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Matsuda A, Hasegawa T, Ikeda Y, Wada A, Ikeda S. Histological and molecular restoration of type VII collagen in Recessive dystrophic epidermolysis bullosa mouse skin by topical injection of keratinocyte-like cells differentiated from human adipose-derived mesenchymal stromal cells. J Dermatol Sci 2024; 115:42-50. [PMID: 38876908 DOI: 10.1016/j.jdermsci.2024.05.004] [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: 12/21/2023] [Revised: 04/18/2024] [Accepted: 05/23/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Recessive dystrophic epidermolysis bullosa (RDEB) is a severe skin fragility disorder caused by mutations in the COL7A1 gene, which encodes type VII collagen (COL7), the main constituent of anchoring fibrils for attaching the epidermis to the dermis. Persistent skin erosions frequently result in intractable ulcers in RDEB patients. Adipose-derived mesenchymal stromal cells (AD-MSCs) are easily harvested in large quantities and have low immunogenicity. Therefore, they are suitable for clinical use, including applications involving allogeneic cell transplantation. Keratinocyte-like cells transdifferentiated from AD-MSCs (KC-AD-MSCs) express more COL7 than undifferentiated AD-MSCs and facilitate skin wound healing with less contracture. Therefore, these cells can be used for skin ulcer treatment in RDEB patients. OBJECTIVE We investigated whether KC-AD-MSCs transplantation ameliorated the RDEB phenotype severity in the grafted skin of a RDEB mouse model (col7a1-null) on the back of the immunodeficient mouse. METHODS KC-AD-MSCs were intradermally injected into the region surrounding the skin grafts, and this procedure was repeated after 7 days. After a further 7-day interval, the skin grafts were harvested. RESULTS Neodeposition of COL7 and generation of anchoring fibrils at the dermal-epidermal junction were observed, although experiments were based on qualitative. CONCLUSION KC-AD-MSCs may correct the COL7 insufficiency, repair defective/reduced anchoring fibrils, and improve skin integrity in RDEB patients.
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Affiliation(s)
- Akinori Matsuda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Japan
| | - Toshio Hasegawa
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Japan
| | - Yuri Ikeda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Japan
| | - Akino Wada
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Japan
| | - Shigaku Ikeda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Japan; Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Japan.
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Steinbeck BJ, Gao XD, McElroy AN, Pandey S, Doman JL, Riddle MJ, Xia L, Chen W, Eide CR, Lengert AH, Han SW, Blazar BR, Wandall HH, Dabelsteen S, Liu DR, Tolar J, Osborn MJ. Twin prime editing mediated exon skipping/reinsertion for restored collagen VII expression in recessive dystrophic epidermolysis bullosa. J Invest Dermatol 2024:S0022-202X(24)00372-5. [PMID: 38763174 DOI: 10.1016/j.jid.2024.04.013] [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: 08/28/2023] [Revised: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 05/21/2024]
Abstract
Gene editing nucleases, base editors, and prime editors are potential locus specific genetic treatment strategies for recessive dystrophic epidermolysis bullosa (RDEB); however, many RDEB COL7A1 mutations are unique, making the development of personalized editing reagents challenging. 270 of the ∼320 COL7A1 EB mutations reside in exons that can be skipped, and antisense oligonucleotides (ASO) and gene editing nucleases have been used to create in-frame deletions. ASOs are transient and nucleases generate deleterious double stranded DNA breaks (DSB) and uncontrolled mixtures of allele products. We developed a twin prime editing (twinPE) strategy using the PEmax and recently evolved PE6 prime editors and dual prime editing guide RNAs flanking COL7A1 exon five. Prime editing-mediated deletion of exon 5 with a homozygous premature stop codon was achieved in RDEB fibroblasts, keratinocytes, and iPSC with minimal DSBs, and collagen type VII (C7) protein was restored. TwinPE can replace the target exon with recombinase attachment sequences, and we exploited this to re-insert a normal copy of exon 5 using the Bxb1 recombinase. These findings demonstrate that twinPE can facilitate locus-specific, predictable, in-frame deletions and sequence replacement with few DSBs as a strategy that may enable a single therapeutic agent to treat multiple RDEB patient cohorts.
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Affiliation(s)
- Benjamin J Steinbeck
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Xin D Gao
- Merkin Institute of Transformative Technologies in Healthcare, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA; Howard Hughes Medical Institute, Harvard University, Cambridge, MA, USA
| | - Amber N McElroy
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Smriti Pandey
- Merkin Institute of Transformative Technologies in Healthcare, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA; Howard Hughes Medical Institute, Harvard University, Cambridge, MA, USA
| | - Jordan L Doman
- Merkin Institute of Transformative Technologies in Healthcare, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA; Howard Hughes Medical Institute, Harvard University, Cambridge, MA, USA
| | - Megan J Riddle
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Lily Xia
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Weili Chen
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Cindy R Eide
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Andre H Lengert
- Universidade Federal de Sao Paulo Escola Paulista de Medicina: Sao Paulo, SP, BR
| | - Sang Won Han
- Universidade Federal de Sao Paulo Escola Paulista de Medicina: Sao Paulo, SP, BR
| | - Bruce R Blazar
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Hans H Wandall
- University of Copenhagen, Centre for Glycomics, Department of Cellular and Molecular Medicine, Copenhagen, Denmark
| | - Sally Dabelsteen
- University of Copenhagen, Centre for Glycomics, Department of Cellular and Molecular Medicine, Copenhagen, Denmark
| | - David R Liu
- Merkin Institute of Transformative Technologies in Healthcare, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA, USA; Howard Hughes Medical Institute, Harvard University, Cambridge, MA, USA
| | - Jakub Tolar
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA
| | - Mark J Osborn
- Department of Pediatrics, Division of Blood and Marrow Transplant and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA.
