These data support previous results that demonstrate the osteogenic differentiation of cells of the osteoblastic lineage can be modulated in the presence of GAG-modifying enzymes.[17], [32] When cultured on enzyme-treated ECMs produced by CIObs for short periods, we observed that osteoblasts from craniosynostosis patients exhibited increased expression of ALP and RUNX2, both early indicators of osteogenesis, compared to cells cultured on untreated ECMs. This evidence concerns the gene RUNX2 and craniosynostosis.