A B S T R A C T Of the total urinary hydroxyproline in normal subjects and those with skeletal disorders, between 4 and 20% was nondialyzable. In some patients with Paget's disease of bone, hyperparathyroidism with osteitis fibrosa, hyperphosphatasia, and extensive fibrous dysplasia the total urinary hydroxyproline was sufficiently high to permit purification of this polypeptide hydroxyproline by gel filtration and ion exchange chromatography. The partially purified polypeptides had molecular weights between 4500 and 10,000 and amino acid compositions and physical properties resembling those of gelatin. The polypeptide fractions also contained neutral sugar and glucosamine. These fragments had been shown to be susceptible to cleavage by purified bacterial collagenase suggesting the presence of the sequence -Pro-X-Gly-Pro-Y-.After administration of proline-"C to patients with Paget's disease hydroxyproline-"C was excreted in the urine. The hydroxyproline-14C specific activity reached a peak in 2-4 hr and declined rapidly. The specific activity of the polypeptide (retentate) portion was severalfold greater than that of the raw urine and diffusate. When the labeled urines were subjected to gel filtration the hydroxyproline-'4C fractions of highest molecular weight which were eluted first from the columns had the highest specific activities. Exposure of the hydroxyproline-14C-containing polypeptides to bacterial collagenase rendered them dialyzable.Four patients with hyperparathyroidism and osteitis fibrosa were studied before and after removal of a parathyroid adenoma, a period of transition from a predominance of bone collagen resorption to one of relatively increased bone collagen synthesis. The total urinary hydroxyproline fell rapidly after operation whereas the ratio of the polypeptide fraction to the total rose three-to fourfold. INTRODUCTION Collagen is the most abundant extracellular protein in mammalian tissues and is the major component of the organic matrix of bone (1). As bone is remodeled the collagen is resorbed and resynthesized, and the rate of its turnover in adults may be greater than that of collagen in other tissues such as skin and tendon (2). Since hydroxyproline is an amino acid present almost exclusively in collagen and is not reutilized for the synthesis of collagen, the urinary excretion of free and peptidebound hydroxyproline has been assumed to reflect the metabolism of this protein (3). Hydroxylysine is another amino acid present almost exclusively in collagen and the rate of urinary excretion of peptides containing hydroxylysine also has been suggested to reflect collagen metabolism (4, 5).The results of studies utilizing radioisotopically labeled proline (the precursor of collagen hydroxyproline) which compare the specific activities of hydroxyproline in urinary peptides and collagens of the tissues of the rat have suggested that a large part of the urinary hydroxyproline is derived from the breakdown of mature collagen (6, 7). In man it has been shown by Meilman, Urivetsky, and Rapop...