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De Gregorio C, Catalán E, Garrido G, Morandé P, Bennett JC, Muñoz C, Cofré G, Huang YL, Cuadra B, Murgas P, Calvo M, Altermatt F, Yubero MJ, Palisson F, South AP, Ezquer M, Fuentes I. Maintenance of chronicity signatures in fibroblasts isolated from recessive dystrophic epidermolysis bullosa chronic wound dressings under culture conditions. Biol Res 2023; 56:23. [PMID: 37161592 PMCID: PMC10170710 DOI: 10.1186/s40659-023-00437-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/27/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Recessive Dystrophic Epidermolysis Bullosa (RDEB) is a rare inherited skin disease caused by variants in the COL7A1 gene, coding for type VII collagen (C7), an important component of anchoring fibrils in the basement membrane of the epidermis. RDEB patients suffer from skin fragility starting with blister formation and evolving into chronic wounds, inflammation and skin fibrosis, with a high risk of developing aggressive skin carcinomas. Restricted therapeutic options are limited by the lack of in vitro models of defective wound healing in RDEB patients. RESULTS In order to explore a more efficient, non-invasive in vitro model for RDEB studies, we obtained patient fibroblasts derived from discarded dressings) and examined their phenotypic features compared with fibroblasts derived from non-injured skin of RDEB and healthy-donor skin biopsies. Our results demonstrate that fibroblasts derived from RDEB chronic wounds (RDEB-CW) displayed characteristics of senescent cells, increased myofibroblast differentiation, and augmented levels of TGF-β1 signaling components compared to fibroblasts derived from RDEB acute wounds and unaffected RDEB skin as well as skin from healthy-donors. Furthermore, RDEB-CW fibroblasts exhibited an increased pattern of inflammatory cytokine secretion (IL-1β and IL-6) when compared with RDEB and control fibroblasts. Interestingly, these aberrant patterns were found specifically in RDEB-CW fibroblasts independent of the culturing method, since fibroblasts obtained from dressing of acute wounds displayed a phenotype more similar to fibroblasts obtained from RDEB normal skin biopsies. CONCLUSIONS Our results show that in vitro cultured RDEB-CW fibroblasts maintain distinctive cellular and molecular characteristics resembling the inflammatory and fibrotic microenvironment observed in RDEB patients' chronic wounds. This work describes a novel, non-invasive and painless strategy to obtain human fibroblasts chronically subjected to an inflammatory and fibrotic environment, supporting their use as an accessible model for in vitro studies of RDEB wound healing pathogenesis. As such, this approach is well suited to testing new therapeutic strategies under controlled laboratory conditions.
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Affiliation(s)
- Cristian De Gregorio
- Centro de Medicina Regenerativa, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, 7610658, Chile
| | - Evelyng Catalán
- DEBRA Chile, Francisco de Villagra 392, Ñuñoa, Santiago, Chile
| | - Gabriel Garrido
- DEBRA Chile, Francisco de Villagra 392, Ñuñoa, Santiago, Chile
| | - Pilar Morandé
- DEBRA Chile, Francisco de Villagra 392, Ñuñoa, Santiago, Chile
| | | | - Catalina Muñoz
- DEBRA Chile, Francisco de Villagra 392, Ñuñoa, Santiago, Chile
| | - Glenda Cofré
- DEBRA Chile, Francisco de Villagra 392, Ñuñoa, Santiago, Chile
| | - Ya-Lin Huang
- Centro de Medicina Regenerativa, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, 7610658, Chile
| | - Bárbara Cuadra
- Centro de Medicina Regenerativa, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, 7610658, Chile
| | - Paola Murgas
- Instituto de Bioquímica y Microbiología, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile
| | - Margarita Calvo
- Facultad de Ciencias Biológicas y División de Anestesiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Núcleo milenio para el estudio del dolor MINUSPAIN, Santiago, Chile
| | - Fernando Altermatt
- División de Anestesiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Joao Yubero
- DEBRA Chile, Francisco de Villagra 392, Ñuñoa, Santiago, Chile
- Pediatrics and Pediatric Infectious Diseases of Clínica Alemana, Facultad de Medicina Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Francis Palisson
- DEBRA Chile, Francisco de Villagra 392, Ñuñoa, Santiago, Chile
- Servicio de Dermatología, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Andrew P South
- Department of Dermatology & Cutaneous Biology, Thomas Jefferson University, Philadelphia, USA
| | - Marcelo Ezquer
- Centro de Medicina Regenerativa, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, 7610658, Chile.
| | - Ignacia Fuentes
- DEBRA Chile, Francisco de Villagra 392, Ñuñoa, Santiago, Chile.
- Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, 7610658, Chile.
