Cellular stress due to impairment of collagen prolyl hydroxylation complex is rescued by the chaperone 4-phenylbutyrate

Osteogenesis imperfecta (OI) types VII, VIII and IX, caused by recessive mutations in cartilage associated protein (CRTAP), prolyl-3-hydroxylase 1 (P3H1), and cyclophilin B (CyPB), respectively, are characterized by the synthesis of overmodified collagen. The genes encode for the components of the endoplasmic reticulum (ER) complex responsible for the 3-hydroxylation of specific proline residues in collagen type I. Our study dissects the effects of mutations in the proteins of the complex on cellular homeostasis, using primary fibroblasts from seven recessive OI patients. In all cell lines the intracellular retention of overmodified type I collagen molecules causes ER enlargement associated to the presence of protein aggregates, activation of the PERK branch of the unfolded protein response and apoptotic death. The administration of 4-phenylbutyrate (4-PBA) alleviates cellular stress by restoring ER cisternae size, normalizing the p-PERK/PERK ratio and the expression of apoptotic marker. The drug has also a stimulatory effect on autophagy. We proved that the rescue of cellular homeostasis following 4-PBA treatment is associated to its chaperone activity, since it increases protein secretion, restoring ER proteostasis and reducing PERK activation and cell survival also in presence of autophagy pharmacological inhibition.Our results provide a novel insight into the mechanism of 4-PBA action and demonstrated that the intracellular stress in recessive OI can be tuned by 4-PBA therapy, similarly to what we recently reported for dominant OI, thus allowing a common target for OI forms characterized by overmodified collagen.