these changes in collagen cause the signs and symptoms of the disorder. Ehlers–Danlos type IV is most attributed to abnormalities in the reticular fibers (collagen Type III). Without the hydroxylation of lysine, by the enzyme lysyl hydroxylase, the final collagen structure cannot form. Osteogenesis imperfecta, type I: Osteogenesis imperfecta is the most common disorder caused by mutations in this gene. Mutations that inactivate one of the two copies of the COL1A1 gene cause osteogenesis imperfecta type I. The mutated copy of the gene does not produce any pro-alpha1(I) collagen chains. Because only one copy of the gene is directing the cell to make pro-alpha1(I) chains, cells from people with this disorder make only half of the normal amount of type I collagen, which results in bone fragility and other symptoms. Osteogenesis imperfecta, type II: Many different types of mutations in the COL1A1 gene can cause osteogenesis imperfecta type II. These mutations range from missing pieces of the COL1A1 gene to amino acid substitutions, in which the amino acid glycine is replaced by another amino acid in the protein strand. Sometimes one end of the gene (called the C-terminus) is altered, which interferes with the association of the protein strands. All of these changes prevent the normal production of mature type I collagen, which results in this severe condition, type II osteogenesis imperfecta. Osteogenesis imperfecta, type III: Mutations in the COL1A1 gene may result in the production of a protein that is missing segments, making it unusable for collagen production. Other mutations cause the amino acid glycine to be replaced by a different amino acid in the pro-alpha1(I) chain, which inhibits the essential interaction between protein chains. Type I collagen production is inhibited by the inability of the altered procollagen strands to associate and form the triple-stranded, ropelike structure of mature collagen. These alterations negatively affect tissues that are rich in type I collagen, such as the skin, bones, teeth, and tendons, leading to the signs and symptoms of type III osteogenesis imperfecta. Osteogenesis imperfecta, type IV: Several different types of mutations in the COL1A1 gene cause osteogenesis imperfecta type IV. These mutations may involve missing pieces of the COL1A1 gene or changes in base pairs (the building blocks of DNA). These gene alterations result in a protein that is missing segments or has amino acid substitutions; specifically, the amino acid glycine is replaced by another amino acid. All of these