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Naso G, Gkazi S, Georgiadis C, Jayarajan V, Jacków J, Fleck R, Allison L, Ogunbiyi O, McGrath J, Ilic D, Di W, Petrova A, Qasim W. Cytosine deaminase base editing to restore COL7A1 in dystrophic epidermolysis bullosa human:murine skin model. JID INNOVATIONS 2023; 3:100191. [DOI: 10.1016/j.xjidi.2023.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 12/26/2022] [Accepted: 01/06/2023] [Indexed: 02/22/2023] Open
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Ivanenko AV, Evtushenko NA, Gurskaya NG. Genome Editing in Therapy of Genodermatoses. Mol Biol 2022. [DOI: 10.1134/s0026893322060085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Kocher T, Petkovic I, Bischof J, Koller U. Current developments in gene therapy for epidermolysis bullosa. Expert Opin Biol Ther 2022; 22:1137-1150. [PMID: 35235467 DOI: 10.1080/14712598.2022.2049229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The genodermatosis epidermolysis bullosa (EB) is a monogenetic disease, characterized by severe blister formation on the skin and mucous membranes upon minimal mechanical trauma. Causes for the disease are mutations in genes encoding proteins that are essential for skin integrity. In EB, one of these proteins is either functionally impaired or completely absent. Therefore, the development and improvement of DNA and RNA-based therapeutic approaches for this severe blistering skin disease is mandatory to achieve a treatment option for the patients. AREAS COVERED Currently, there are several forms of DNA/RNA therapies potentially feasible for EB. Whereas some of them are still at the preclinical stage, others are clinically advanced and have already been applied to patients. In particular, this is the case for a cDNA replacement approach successfully applied for a small number of patients with junctional EB. EXPERT OPINION The heterogeneity of EB justifies the development of therapeutic options with distinct modes of action at a DNA or RNA level. Besides, splicing-modulating therapies, based on RNA trans-splicing or short antisense oligonucleotides, especially designer nucleases, have steadily improved in efficiency and safety and thus likely represent the most promising gene therapy tool in the near future.
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Affiliation(s)
- Thomas Kocher
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Igor Petkovic
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Johannes Bischof
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Ulrich Koller
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
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Subramaniam KS, Antoniou MN, McGrath JA, Lwin SM. The potential of gene therapy for recessive dystrophic epidermolysis bullosa. Br J Dermatol 2021; 186:609-619. [PMID: 34862606 DOI: 10.1111/bjd.20910] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/12/2021] [Accepted: 11/28/2021] [Indexed: 11/30/2022]
Abstract
Epidermolysis bullosa (EB) encompasses a heterogeneous group of inherited skin fragility disorders with mutations in genes encoding the basement membrane zone (BMZ) proteins that normally ensure dermal-epidermal integrity. Of the four main EB types, recessive dystrophic EB (RDEB), especially the severe variant, represents one of the most debilitating clinical entities with recurrent mucocutaneous blistering and ulceration leading to chronic wounds, infections, inflammation, scarring and ultimately cutaneous squamous cell carcinoma, which leads to premature death. Improved understanding of the molecular genetics of EB over the past three decades and advances in biotechnology has led to rapid progress in developing gene and cell-based regenerative therapies for EB. In particular, RDEB is at the vanguard of advances in human clinical trials of advanced therapeutics. Furthermore, the past decade has witnessed the emergence of a real collective, global effort involving academia and industry, supported by international EB patient organisations such as the Dystrophic Epidermolysis Bullosa Research Association (DEBRA), amongst others, to develop clinically relevant and marketable targeted therapeutics for EB. Thus, there is an increasing need for the practising dermatologist to become familiar with the concept of gene therapy, fundamental differences between various approaches and their human applications. This review explains the principles of different approaches of gene therapy; summarises its journey and discusses its current and future impact in RDEB.
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Affiliation(s)
- K S Subramaniam
- Genetic Skin Diseases Group, St John's Institute of Dermatology, King's College London, Guy's Hospital, London, UK
| | - M N Antoniou
- Gene Expression and Therapy Group, Department of Medical & Molecular Genetics, King's College London, Guy's Hospital, London, UK
| | - J A McGrath
- Genetic Skin Diseases Group, St John's Institute of Dermatology, King's College London, Guy's Hospital, London, UK
| | - S M Lwin
- Genetic Skin Diseases Group, St John's Institute of Dermatology, King's College London, Guy's Hospital, London, UK
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Popp CM, Miller WC, Eide CR, Tolar J. Future applications of 3D bioprinting: A promising technology for treating recessive dystrophic epidermolysis bullosa. Exp Dermatol 2021; 31:384-392. [PMID: 34699623 DOI: 10.1111/exd.14484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/05/2021] [Accepted: 10/24/2021] [Indexed: 02/06/2023]
Abstract
Three-dimensional (3D) bioprinting is a rapidly developing technology that has the potential to initiate a paradigm shift in the treatment of skin wounds arising from burns, ulcers and genodermatoses. Recessive dystrophic epidermolysis bullosa (RDEB), a severe form of epidermolysis bullosa, is a rare genodermatosis that results in mechanically induced blistering of epithelial tissues that leads to chronic wounds. Currently, there is no cure for RDEB, and effective treatment is limited to protection from trauma and extensive bandaging. The care of chronic wounds and burns significantly burdens the healthcare system, further illustrating the dire need for more beneficial wound care. However, in its infancy, 3D bioprinting offers therapeutic potential for wound healing and could be a breakthrough technology for the treatment of rare, incurable genodermatoses like RDEB. This viewpoint essay outlines the promise of 3D bioprinting applications for treating RDEB, including skin regeneration, a delivery system for gene-edited cells and small molecules, and disease modelling. Although the future of 3D bioprinting is encouraging, there are many technical challenges to overcome-including optimizing bioink and cell source-before this approach can be widely implemented in clinical practice.
