Elevated homocysteine (Hcys) serum levels represent a risk factor for several chronic pathologies, including cardiovascular disease, atherosclerosis, and chronic renal failure, and affect bone development, quality, and homeostasis. Hcys influences the formation of a stable bone matrix directly through the inhibition of the collagen cross-linking enzyme lysyl oxidase (Lox) and, as we have shown recently, by repressing its mRNA expression. The aim of this study was to investigate the mechanisms involved in this process. Epidemiological studies have shown that high homocysteine (Hcys) 2 serum levels represent a risk factor for several chronic disorders such as cardiovascular disease, atherosclerosis, chronic renal failure, diabetes, or the metabolic syndrome (1, 2). Moreover, hyperhomocysteinemia is known to affect bone development and homeostasis (3-6). Hcys has been shown to interfere with post-translational modifications of collagen directly by inhibiting lysyl oxidase (Lox) (7) and indirectly by down-regulation of its mRNA expression and of other genes involved in collagen cross-linking. Enzymatic inhibition or mRNA down-regulation of Lox results in changes in collagen cross-linking pattern in vitro (8 -10) and in vivo resulting in decreased bone quality (11)(12)(13). In this context, we have recently reported a correlation between plasma Hcys levels and a collagen cross-link ratio in forming trabecular surfaces in human bone (14).Lysyl oxidase was also identified as a phenotypic suppressor of the ras oncogene in H-ras-transformed NIH3T3 fibroblasts. In this transformed cell line, H-ras participates in an elaborate pathway attenuating the expression of Lox and of many other genes by CpG methylation on DNA. These genes are reactivated by treatment with azacytidine, an inhibitor of DNA (cytosine-5)-methyltransferases. Methylation of cytosine-guanine dinucleotides (CpGs) on DNA is an important epigenetic mechanism involved in the selective regulation of gene expression and in the stabilization of chromatin, thus controlling tissue development and pathogenesis. Aberrant CpG methylation of specific genes is often found in many tumors and tumorigenic cell lines (15).Besides its role as inhibitor of collagen cross-linking, Hcys is also known to play a role in epigenetic gene regulation being directly involved in the DNA methylation process. Hcys represents a methyl group carrier involved in the S-adenosylmethionine-S-adenosylhomocysteine methylation cycle. Here, Hcys is remethylated to methionine, which is further activated to S-adenosylmethionine, the methyl donor in DNA methylation. S-Adenosylmethionine converts to S-adenosylhomocysteine after DNA methylation. Hydrolysis of S-adenosylhomocysteine to homocysteine completes the cycle (16).