Missense mutations in the collagen triple helix that replace one Gly residue in the (Gly-X-Y) n repeating pattern by a larger amino acid have been shown to delay triple helix folding. One hypothesis is that such mutations interfere with the C-to N-terminal directional propagation and that the identity of the residues immediately N-terminal to the mutation site may determine the delay time and the degree of clinical severity. Model peptides are designed to clarify the role of tripeptide sequences N-terminal to the mutation site, with respect to length, stability, and nucleation propensity, to complete triple helix folding. Two sets of peptides with different N-terminal sequences, one with the natural sequence ␣1(I) 886 -900, which is just adjacent to the Gly 901 mutation, and one with a GPO(GAO) 3 sequence, which occurs at ␣1(I) 865-879, are studied by CD and NMR. Placement of the five tripeptides of the natural ␣1(I) collagen sequence N-terminal to the Gly to Ala mutation site results in a peptide that is folded only C-terminal to the mutation site. In contrast, the presence of the Hyp-rich sequence GPO(GAO) 3 N-terminal to the mutation allows complete refolding in the presence of the mutation. The completely folded peptide contains an ordered central region with unusual hydrogen bonding while maintaining standard triple helix structure at the N-and C-terminal ends. These peptide results suggest that the location and sequences of downstream regions favorable for renucleation could be the key factor in the completion of a triple helix N-terminal to a mutation.Abnormalities in protein folding are known to play a role in many diseases, including those arising from mutations in the collagen triple helix (1). The best characterized collagen disease is osteogenesis imperfecta (OI), 5 or brittle bone disease, in which there is defective mineralization of bones in type I collagen (2, 3). Missense mutations that change one Gly in the repetitive (Gly-X-Y) sequence are the most common mutations (4). Such Gly mutations are found all along the collagen chain, suggesting that the loss of a Gly at any site in the triple helix has pathological consequences. The phenotype of the disease varies widely, depending on the type of amino acid substitution and the site of the mutation (5, 6). There is evidence of abnormal folding of collagen in OI and other collagen diseases, which may relate to the pathology (7, 8).Folding of the triple helix is a complex, multistep process that includes association of three chains to form the supercoiled polyproline II triple helical structure (8). Collagen is synthesized in a procollagen form, with N-and C-terminal globular propeptides flanking the (Gly-X-Y) n central domain (9, 10). Posttranslational hydroxylation of Pro and Lys residues in the Y positions and further glycosylation of Hyl occur while the chains are unfolded (11, 12). Trimerization occurs through the association of three C-terminal propeptides, and then nucleation of the triple helix takes place at the (Gly-Pro-Hyp) n -rich sequence...