Fulvic acid disturbs processing of procollagen II in articular cartilage of embryonic chicken and may also cause Kashin-Beck disease.

Kashin-Beck disease is an endemic osteoarthropathy in China which may lead to skeletal deformation and dwarfism. We have analysed articular cartilage from two patients and found an accumulation of the precursor molecule, pro-pN-collagen II (pN, peptide attached at the amino-terminus) which was not present in extracts of control fetal cartilage. In addition, collagen II isolated from the same tissue by limited pepsin digestion had a decreased electrophoretic mobility, increased proline hydroxylation and decreased thermal stability. Previously, a genetic defect in pro-pN-collagen-I processing has been described in calf and sheep (dermatosparaxis) and man (Ehlers-Danlos, type VII) which caused an extreme fragility of the skin [Lenaers, A., Ansay, M., Nusgens, B.V. & Lapière, C.M. (1971) Eur. J. Biochem. 23, 533-541; Helle, O. & Nes, N.J. (1972) Acta Vet. Scand. 13, 443-445; Lichtenstein, J.R., Martin, G.R., Kohn, L.D., Byers, P.H. & McKusick, V.A. (1973) Science 182, 298-300]. Accordingly, one may assume that the impaired conversion of pro-pN-collagen II to collagen II and the structural alteration of collagen II, presumably caused by fulvic acid and other environmental factors, play an important role in the pathogenesis of Kashin-Beck disease.