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Affiliation(s)
- Courtney M Popp
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - William C Miller
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cindy R Eide
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jakub Tolar
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA
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Zeng M, Xu Q, Zhou D, A S, Alshehri F, Lara-Sáez I, Zheng Y, Li M, Wang W. Highly branched poly(β-amino ester)s for gene delivery in hereditary skin diseases. Adv Drug Deliv Rev 2021; 176:113842. [PMID: 34293384 DOI: 10.1016/j.addr.2021.113842] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/28/2021] [Accepted: 06/15/2021] [Indexed: 12/11/2022]
Abstract
Non-viral gene therapy for hereditary skin diseases is an attractive prospect. However, research efforts dedicated to this area are rare. Taking advantage of the branched structural possibilities of polymeric vectors, we have developed a gene delivery platform for the treatment of an incurable monogenic skin disease - recessive dystrophic epidermolysis bullosa (RDEB) - based on highly branched poly(β-amino ester)s (HPAEs). The screening of HPAEs and optimization of therapeutic gene constructs, together with evaluation of the combined system for gene transfection, were comprehensively reviewed. The successful restoration of type VII collagen (C7) expression both in vitro and in vivo highlights HPAEs as a promising generation of polymeric vectors for RDEB gene therapy into the clinic. Considering that the treatment of patients with genetic cutaneous disorders, such as other subtypes of epidermolysis bullosa, pachyonychia congenita, ichthyosis and Netherton syndrome, remains challenging, the success of HPAEs in RDEB treatment indicates that the development of viable polymeric gene delivery vectors could potentially expedite the translation of gene therapy for these diseases from bench to bedside.
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Larose AE, Dakiw-Piaceski A, Barbier MA, Larouche D, Gauvin R, Caruso M, Pope E, Germain L. Peel Test to Assess the Adhesion Strength of the Dermal-Epidermal Junction in Tissue-Engineered Skin. Tissue Eng Part C Methods 2021; 26:180-189. [PMID: 32085694 DOI: 10.1089/ten.tec.2019.0268] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Innovative therapies combining gene-corrected stem cells and the production of bioengineered tissues to treat epidermolysis bullosa are emerging. However, quantitative tests to measure the adhesion forces between two highly viscoelastic substrates such as those found in bilayered bioengineered skin are needed and are still lacking. The objective of this study was to develop a mechanical test to measure the dermal-epidermal adhesion strength of our bilayered tissue-engineered skin substitute (TES) produced with the self-assembly method. We developed a peel test, which allows the displacement of both skin layers in a T configuration, based on the ASTM International standard. A MATLAB program was written to process and analyze raw data. The experimental setup was tested by measuring the dermal-epidermal adhesion strength in TESs produced with normal or collagen VII-deficient cells. Our peel testing method allowed us to detect the impact of the absence of collagen VII in the dermal-epidermal adhesion strength of TESs and also to examine the progression of the dermal-epidermal adhesion strength in relation to culture time in normal TES. Impact statement This study describes a method for assessing the adhesion strength at the dermal-epidermal junction of individual tissue-engineered skin substitute (TES). An ASTM standardized protocol of peel testing was designed to measure this important mechanical property. Our innovative approach will serve as a quality control in the production, improvement, and application of TESs for the treatment of pathologies affecting the dermal-epidermal adhesion such as epidermolysis bullosa. Data presented contribute to research on the interfaces between biological substrates and provide a reference factor for the characterization of products derived from tissue engineering.
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Affiliation(s)
- Alex E Larose
- CHU of Québec-Laval University Research Center and Center of Research in Experimental Organogenesis of Laval University/LOEX, Québec, Canada.,Department of Surgery, Faculty of Medicine, Université Laval, Québec, Canada
| | - Angela Dakiw-Piaceski
- CHU of Québec-Laval University Research Center and Center of Research in Experimental Organogenesis of Laval University/LOEX, Québec, Canada
| | - Martin A Barbier
- CHU of Québec-Laval University Research Center and Center of Research in Experimental Organogenesis of Laval University/LOEX, Québec, Canada.,Department of Surgery, Faculty of Medicine, Université Laval, Québec, Canada
| | - Danielle Larouche
- CHU of Québec-Laval University Research Center and Center of Research in Experimental Organogenesis of Laval University/LOEX, Québec, Canada
| | - Robert Gauvin
- CHU of Québec-Laval University Research Center and Center of Research in Experimental Organogenesis of Laval University/LOEX, Québec, Canada.,Department of Surgery, Faculty of Medicine, Université Laval, Québec, Canada
| | - Manuel Caruso
- CHU of Québec-Laval University Research Center and Center of Research in Experimental Organogenesis of Laval University/LOEX, Québec, Canada.,Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Université Laval Cancer Research Center, Université Laval, Québec, Canada
| | - Elena Pope
- Paediatric Dermatology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Lucie Germain
- CHU of Québec-Laval University Research Center and Center of Research in Experimental Organogenesis of Laval University/LOEX, Québec, Canada.,Department of Surgery, Faculty of Medicine, Université Laval, Québec, Canada
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Ryumina II, Goryunov KV, Silachev DN, Shevtsova YA, Babenko VA, Marycheva NM, Kotalevskaya YY, Zubkov VV, Zubkov GT. Pathogenetic Therapy of Epidermolysis Bullosa: Current State and Prospects. Bull Exp Biol Med 2021; 171:109-121. [PMID: 34050833 DOI: 10.1007/s10517-021-05182-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Indexed: 11/27/2022]
Abstract
Epidermolysis bullosa is a severe hereditary disease caused by mutations in genes encoding cutaneous basement membrane proteins. These mutations lead to dermal-epidermal junction failure and, as a result, to disturbances in the morphological integrity of the skin. Clinically, it manifests in the formation of blisters on the skin or mucosa that in some cases can turn into non-healing chronic wounds, which not only impairs patient's quality of life, but also is a live-threatening condition. Now, the main approaches in the treatment of epidermolysis bullosa are symptomatic therapy and palliative care, though they are little effective and are aimed at reducing the pain, but not to complete recovery. In light of this, the development of new treatment approaches aimed at correction of genetic defects is in progress. Various methods based on genetic engineering technologies, transplantation of autologous skin cells, progenitor skin cells, as well as hematopoietic and mesenchymal stem cells are studied. This review analyzes the pathogenetic methods developed for epidermolysis bullosa treatment based on the latest achievements of molecular genetics and cellular technologies, and discusses the prospects for the use of these technologies for the therapy of epidermolysis bullosa.
