A 54-year-old man undergoes laparoscopic hernia repair. In spite of the small size of the incisions, he has poor wound healing. Further history reveals that his usual diet has poor nutritional value and is deficient in vitamin C. Synthesis of which of the following extracellular matrix components is most affected by this deficiency?
High-Yield Explanation
Vitamin C deficiency leads to scurvy, with reduced lysyl oxidase enzyme activity that helps cross-link fibrillar collagens to provide tensile strength. Though elastin is a fibrillar protein, it tends to regenerate poorly in scar tissue, even with the best of nutrition, explaining why a scar does not stretch like the skin around it. The other listed choices are glycoproteins that have an adhesive quality and are not vitamin C dependent.