T he extracellular matrix proteins collagen and elastin determine, to a large extent, the biomechanical properties of the vessel wall. Both molecules are secreted as monomers, but are posttranslationally modified in the extracellular space in order to generate stable polymers. A critical feature of collagen and elastin fibers is the degree of cross-linking. The first step in cross-linking is the oxidative deamination of the ⑀-amino group of certain peptidyl (hydroxy)lysyl residues, resulting in the aldehyde (hydroxy)allysine. In collagen, (hydroxy)allysine is restricted to the Cand N-telopeptide. The aldehyde reacts with a lysyl (Lys) or hydroxylysyl (Hyl) residue in the triple helix, resulting in a variety of cross-links. 1 In elastin, the oxidative deamination of Lys (Hyl is absent in elastin) is less restrictive, resulting in modification of most of the Lys residues. Well known elastin cross-links are lysinonorleucine and the pyridiniums desmosine and isodesmosine. 1 The cross-links in collagen are responsible for the stiffness of collagen fibers, 2 whereas the cross-links in elastin are important for the rubber-like properties of elastin fibers. 3
See page 1409The enzyme responsible for the oxidative deamination of the ⑀-amino groups is lysyl oxidase (LOX), a copperdependent amine oxidase. 4 Reduced activity levels of this enzyme result in decreased degree of cross-linking, affecting the biomechanical properties of extracellular matrices 2 as well as the susceptibility of collagen and elastin to degradation by proteinases. 5 In this issue, Rodríguez et al 6 describe the downregulation of LOX expression in porcine endothelial cells subjected to atherogenic levels of LDL. The authors hypothesize that this results in a decreased degree of elastin and/or collagen cross-linking, which leads to alterations in the integrity of the extracellular matrix and thereby enhances endothelial permeability. This is an interesting hypothesis that points to the intimate interaction between the cell matrix and cell functioning. It shows resemblance with the increased endothelial permeability found in diabetic vessels, which is also accompanied by alterations in the extracellular matrix. This attractive idea asks for further testing. For example, apart from LOX, four more LOX-like genes have recently been cloned (LOXL1 to 4). 7 The substrate specificity of these enzymes in vivo is hardly known, as is the expression in endothelial cells. It is likely that at least some of them are involved in cross-linking, 8,9 and at this stage, it cannot be excluded that they are able to compensate for the decrease of LOX expression levels in the model described by Rodríguez et al. 6 Multiple novel biological functions have recently been attributed to LOX, such as suppressing the ras oncogene, being a stimulator of collagen type III promotor activity, playing a role in cell adhesion and growth control, 4,10 and acting intracellularly. 11,12 It is therefore possible that the increased endothelial permeability is due to a phenomenon other than cr...