The Rieger syndrome is an autosomal dominant disease characterized by ocula
r, craniofacial, and umbilical defects. Patients have mutations in PITX2, a
paired-bicoid homeobox gene, also involved in left/right polarity determin
ation. In this study we have identified a family of genes for enzymes respo
nsible for hydroxylizing lysines in collagens as one group of likely cognat
e targets of PITX2 transcriptional regulation. The mouse procollagen lysyl
hydroxylase (Plod)-2 gene was enriched for by chromatin precipitation using
a PITX2/Pitx2-specific antibody. Plod-2, as well as the human PLOD-1 promo
ters, contains multiple bicoid (PITX2) binding elements. We show these elem
ents to bind PITX2 specifically in vitro. The PLOD-1 promoter induces the e
xpression of a luciferase reporter gene in the presence of PITX2 in cotrans
fection experiments. The Rieger syndrome causing PITX2 mutant T68P fails to
induce PLOD-l-luciferase. Mutations and rearrangements in PLOD-1 are known
to be prevalent in patients with Ehlers-Danlos syndrome, kyphoscoliosis ty
pe (type VI [EDVI]). Several of the same organ systems are involved in Rieg
er syndrome and EDVI.