Matrix assembly and homeostasis in collagen-rich tissues are mediated by interactions with proteoglycans (PGs) substituted with sulfated glycosaminoglycans (GAGs). The major GAG in cornea is keratan sulfate (KS), which is N-linked to one of three PG core proteins. To ascertain the importance of the carbohydrate chain sulfation step in KS functionality, we generated a strain of mice with a targeted gene deletion in Chst5, which encodes an N-acetylglucosamine-6-O-sulfotransferase that is integral to the sulfation of KS chains. Corneas of homozygous mutants were significantly thinner than those of WT or heterozygous mice. They lacked high-sulfated KS, but contained the core protein of the major corneal KSPG, lumican. Histochemically stained KSPGs coassociated with fibrillar collagen in WT corneas, but were not identified in the Chst5-null tissue. Conversely, abnormally large chondroitin sulfate͞dermatan sulfate PG complexes were abundant throughout the Chst5-deficient cornea, indicating an alteration of controlled PG production in the mutant cornea. The corneal stroma of the Chst5-null mouse exhibited widespread structural alterations in collagen fibrillar architecture, including decreased interfibrillar spacing and a more spatially disorganized collagen array. The enzymatic sulfation of KS GAG chains is thus identified as a key requirement for PG biosynthesis and collagen matrix organization.collagen ͉ glycosaminoglycans ͉ proteoglycans G lycosaminoglycans (GAGs) substituted on proteoglycans (PGs) are influential in defining collagen fibrillar architecture in a wide range of connective tissue matrices. Keratan sulfate (KS) is an important constituent of several collagen-rich tissues and is the major GAG in cornea where it is N-linked to asparagine residues in one of three PG core proteins: lumican (1), keratocan (2), and mimecan͞osteoglycin (3). Human corneal GlcNAc 6-O-sulfotransferase (also known as human GlcNAc6ST-5 and GST4) is the responsible enzyme for the synthesis of high-sulfated KS via the transfer of sulfate onto the GlcNAc 6-O position of the KS backbone (4).Fairly compelling evidence exists for a regulatory role for KSPGs in the maintenance of corneal matrix structure in a number of species. The avian cornea in ovo, for example, synthesizes an unsulfated form of KS midway through development when it is structurally disorganized and transmits relatively little light, but switches to produce a sulfated KS GAG as it becomes transparent and attains a more well ordered collagen fibrillar ultrastructure (5, 6). KS sulfation patterns are also altered in opaque, structurally disorganized corneal scar tissue in rabbits (7,8) and in cloudy human corneas with the inherited disease, macular corneal dystrophy (9), which is caused by mutations in CHST6, a gene encoding human corneal GlcNAc 6-O-sulfotransferase (10).Hybrid type I͞V collagen fibrils are the cornea's main nonspecular light-scattering elements and are formed into wide, interweaving belts or lamellae that lie approximately in the tissue plane (11). Wit...