 for 24 h at 37°C.

Structure homology modeling
The program CLUSTALW (29) was used to align the sequences of domains N2 to N9 of human {alpha}3(VI) collagen with those of A domains of known structure, namely, domains A1 (PDB accession codes 1oak, 1auq) and A3 (1atz, 1au3) of human von Willebrand factor (VWF) and the I domains of human integrins CD11a/CD18 (1ido) and CD11b/CD18 (1lfa). From this multiple alignment, the VWF A1 domain was judged to be the best template for homology modeling of the region around Gly1679 in {alpha}3(VI) collagen. Residue changes were done with the program O (30) . Side chain conformations were taken from the rotamer database of O and then optimized. The main chain conformation was not changed significantly, with the exception of a short stretch of amino acids following helix {alpha}1 (residues 1732 to 1736), which is at some distance from the site of mutation.

Immunological assays
A rabbit antiserum against fragment N9-N2 (19) was used throughout the study. Part of it was affinity-purified on a column of fragment N2. Antibodies eluted from the column reacted in enzyme-linked immunoassay equally well with N2 and N9-N2, whereas the nonbinding antibodies showed a high titer for N9-N2 (1:2.104) but not for N2 (titer less than 1:400). Both sets of antibodies were used in immunoblots following a previously described procedure (31) . Radioimmuno-inhibition assays were established with the antiserum and 1 ng each of 125I-labeled N2-N9 (antiserum dilution 1:3.104) or N2 (dilution 1:2500) following established protocols (32) . They were used for quantitation of samples with either fragment N2 or N9-N2 as reference inhibitor. All the concentrations determined are recorded as equivalents of N2 or N9-N2, respectively.

Cell cultures
Skin fibroblasts from patients and nonaffected controls (8) were grown to confluency in Dulbecco’s minimal essential medium containing 10% fetal calf serum. They were then incubated in serum-free medium (6 ml) before collecting the cells and medium. Intracellular and matrix deposited collagen VI was solubilized by detergent extraction (1 ml) as described previously (31) . The medium and the cell lysate were used in radioimmuno-inhibition assays and contained approximately equal amounts of collagen VI antigens.


   RESULTS
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
Recombinant production of domain N2 and its mutants
Human EBNA-293 kidney cells were transfected with episomal expression vectors encoding wild-type N2 (positions 1634–1833) and the mutants G1679A, G1679E, and G1679Q. Northern blots of total RNA from transfected cells showed the same size of mRNA (1.4 kb), with amounts varying only by a factor of 2 (Fig. 1 ). This level of variation is a common observation and reflects how well the transfected cells were selected by the puromycin treatment. Quantitation of domain N2 in serum-free culture medium and cell lysates by radioimmunoassays (see below) revealed striking differences in protein production, however (Table 1 ). Comparably high levels were found for wild-type N2 and mutant G1679A, but levels were 30- to 100-fold lower for mutants G1679E and G1679Q. This strongly indicated extensive intracellular degradation of the latter two mutants.



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Figure 1. Northern blots of 293-EBNA cells transfected with episomal expression vectors for collagen {alpha}3(VI) domain N2 and its mutants. Lanes were loaded with total RNA (5 µg) from wild-type N2 (lane 1) and mutants G1679E (lane 2), G1679Q (lane 3) and G1679A (lane 4). Lane 5: nontransfected cells.


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Table 1. Production of domain N2 and its mutants in transfected EBNA-293 cells

Serum-free culture medium was used to purify N2 and mutants G1679A and G1679E by ion-exchange and molecular sieve chromatography. Fragments N2 and mutant G1679A were obtained in good purity and yields (6–12 mg/l medium) and showed a main electrophoretic band of 26 kDa (Fig. 2 , lanes 1, 2). Both products started with a single amino-terminal sequence, APLAEKKK, where APLA is derived from the signal peptide cleavage region of the expression vector (27) . Because of low production, mutant G1679E could only be partially purified, but contained a major band of ~28 kDa (Fig. 2 , lane 3). This band was identified as the mutant by immunoblotting and amino-terminal sequencing. Its slower electrophoretic mobility is presumably explained by a greater amount of unfolding caused by SDS used during electrophoresis.



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Figure 2. SDS gel electrophoresis of purified recombinant N2 fragments and their chymotrypsin digests. The fragments were N2 (lane 1) and from mutants G1679A (lane 2) and G1679E (lane 3). The digests were from N2 (lane 4), G1679A (lane 5), and G1679E (lane 6). The run was carried out under reducing conditions and calibrated as indicated in kilodaltons.