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Affiliation(s)
- I I Ryumina
- V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russian Federation, Moscow, Russia
| | - K V Goryunov
- V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russian Federation, Moscow, Russia
| | - D N Silachev
- V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russian Federation, Moscow, Russia.
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia.
| | - Yu A Shevtsova
- V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russian Federation, Moscow, Russia
| | - V A Babenko
- V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russian Federation, Moscow, Russia
- A. N. Belozersky Research Institute of Physico-Chemical Biology, M. V. Lomonosov Moscow State University, Moscow, Russia
| | - N M Marycheva
- V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russian Federation, Moscow, Russia
| | - Yu Yu Kotalevskaya
- M. F. Vladimirskiy Moscow Regional Research Clinical Institute, Moscow, Russia
| | - V V Zubkov
- V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russian Federation, Moscow, Russia
| | - G T Zubkov
- V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russian Federation, Moscow, Russia
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Jiang Z, Li N, Zhu D, Ren L, Shao Q, Yu K, Yang G. Genetically modified cell sheets in regenerative medicine and tissue engineering. Biomaterials 2021; 275:120908. [PMID: 34119885 DOI: 10.1016/j.biomaterials.2021.120908] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/16/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023]
Abstract
Genetically modified cell sheet technology is emerging as a promising biomedical tool to deliver therapeutic genes for regenerative medicine and tissue engineering. Virus-based gene transfection and non-viral gene transfection have been used to fabricate genetically modified cell sheets. Preclinical and clinical studies have shown various beneficial effects of genetically modified cell sheets in the regeneration of bone, periodontal tissue, cartilage and nerves, as well as the amelioration of dental implant osseointegration, myocardial infarction, skeletal muscle ischemia and kidney injury. Furthermore, this technology provides a potential treatment option for various hereditary diseases. However, the method has several limitations, such as safety concerns and difficulties in controlling transgene expression. Therefore, recent studies explored efficient and safe gene transfection methods, prolonged and controllable transgene expression and their potential application in personalized and precision medicine. This review summarizes various types of genetically modified cell sheets, preparation procedures, therapeutic applications and possible improvements.
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Affiliation(s)
- Zhiwei Jiang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Na Li
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Danji Zhu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Lingfei Ren
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Qin Shao
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Ke Yu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Guoli Yang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China.
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Koller U, Bauer JW. Gene Replacement Therapies for Genodermatoses: A Status Quo. Front Genet 2021; 12:658295. [PMID: 33995490 PMCID: PMC8120236 DOI: 10.3389/fgene.2021.658295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/17/2021] [Indexed: 11/29/2022] Open
Abstract
Epidermolysis bullosa (EB) is a genodermatosis, characterized by the formation of extended blisters and lesions on the skin and mucous membranes upon minimal mechanical trauma. The disease is caused by mutations in genes encoding proteins that are essential for skin stability. Functional impairment, reduction, or absence of one of these proteins results in skin fragility due to reduced connectivity between dermis and epidermis. Currently, gene therapy represents the only treatment option with the potential to cure this severe blistering skin disease. Two promising forms of gene therapy are potentially feasible for EB: gene replacement and genome editing. While genome editing for genodermatoses remains at the preclinical stage, gene replacement approaches are clinically advanced and have been applied already to a small number of patients with junctional and dystrophic forms of EB. Here, the viral transduction of the “wild-type” transgene into skin stem cells, followed by autologous grafting of corrected epidermal sheets, led to the regeneration of stable skin. Recent developments regarding designer nuclease-based gene editing strategies enable the establishment of alternative options to restore the gene function in genodermatoses. This is particularly true in cases wherein genetic constellation hinders gene therapy-based gene replacement.
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Affiliation(s)
- Ulrich Koller
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - Johann W Bauer
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
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14
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Naso G, Petrova A. Cellular therapy options for genetic skin disorders with a focus on recessive dystrophic epidermolysis bullosa. Br Med Bull 2020; 136:30-45. [PMID: 32888294 DOI: 10.1093/bmb/ldaa029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/20/2020] [Accepted: 08/04/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Combinatorial cell and gene therapies for life-threatening inherited skin disorders have shown tremendous potential for preclinical and clinical implementation with significant progress made for recessive dystrophic epidermolysis bullosa (RDEB). To date, various cell lineages including resident skin cells and adult stem cells have been investigated for gene and cell therapy for RDEB reaching the clinical trial stage. SOURCES OF DATA Sources of data are key recent literature, ClinicalTrials.gov, Clinicaltrialsregister.eu and pharma press releases. AREAS OF AGREEMENT Cell-based gene transfer using autologous patients' cells has demonstrated positive outcomes in preclinical and clinical trials and highlighted the importance of targeting resident skin stem cells to achieve a meaningful long-term effect. Additionally, adult stem cells, such as mesenchymal stromal cells, have the potential to ameliorate systemic manifestations of the disease. AREAS OF CONTROVERSY While proven safe, the clinical trials of localized treatment have reported only modest and transient improvements. On the other hand, the risks associated with systemic therapies remain high and should be carefully weighed against the potential benefits. It is unclear to what extent adult stem cells can contribute to skin regeneration/wound healing. GROWING POINTS Further research is warranted in order to fulfil the potential of cellular therapies for RDEB. The development of combinatorial gene and cell-based approaches is required to achieve long-term clinical benefits. AREAS TIMELY FOR DEVELOPING RESEARCH Induced pluripotent stem cells can potentially provide a valuable source of autologous patient material for cellular therapies. In addition, recent advances in the field of gene editing can overcome hurdles associated with conventional gene addition approaches. DATA AVAILABILITY STATEMENT No new data were generated or analysed in support of this review.
