Dermal fibroblasts derived from types I and IV EhlersDanlos syndrome (EDS) patients, carrying mutations in. Functionblocking antibodies to COLLV, COLLIII, or ␣ 2  1 integrin induce in control fibroblasts an EDS-like phenotype. These results show that in human fibroblasts ␣ 2  1 integrin organization and function are controlled by its ligand, and that the ␣ 2  1 -COLL interaction, in turn, regulates FN integrin receptor recruitment: high ␣ 2  1 integrin levels induce ␣ 5  1 integrin organization, while low ␣ 2  1 integrin levels lead to ␣ v  3 integrin organization.
The extracellular matrix (ECM)1 is a complex structure formed by distinct molecular networks that interact with specific cell receptors, triggering numerous responses that play essential roles in cell behavior regulation (1). The ECM provides a substrate for cell migration during embryonic development and wound healing, regulating tissue architecture and morphogenesis (2), and is also signaling variations in the cell microenvironment affecting cell proliferation, differentiation, and death (3-7).Collagens (COLLs) and fibronectin (FN) are major ECM protein components (1, 8 -10). COLLs, the most abundant proteins of connective tissues, are formed by three polypeptide chains, synthesized as propeptide (pro-␣ chains), coiled into triple helices, and encoded by the same or different genes (11). Types I, III, V, and XI COLLs are organized in fibrillar structures and are therefore referred to as fibrillar COLLs. In particular, COLLIII is an ␣ 1 (III) 3 homotrimer encoded by the COL3A1 gene and is mainly distributed in skin, tendon, aorta, and cornea (12), whereas COLLV is a quantitatively minor fibrillar COLL with a broad tissue distribution that regulates COLLI fibrillogenesis (13). COLLV molecules may contain ␣1(V), ␣2(V) and ␣3(V) or ␣1(V) 2 ␣2(V) chains (13).Mutations in COLLs are related to a variety of hereditary connective tissue disorders one of which is Ehlers-Danlos syndrome (EDS), a group of heterogeneous diseases (at least 11 types) caused by alterations in different COLL genes, COL1A1, COL1A2, COL3A1, COL5A1,, and to mutations in lysyl hydroxylase (18) and N-proteinase genes (19), altering the post-translational modification of COLLs. In particular, mutations in COL5A1 and COL5A2 genes have been reported in EDSI patients showing classical signs of the syndrome, i.e. widespread scarring and bruising, skin hyperextensibility, and joint laxity (15-16). Mutations in COL3A1 genes have been disclosed in EDSIV patients showing as common features vascular rupture (vascular type), colonic perforation, thin, translucent skin, and severe bruising (15)(16)(17)(18)(19)(20).FN is a dimeric glycoprotein that triggers cell adhesion, migration, cell cycle progression, and differentiation (4,7,21). FN deposition in vivo represents the initial event during fibrillogenesis of connective tissue matrices occurring during embryogenesis and wound healing (3,22,23). Human skin fibroblasts adhere in vitro through the organization of an ECM mainly composed of FN an...