Properties of the recombinant proteins
Electron microscopy of rotary-shadowed recombinant N2 (Fig. 3A ) showed small globular particles that corresponded to the size of individual N modules previously predicted from the larger fragment N9-N2 (19) . The same were observed for mutant G1679A (Fig. 3B ). The circular dichroism spectra of both recombinant fragments were identical to that previously shown for fragment N9-N2 (19) , with two distinct troughs of ellipticity (-13000 deg cm2 dmol-1) at 210 and 222 nm. This indicates ~40% {alpha} helix and some ß structure. Together, the data support the correct folding of recombinant N2 and mutant G1679A.



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Figure 3. Electron microscopy of rotary-shadowed domain N2 (A) and mutant G1679A (B). Bar: 100 nm.

Chymotrypsin was previously shown to cleave fragment N9-N2 at the borders between individual domains (19) . In agreement with this, recombinant N2 and mutant G1679A were now shown to be stable against chymotrypsin proteolysis (Fig. 2 , lanes 4, 5). The 28 kDa band of the mutant G1679E disappeared completely on this treatment, however (Fig. 2 , lane 6), and no smaller fragments could be detected by immunoblotting. A chymotrypsin fragment N3-N2 was previously shown to bind heparin (19) . This property is not shared by recombinant N2, which therefore implies involvement of domain N3 in the binding epitope.

A specific radioimmuno-inhibition assay for N2 epitopes was developed using an antiserum against N9-N2 (Fig. 4 ). This assay could be equally well inhibited by fragments N2 (26 kDa) and N9-N2 (180 kDa) with half-maximal inhibition at 0.15 nM. Culture medium and cell lysates from cells transfected with N2 or the mutant G1679A showed similar inhibition gradients, which demonstrated identical antigenic epitopes and allowed us to determine precisely the concentrations of the recombinant products (Table 1) . These concentrations were lower in cell lysate and medium of mutants G1679E and G1679Q (Table 1) ; because the inhibition curves were distinctly less steep (Fig. 4) , they could not be determined with great accuracy. The lower steepness of these curves also indicated that these mutants share some but not all epitopes (32) , presumably due to imperfect folding. This also suggested rapid intracellular degradation that prevents any significant secretion of the mutants (Table 1) .



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Figure 4. Radioimmuno-inhibition assay for collagen VI fragment N2. The assay consisted of 1 ng 125I-labeled N2 and a fixed dilution of an antiserum against N9-N2. Reference inhibitors were fragments N2 (•) and N9-N2 ({circ}). Biological samples were medium ({blacksquare}) and cell lysate ({square}) from cells transfected with wild-type N2 and medium ({blacktriangleup}) and cell lysate ({Delta}) from cells transfected with the G1679E mutant, used at the dilutions shown at the top.

A second inhibition assay with 125I-labeled fragment N9-N2 and the same antiserum could similarly be inhibited by N9-N2, with half-maximal inhibition at 0.06 nM (data not shown). Fragment N2, however, showed only 8–10% inhibition over a broad concentration range (0.02–14 nM), indicating a relatively minor contribution of antigenic epitopes. Furthermore, since the assays for N2 and N9-N2 show a two- to threefold difference in sensitivity, they could only be used for a relative quantitation of antigenic epitopes in biological samples (see below).

Structural modeling of the mutations
To understand the effect of the G1679E mutation on protein folding, we initially tried to obtain crystals of the N2 domain of the type VI collagen {alpha}3(VI) chain, but these attempts were not successful. We therefore used homology modeling to understand this detrimental effect. A pairwise sequence alignment of the collagen {alpha}3(VI) N2 domain and the A1 domain of van Willebrand factor is shown in Fig. 5A (20.1% sequence identity, 42.3% similarity). We used the structure of the VWF A1 domain, determined independently at 2.2 Å (21) and 2.3Å resolution (22) , as a template to model the local structure around the site of the G1679E mutation in domain N2. Only small adjustments in main chain conformation were required to accommodate the residue changes. Figure 5B shows the resulting model. Gly1679 in N2 corresponds to Ala554 in VWF A1; the requirement for a glycine, alanine, or serine residue at this position throughout all A domains has been noted previously (8) . Val1641, Val1681, Leu1693, and Phe1731, which surround Gly1679, are strictly conserved between N2 and VWF A1. These residues are also highly conserved in all other members of the A domain superfamily. The salt bridge between Asp1689 and His1725 appears to be unique to the domain N2 and replaces a pair of conserved hydrophobic or aromatic residues in other A domains. Likewise, His1730 replaces an invariant apolar residue (valine, leucine, or isoleucine in most cases). Finally, Phe1692, the side chain of which stacks with that of His1730 in our model, replaces Gly606 of the VWF A1 domain. It is noted, however, that an apolar residue at this position is found in five of the nine N domains of collagen {alpha}3(VI) chains (18) .