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Affiliation(s)
- Gaetano Naso
- Molecular and Cellular Immunology Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford street, London WC1N 1EH, UK
| | - Anastasia Petrova
- Molecular and Cellular Immunology Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford street, London WC1N 1EH, UK
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Titeux M, Bonnet des Claustres M, Izmiryan A, Ragot H, Hovnanian A. Emerging drugs for the treatment of epidermolysis bullosa. Expert Opin Emerg Drugs 2020; 25:467-489. [DOI: 10.1080/14728214.2020.1839049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Matthias Titeux
- Imagine Institute, Laboratory of Genetic Skin Diseases, INSERM UMR 1163, Université de Paris, Paris, France
| | | | - Araksya Izmiryan
- Imagine Institute, Laboratory of Genetic Skin Diseases, INSERM UMR 1163, Université de Paris, Paris, France
| | - Helene Ragot
- Imagine Institute, Laboratory of Genetic Skin Diseases, INSERM UMR 1163, Université de Paris, Paris, France
| | - Alain Hovnanian
- Imagine Institute, Laboratory of Genetic Skin Diseases, INSERM UMR 1163, Université de Paris, Paris, France
- Départment de Génétique, AP-HP, Hôpital Necker-Enfants Malades, Paris, France
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16
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De Rosa L, Latella MC, Secone Seconetti A, Cattelani C, Bauer JW, Bondanza S, De Luca M. Toward Combined Cell and Gene Therapy for Genodermatoses. Cold Spring Harb Perspect Biol 2020; 12:a035667. [PMID: 31653644 PMCID: PMC7197428 DOI: 10.1101/cshperspect.a035667] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To date, more than 200 monogenic, often devastating, skin diseases have been described. Because of unmet medical needs, development of long-lasting and curative therapies has been consistently attempted, with the aim of correcting the underlying molecular defect. In this review, we will specifically address the few combined cell and gene therapy strategies that made it to the clinics. Based on these studies, what can be envisioned for the future is a patient-oriented strategy, built on the specific features of the individual in need. Most likely, a combination of different strategies, approaches, and advanced therapies will be required to reach the finish line at the end of the long and winding road hampering the achievement of definitive treatments for genodermatoses.
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Affiliation(s)
- Laura De Rosa
- Holostem Terapie Avanzate S.r.l., Center for Regenerative Medicine "Stefano Ferrari," 41125 Modena, Italy
| | - Maria Carmela Latella
- Holostem Terapie Avanzate S.r.l., Center for Regenerative Medicine "Stefano Ferrari," 41125 Modena, Italy
| | - Alessia Secone Seconetti
- Holostem Terapie Avanzate S.r.l., Center for Regenerative Medicine "Stefano Ferrari," 41125 Modena, Italy
| | - Cecilia Cattelani
- Center for Regenerative Medicine "Stefano Ferrari," Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Johann W Bauer
- EB House Austria and Department of Dermatology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria
| | - Sergio Bondanza
- Holostem Terapie Avanzate S.r.l., Center for Regenerative Medicine "Stefano Ferrari," 41125 Modena, Italy
| | - Michele De Luca
- Center for Regenerative Medicine "Stefano Ferrari," Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Petrova A, Georgiadis C, Fleck RA, Allison L, McGrath JA, Dazzi F, Di WL, Qasim W. Human Mesenchymal Stromal Cells Engineered to Express Collagen VII Can Restore Anchoring Fibrils in Recessive Dystrophic Epidermolysis Bullosa Skin Graft Chimeras. J Invest Dermatol 2020; 140:121-131.e6. [DOI: 10.1016/j.jid.2019.05.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/22/2019] [Accepted: 05/15/2019] [Indexed: 10/26/2022]
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18
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Karamova AE, Albanova VI, Monchakovskaya ES. Management of patients with congenital epidermolysis bullosa. VESTNIK DERMATOLOGII I VENEROLOGII 2019. [DOI: 10.25208/0042-4609-2019-95-4-24-30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Congenital epidermolysis bullosa (EB) is a clinically and genetically heterogeneous group of hereditary skin diseases characterized by the formation of blisters and/or erosions in response to minimal trauma. Etiopathogenetic methods for treating the disease are undergoing various stages of clinical research; therefore, external therapy implying caring for affected and non-affected skin remains to be the main treatment method. Such a therapy aims to reduce the healing period of erosive and ulcerative skin defects, thus improving the overall quality of patients’ life. This review sets out to provide clinical recommendations for the management of EB patients developed by different groups of experts, which generalize methods for treating EB patients, main principles of external therapy and relieving subjective sensations, as well as to describe specific situations entailing this pathology.
