Lysyl hydroxylase 3 (LH3) is a multifunctional enzyme possessing lysyl hydroxylase, collagen galactosyltransferase, and glucosyltransferase (GGT) activities. We report here an important role for LH3 in the organization of the extracellular matrix (ECM) and cytoskeleton. Deposition of ECM was affected in heterozygous LH3 knock-out mouse embryonic fibroblasts (MEF ؉/؊ ) and in skin fibroblasts collected from a member of a Finnish epidermolysis bullosa simplex (EBS) family known to be deficient in GGT activity. We show the GGT deficiency to be due to a transcriptional defect in one LH3 allele. The ECM abnormalities also lead to defects in the arrangement of the cytoskeleton in both cell lines. Ultrastructural abnormalities were observed in the skin of heterozygous LH3 knock-out mice indicating that even a moderate decrease in LH3 has deleterious consequences in vivo. The LH3 null allele in the EBS family member and the resulting abnormalities in the organization of the extracellular matrix, similar to those found in MEF ؉/؊ , may explain the correlation between the severity of the phenotype and the decrease in GGT activity reported in this family.Lysyl hydroxylase (LH) 2 catalyzes the post-translational formation of hydroxylysines in -X-Lys-Gly-sequences in collagens and other proteins with collagen-like domains (1, 2). Three lysyl hydroxylase isoforms (LH1, LH2, and LH3) have been identified from human, mouse, rat, and zebrafish (3-10). In addition, LH2 has two alternatively spliced forms, LH2a (short) and LH2b (long) (11). Several mutations of the LH1 gene (PLOD1) have been identified in patients with Ehlers-Danlos syndrome (EDS) type VIA, a heritable disorder characterized by kyphoscoliosis, joint laxity, skin fragility, and muscle hypotonia (12, 13). EDS VIA data indicate that LH1 hydroxylates helical crosslinking lysines of type I collagen in bone and type II collagen in cartilage (14,15). Patients with Bruck syndrome, characterized by joint contractures, fragile bones, and osteoporosis, have mutations in the LH2 gene (PLOD2) that result in the complete absence of telopeptide hydroxylysine residues in bone collagens (16,17). In addition, overexpression of LH2b has been linked to an increase in the hydroxylysine content of collagen telopeptides seen in fibrotic disorders (18).LH3 differs from the other lysyl hydroxylase isoforms in that it possesses, in addition to lysyl hydroxylase activity (6, 19), hydroxylysyl galactosyltransferase and galactosylhydroxylysyl glucosyltransferase (GGT) activities (20 -22), thus LH3 is able to catalyze the formation of glucosylgalactosylhydroxylysine residues. Recent studies show that LH3 is located not only in the endoplasmic reticulum but also in the extracellular space, and that the GGT activity in serum originates from LH3 (23). Furthermore, LH3 knock-out studies in mice demonstrate that the loss of LH3 leads to embryonic lethality due to disruption of the formation of basement membranes (24,25). Analyses of LH3 knock-out embryos and embryonic fibroblasts indicate that the ...