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Figure 5. Sequence alignment and structural modeling of the N2 region involved in the mutation. A) Sequence alignment of the {alpha}3(VI) collagen N2 domain and the VWF A1 domain. Identical residues are indicated by pink shading. Gly1679 is marked by a red arrowhead. The secondary structure elements of the VWF A1 structure (20 , 21) are indicated above the alignment. Residues shown in panel B are in italics. B) Local structure around Gly1679 in the N2 domain of {alpha}3(VI) collagen. Selected important residues (see text) are shown as stick models. The C{alpha} atom of Gly1679 is shown as a large yellow sphere. The presumed hydrogen bond between His1725 and Asp1689 is represented by a thin line. Note that the short ß-strand ß3 (residues 1688 to 1691) is shown as a C{alpha} trace for reasons of clarity.

Antigenic epitopes of domain N2 in control and patient fibroblasts
Autosomal dominant mutations of single amino acid residues are usually difficult to analyze in tissue samples, and no significant differences in size or ratios of the collagen type VI {alpha} chains have been detected before between fibroblasts from patients with the G1679E mutation and unaffected family members (8) . We have now used antibodies against fragment N9-N2 and made them specific for domain N2 and the remaining N9-N3 structure by immunoadsorption. In immunoblots of medium from patient and control fibroblasts, both sets of antibodies reacted with a major broad band of ~250 kDa (Fig. 6 ), which corresponds to the natural, processed form of the {alpha}3(VI) chain (33) . Both sets of antibodies also recognized a series of weaker bands, particularly in the region 120–200 kDa and around 70 kDa, indicating further proteolytic processing. However, there was no significant difference in these additional collagen VI bands between the patient and control samples.



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Figure 6. Immunoblots of collagen VI using medium from fibroblasts from a normal control (a) and a patient with the G1679E mutation (b). The antibodies were against fragment N2 (A) and against the N9-N3 structure (B). Equal amounts of medium were reduced and loaded on the gels. Numbers refer to the position of calibrating proteins in kilodaltons.

The radioimmuno-inhibition assays for N9-N2 and N2 described above were used as a second approach to analyze the fibroblast medium and cell lysate from two patients and two controls (Table 2 ). The data showed the presence of both antigenic epitopes, but also a considerable individual variability between the different sources of the fibroblasts. The relative ratio of N9-N2 to N2 epitopes was ~3 in the controls and increased to 4.2 and 4.9 in the patients, which indicates ~20–30% loss of N2 epitopes. This could be due to unfolding, as shown for the recombinant products, or may reflect partial degradation of N2.


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Table 2. Contents of amino-terminal epitopes (N9-N2, N2) in fibroblast cultures of patients and controls


   DISCUSSION
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 
Successful recombinant production of collagen VI structures in human cells has been reported for the {alpha}1(VI) and {alpha}2(VI) chains (34) and domain N9-N2 of the {alpha}3(VI) chain (19) . Furthermore, it was shown that the {alpha}3(VI) chain containing N6-N1 was essential for chain association and secretion of collagen VI (35) . This also demonstrated that these large recombinant proteins possess all the information necessary for proper folding. Similar studies with other extracellular matrix proteins and domains, however, showed that this is critically dependent on the correct choice of module boundaries (22 , 24 , 25) and also on individual amino acid substitutions (12 , 36) . This led to the conclusion that proteases within the rough endoplasmic reticulum are important quality controllers for folding (23) .

Using transfected human cells, we show here that domain N2 of collagen VI folds autonomously into a globular structure that is resistant to proteases. When Gly1679, a critical residue in a family with Bethlem myopathy (8) , was mutated to Ala, these properties did not change. However, mutation of this residue to Glu, as found in the patients, or to Gln was correlated with low levels of secretion very likely caused by rapid intracellular degradation. Since the N2 mutant Gly1679Gln could not be detected at all in the culture medium by radioimmunoassay and immunoblotting, it might cause an even more severe phenotype than the natural Glu mutation found uniformly in 19 patients (8) .