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Affiliation(s)
- A. E. Karamova
- State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation
| | - V. I. Albanova
- State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation
| | - E. S. Monchakovskaya
- State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian Federation
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19
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Prodinger C, Reichelt J, Bauer JW, Laimer M. Epidermolysis bullosa: Advances in research and treatment. Exp Dermatol 2019; 28:1176-1189. [PMID: 31140655 PMCID: PMC6900197 DOI: 10.1111/exd.13979] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/21/2019] [Indexed: 12/15/2022]
Abstract
Epidermolysis bullosa (EB) is the umbrella term for a group of rare inherited skin fragility disorders caused by mutations in at least 20 different genes. There is no cure for any of the subtypes of EB resulting from different mutations, and current therapy only focuses on the management of wounds and pain. Novel effective therapeutic approaches are therefore urgently required. Strategies include gene-, protein- and cell-based therapies. This review discusses molecular procedures currently under investigation at the EB House Austria, a designated Centre of Expertise implemented in the European Reference Network for Rare and Undiagnosed Skin Diseases. Current clinical research activities at the EB House Austria include newly developed candidate substances that have emerged out of our translational research initiatives as well as already commercially available medications that are applied in off-licensed indications. Squamous cell carcinoma is the major cause of death in severe forms of EB. We are evaluating immunotherapy using an anti-PD1 monoclonal antibody as a palliative treatment option for locally advanced or metastatic squamous cell carcinoma of the skin unresponsive to previous systemic therapy. In addition, we are evaluating topical calcipotriol and topical diacerein as potential agents to improve the healing of skin wounds in EBS patients. Finally, the review will highlight the recent advancements of gene therapy development for EB.
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Affiliation(s)
- Christine Prodinger
- EB House AustriaResearch Program for Molecular Therapy of GenodermatosesDepartment of DermatologyUniversity Hospital of the Paracelsus Medical University SalzburgSalzburgAustria
- Department of DermatologyUniversity Hospital of the Paracelsus Medical UniversitySalzburgAustria
| | - Julia Reichelt
- Department of DermatologyVenereology and Allergology, Medical University of InnsbruckInnsbruckAustria
| | - Johann W. Bauer
- EB House AustriaResearch Program for Molecular Therapy of GenodermatosesDepartment of DermatologyUniversity Hospital of the Paracelsus Medical University SalzburgSalzburgAustria
- Department of DermatologyUniversity Hospital of the Paracelsus Medical UniversitySalzburgAustria
| | - Martin Laimer
- EB House AustriaResearch Program for Molecular Therapy of GenodermatosesDepartment of DermatologyUniversity Hospital of the Paracelsus Medical University SalzburgSalzburgAustria
- Department of DermatologyUniversity Hospital of the Paracelsus Medical UniversitySalzburgAustria
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20
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Lwin SM, Syed F, Di WL, Kadiyirire T, Liu L, Guy A, Petrova A, Abdul-Wahab A, Reid F, Phillips R, Elstad M, Georgiadis C, Aristodemou S, Lovell PA, McMillan JR, Mee J, Miskinyte S, Titeux M, Ozoemena L, Pramanik R, Serrano S, Rowles R, Maurin C, Orrin E, Martinez-Queipo M, Rashidghamat E, Tziotzios C, Onoufriadis A, Chen M, Chan L, Farzaneh F, Del Rio M, Tolar J, Bauer JW, Larcher F, Antoniou MN, Hovnanian A, Thrasher AJ, Mellerio JE, Qasim W, McGrath JA. Safety and early efficacy outcomes for lentiviral fibroblast gene therapy in recessive dystrophic epidermolysis bullosa. JCI Insight 2019; 4:126243. [PMID: 31167965 DOI: 10.1172/jci.insight.126243] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/17/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUNDRecessive dystrophic epidermolysis bullosa (RDEB) is a severe form of skin fragility disorder due to mutations in COL7A1 encoding basement membrane type VII collagen (C7), the main constituent of anchoring fibrils (AFs) in skin. We developed a self-inactivating lentiviral platform encoding a codon-optimized COL7A1 cDNA under the control of a human phosphoglycerate kinase promoter for phase I evaluation.METHODSIn this single-center, open-label phase I trial, 4 adults with RDEB each received 3 intradermal injections (~1 × 106 cells/cm2 of intact skin) of COL7A1-modified autologous fibroblasts and were followed up for 12 months. The primary outcome was safety, including autoimmune reactions against recombinant C7. Secondary outcomes included C7 expression, AF morphology, and presence of transgene in the injected skin.RESULTSGene-modified fibroblasts were well tolerated, without serious adverse reactions or autoimmune reactions against recombinant C7. Regarding efficacy, there was a significant (P < 0.05) 1.26-fold to 26.10-fold increase in C7 mean fluorescence intensity in the injected skin compared with noninjected skin in 3 of 4 subjects, with a sustained increase up to 12 months in 2 of 4 subjects. The presence of transgene (codon-optimized COL7A1 cDNA) was demonstrated in the injected skin at month 12 in 1 subject, but no new mature AFs were detected.CONCLUSIONTo our knowledge, this is the first human study demonstrating safety and potential efficacy of lentiviral fibroblast gene therapy with the presence of COL7A1 transgene and subsequent C7 restoration in vivo in treated skin at 1 year after gene therapy. These data provide a rationale for phase II studies for further clinical evaluation.TRIAL REGISTRATIONClincalTrials.gov NCT02493816.FUNDINGCure EB, Dystrophic Epidermolysis Bullosa Research Association (UK), UK NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, and Fondation René Touraine Short-Exchange Award.
