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Harmon RM, Ayers JL, McCarthy EF, Kowalczyk AP, Green KJ, Simpson CL. Pumping the Breaks on Acantholytic Skin Disorders: Targeting Calcium Pumps, Desmosomes, and Downstream Signaling in Darier, Hailey-Hailey, and Grover Disease. J Invest Dermatol 2024:S0022-202X(24)01925-0. [PMID: 39207315 DOI: 10.1016/j.jid.2024.06.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 09/04/2024]
Abstract
Acantholytic skin disorders, by definition, compromise intercellular adhesion between epidermal keratinocytes. The root cause of blistering in these diseases traces back to direct disruption of adhesive cell-cell junctions, exemplified by autoantibody-mediated attack on desmosomes in pemphigus. However, genetic acantholytic disorders originate from more indirect mechanisms. Darier disease and Hailey-Hailey disease arise from mutations in the endoplasmic reticulum calcium pump, SERCA2, and the Golgi calcium/manganese pump, SPCA1, respectively. Though the disease-causing mutations have been known for nearly 25 years, the mechanistic linkage between dysregulation of intracellular ion stores and weakening of cell-cell junctions at the plasma membrane remains puzzling. The molecular underpinnings of a related idiopathic disorder, Grover disease, are even less understood. Due to an incomplete understanding of acantholytic pathology at the molecular level, these disorders lack proven, targeted treatment options, leaving patients with the significant physical and psychological burdens of chronic skin blistering, infections, and pain. This article aims to review what is known at the molecular, cellular, and clinical levels regarding these under-studied disorders and to highlight knowledge gaps and promising ongoing research. Armed with this knowledge, our goal is to aid investigators in defining essential questions about disease pathogenesis and to accelerate progress toward novel therapeutic strategies.
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Affiliation(s)
- Robert M Harmon
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
| | - Jessica L Ayers
- Molecular Medicine and Mechanisms of Disease PhD Program, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA; Department of Dermatology, University of Washington, Seattle, Washington, USA; Institute for Stem Cell & Regenerative Medicine, University of Washington, Seattle, Washington, USA
| | - Erin F McCarthy
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Andrew P Kowalczyk
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA; Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Kathleen J Green
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Cory L Simpson
- Department of Dermatology, University of Washington, Seattle, Washington, USA; Institute for Stem Cell & Regenerative Medicine, University of Washington, Seattle, Washington, USA.
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Song D, Geng J, Yi Q, Liu H, Wang S, Jiang X. Extensive Darier disease accompanied by pterygium and scoliosis in a patient with a start codon mutation of the ATP2A2 gene. Indian J Dermatol Venereol Leprol 2024; 0:1-3. [PMID: 38841935 DOI: 10.25259/ijdvl_77_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/15/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Deyu Song
- Department of Dermatology, West China Hospital of Sichuan University, Wuhou district, Guoxue alley, Sichuan
| | - Jia Geng
- Institute of Rare Diseases, West China Hospital of Sichuan University, Chengdu, China
| | - Qin Yi
- Department of Dermatology, West China Hospital of Sichuan University, Wuhou district, Guoxue alley, Sichuan
| | - Hongjie Liu
- Department of Dermatology, West China Hospital of Sichuan University, Wuhou district, Guoxue alley, Sichuan
| | - Sheng Wang
- Department of Dermatology, West China Hospital of Sichuan University, Wuhou district, Guoxue alley, Sichuan
| | - Xian Jiang
- Department of Dermatology, West China Hospital of Sichuan University, Wuhou district, Guoxue alley, Sichuan
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Reiter O, Leshem A, Alexander-Shani R, Brandwein M, Cohen Y, Yeshurun A, Ziv M, Elinav E, Hodak E, Dodiuk-Gad RP. Bacterial Skin Dysbiosis in Darier Disease. Dermatology 2024; 240:443-452. [PMID: 38330926 PMCID: PMC11168447 DOI: 10.1159/000537714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/05/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Darier disease is a rare inherited disease with dominant skin manifestations including keratotic papules and plaques on sebaceous and flexural areas. Secondary infection of skin lesions is common, and Staphylococcus aureus commonly colonizes these lesions. The aim of the study was to characterize the bacterial microbiome of cutaneous Darier lesions compared to normal-looking skin and disease severity. METHODS All patients with a history of Darier followed up at Emek Medical Center were invited to participate in the study. Patients that did not use antibiotics in the past month and signed informed consent had four skin sites sampled with swabs: scalp, chest, axilla, and palm. All samples were analyzed for bacterial microbiome using 16S rDNA sequencing. RESULTS Two hundred and eighty microbiome samples obtained from lesional and non-lesional skin of the scalp, chest, axilla, and palm of 42 Darier patients were included in the analysis. The most abundant bacterial genera across all skin sites were Propionibacterium, Corynebacterium, Paracoccus, Micrococcus, and Anaerococcus. Scalp and chest lesions featured a distinct microbiome configuration that was mainly driven by an overabundance of Staphylococci species. Patients with more severe disease exhibited microbiome alterations in the chest, axilla, and palm compared with patients with only mild disease, driven by Peptoniphilus and Moryella genera in scalp and palmar lesions, respectively. CONCLUSION Staphylococci were significantly associated with Darier lesions and drove Darier-associated dysbiosis. Severity of the disease was associated with two other bacterial genera. Whether these associations also hold a causative role and may serve as a therapeutic target remains to be determined and requires further investigation.
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Affiliation(s)
- Ofer Reiter
- Division of Dermatology, Rabin Medical Center, Petah Tikvah, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Avner Leshem
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Systems Immunology Department, Weizmann Institute of Science, Rehovot, Israel
- Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | | | - Yotam Cohen
- Systems Immunology Department, Weizmann Institute of Science, Rehovot, Israel
| | - Algit Yeshurun
- Department of Dermatology, Emek Medical Center, Afula, Israel
| | - Michael Ziv
- Department of Dermatology, Emek Medical Center, Afula, Israel
- Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Eran Elinav
- Systems Immunology Department, Weizmann Institute of Science, Rehovot, Israel
- Microbiome and Cancer Division, DKFZ, Heidelberg, Germany
| | - Emmilia Hodak
- Division of Dermatology, Rabin Medical Center, Petah Tikvah, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petah Tikva, Israel
| | - Roni P. Dodiuk-Gad
- Department of Dermatology, Emek Medical Center, Afula, Israel
- Bruce and Ruth Rappaport Faculty of Medicine, Technion, Haifa, Israel
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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Knani L, Oueslati M, Ghachem M, Mkhinini H, Frini S, Aounallah A, Sriha B, Ghorbel M. [Eyelid manifestations in patients with Darier-White disease]. J Fr Ophtalmol 2023; 46:e210-e211. [PMID: 37085368 DOI: 10.1016/j.jfo.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/10/2023] [Accepted: 01/19/2023] [Indexed: 04/23/2023]
Affiliation(s)
- L Knani
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - M Oueslati
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie.
| | - M Ghachem
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - H Mkhinini
- Service de dermatologie-vénéréologie, CHU de Farhat-Hached de Sousse, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - S Frini
- Laboratoire d'anatomie et de cytologie pathologiques, CHU de Farhat-Hached de Sousse, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
| | - A Aounallah
- Service de dermatologie-vénéréologie, CHU de Farhat-Hached de Sousse, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - B Sriha
- Laboratoire d'anatomie et de cytologie pathologiques, CHU de Farhat-Hached de Sousse, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - M Ghorbel
- Service d'ophtalmologie, CHU de Farhat-Hached de Sousse, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
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