The model of the N2 domain of {alpha}3(VI) collagen presented in Fig. 5 readily explains the detrimental effect of the Gly1679Glu mutation on the folding and stability of this domain. Gly1679 is located in ß-strand ß2, a highly conserved region of the VWA module, and is surrounded by conserved apolar residues. The {alpha}-helix {alpha}3, which covers one face of the central ß-sheet of the A1 domain, contributes His1730, the side chain of which is in close contact with both the C{alpha} atom of Gly1679 and a number of key apolar resides in the area. Due to the tight packing of residues around Gly1679, the large charged side chain of a glutamic acid at position 1679 could not be accommodated without drastic structural changes. In particular, in the present model of domain N2 every possible conformation of a glutamic acid would result in a serious clash of the carboxylate group with the imidazole ring of His1730. Such changes could have an effect on collagen VI fibril assembly or the interaction with other extracellular matrix proteins. However, the Gly1679Glu mutation may cause disease simply by decreasing the amount of {alpha}3(VI) chain available for collagen triple helix formation. It is not clear whether an N2 domain carrying the Gly1679Glu mutation would fold at all, with misfolded protein being rapidly cleared in vivo. This scenario seems to be supported by the somewhat lower content of domain N2 in fibroblast cultures of patients, as indicated from radioimmunoassays.

Bethlem myopathy is dominantly inherited (17) , and in affected families the disease has been linked to either chromosomes 2 or 21 (14 , 37) , where the three collagen type VI chain genes reside (38) . Subsequent molecular analyses have demonstrated that mutations in these collagen genes indeed cause the disease. Missense mutations that disrupt the invariant glycine residues in the triple-helical domains of the {alpha}1(VI), {alpha}2(VI), and {alpha}3(VI) collagen chains are most common, having been reported in three Dutch families and one Italian family (14 , 16) . Haploinsufficiency of collagen type VI due to splice site mutations is also emerging as a mechanism leading to the disease. This was first reported in an Australian family, in whom the mutation introduces a premature stop codon in the {alpha}1(VI) gene, leading to mRNA degradation (15) . More recently, in two other families from Australia and Italy, respectively, the disease was shown to be caused by exon skipping, in which a cysteine residue is deleted in the triple-helical domain of the {alpha}1(VI) chain (39) . This cysteine is thought to be involved in the assembly of type VI collagen dimers prior to secretion (33) . Moreover, mice with targeted inactivation of one {alpha}1(VI) collagen allele showed histopathology of myopathy (40) . This demonstrates that apart from the Gly1679Glu mutation in a large family of French-Canadian descent (8) , several other genetic mechanisms affecting the collagen VI genes lead to similar myopathy phenotypes. This would support the interpretation that a reduced collagen VI content and not a specific functional failure is the common molecular deficiency of Bethlem myopathy.

Two more glycine mutations have been found to impair folding in protein modules not related to the collagen triple helix. These involve a Gly to Ser change in EG modules of coagulation factor IX and fibrillin-1, mutations that are linked to mild forms of hemophilia B or familial aortic aneurism, respectively. Both mutations lead to deficient folding, which is explained by interference of the serine side chain with the formation of a critical disulfide bridge (12) . A Gly to Val change in the carboxyl-terminal C1q-like module of collagen type X, a mutation linked to Schmid’s metaphyseal chondrodysplasia, was previously shown to prevent trimerization (9) and more recently found to interfere with globular folding (41) . Recombinant production of four different mutants in Escherichia coli showed that apart from failing to trimerize, the mutants bound extensively to the GroEL chaperone and were highly sensitive to trypsin. Homology modeling on a related ß jelly roll fold indicated that two mutations in ß strands caused premature stop codons and a Tyr598Asp mutation in a ß-strand is close to the trimerization site. An additional Gly618Val mutation in a loop region may have caused steric incompatibility, as discussed in another study (42) . Here again, it is obvious that different mutations can cause the same molecular defect and hence the same clinical phenotype.

Our study and the data of Dublet et al. (41) clearly indicate that recombinant production in both mammalian and bacterial cells is useful to analyze the effect of mutations on the folding of globular domains. In the first case, this will require the correct choice of module boundaries and misfolding can be identified by lack of production. Bacterial production needs as a prerequisite the proper folding of the wild-type structure, as described in ref 41 . Misfolded products can then be identified by protease sensitivity and/or chaperone binding. The two approaches are complementary but may be also used as alternatives in the identification of Gly mutations, causing the misfolding of globular domains.


   ACKNOWLEDGMENTS
 
We are grateful for the expert technical assistance of Mischa Reiter, Vera van Delden, Christa Wendt, Hanna Wiedemann, and Albert Ries and thank Karlheinz Mann for sequencing. E.H. is a Welcome Trust Senior Fellow. The study was supported by the Deutsche Forschungsgemeinschaft (SFB266) to R.T., NIH grant AR38912 to M.-L. C., and grants from NIH NS26630 and Muscular Dystrophy Association to M.C.S.


   FOOTNOTES
 
Received for publication July 6, 1999. Revised for publication November 4, 1999.


   REFERENCES
TOP
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
REFERENCES
 

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