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Affiliation(s)
- Su M Lwin
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Farhatullah Syed
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Wei-Li Di
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Tendai Kadiyirire
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Lu Liu
- The Robin Eady National Diagnostic Epidermolysis Bullosa Laboratory, Viapath, St Thomas' Hospital, London, United Kingdom
| | - Alyson Guy
- The Robin Eady National Diagnostic Epidermolysis Bullosa Laboratory, Viapath, St Thomas' Hospital, London, United Kingdom
| | - Anastasia Petrova
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Alya Abdul-Wahab
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Fiona Reid
- School of Population Health and Environmental Sciences, King's College London, London, United Kingdom
| | - Rachel Phillips
- School of Population Health and Environmental Sciences, King's College London, London, United Kingdom
| | - Maria Elstad
- School of Population Health and Environmental Sciences, King's College London, London, United Kingdom
| | - Christos Georgiadis
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Sophia Aristodemou
- The Robin Eady National Diagnostic Epidermolysis Bullosa Laboratory, Viapath, St Thomas' Hospital, London, United Kingdom
| | - Patricia A Lovell
- The Robin Eady National Diagnostic Epidermolysis Bullosa Laboratory, Viapath, St Thomas' Hospital, London, United Kingdom
| | - James R McMillan
- The Robin Eady National Diagnostic Epidermolysis Bullosa Laboratory, Viapath, St Thomas' Hospital, London, United Kingdom
| | - John Mee
- Immunodermatology Laboratory, Viapath, St Thomas' Hospital, London, United Kingdom
| | - Snaigune Miskinyte
- INSERM UMR 1163, Imagine Institute, Université Paris Descartes Sorbonne Cite, Paris, France
| | - Matthias Titeux
- INSERM UMR 1163, Imagine Institute, Université Paris Descartes Sorbonne Cite, Paris, France
| | - Linda Ozoemena
- The Robin Eady National Diagnostic Epidermolysis Bullosa Laboratory, Viapath, St Thomas' Hospital, London, United Kingdom
| | - Rashida Pramanik
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Sonia Serrano
- National Institute for Health Research (NIHR) Biomedical Research Centre, Guy's and St Thomas' Hospitals, London, United Kingdom
| | - Racheal Rowles
- National Institute for Health Research (NIHR) Biomedical Research Centre, Guy's and St Thomas' Hospitals, London, United Kingdom
| | - Clarisse Maurin
- National Institute for Health Research (NIHR) Biomedical Research Centre, Guy's and St Thomas' Hospitals, London, United Kingdom
| | - Elizabeth Orrin
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Magdalena Martinez-Queipo
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom.,National Institute for Health Research (NIHR) Biomedical Research Centre, Guy's and St Thomas' Hospitals, London, United Kingdom
| | - Ellie Rashidghamat
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Christos Tziotzios
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Alexandros Onoufriadis
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Mei Chen
- Department of Dermatology, University of Southern California, Los Angeles, California, USA
| | - Lucas Chan
- Department of Haematological Medicine, King's College London, The Rayne Institute, London, United Kingdom
| | - Farzin Farzaneh
- Department of Haematological Medicine, King's College London, The Rayne Institute, London, United Kingdom
| | - Marcela Del Rio
- Epithelial Biomedicine Division, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT); Department of Biomedical Engineering, Carlos III University (UC3M); Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER) U714, Madrid, Spain
| | - Jakub Tolar
- Department of Pediatric Oncology, Hematology and Bone Marrow Transplant, University of Minnesota, Minneapolis, Minnesota, USA
| | - Johann W Bauer
- Department of Dermatology and EB House Austria, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Fernando Larcher
- Epithelial Biomedicine Division, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT); Department of Biomedical Engineering, Carlos III University (UC3M); Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz; Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER) U714, Madrid, Spain
| | - Michael N Antoniou
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Alain Hovnanian
- INSERM UMR 1163, Imagine Institute, Université Paris Descartes Sorbonne Cite, Paris, France
| | - Adrian J Thrasher
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jemima E Mellerio
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Waseem Qasim
- Infection, Immunity and Inflammation Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - John A McGrath
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
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Dourado Alcorte M, Sogayar MC, Demasi MA. Patent landscape of molecular and cellular targeted therapies for recessive dystrophic epidermolysis bullosa. Expert Opin Ther Pat 2019; 29:327-337. [PMID: 31017019 DOI: 10.1080/13543776.2019.1608181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Recessive Dystrophic Epidermolysis Bullosa (RDEB) is a monogenetic inherited genodermatosis associated with deleterious mutations in the gene encoding type VII collagen (COL7A1). COL7A1 is essential for promoting attachment of the epidermis to the dermis, and its dysfunction may lead to generalized mucosal and cutaneous blistering associated to severe deformities. Currently, management of RDEB patients is limited to supportive care, being aimed at treating and preventing common complications associated with this condition. There is a great demand to develop targeted therapies for this devastating disease and RDEB research advances are currently being translated into clinical trials. AREAS COVERED Based on the literature and patent search, the authors have grouped the RDEB targeted therapies into five categories: a) cell-based therapies; b) gene therapy; c) protein replacement therapy; d) molecular therapy based on exon skipping; and e) drug-mediated premature termination codon read-through. The patent searching strategy involved inquiring Google and USPTO patent databases to reveal companies and institutions that are active in the area of RDEB targeted therapies. EXPERT OPINION The patent landscape related to targeted therapies for RDEB is quite heterogeneous, with each targeted therapeutic approach being associated with its own challenges in achieving robust patent protection and identifying opportunities for future development.
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Affiliation(s)
| | - Mari Cleide Sogayar
- a NUCEL - School of Medicine , University of Sao Paulo , São Paulo , SP , Brazil
| | - Marcos Angelo Demasi
- a NUCEL - School of Medicine , University of Sao Paulo , São Paulo , SP , Brazil
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22
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CRISPR/Cas9 gene editing for genodermatoses: progress and perspectives. Emerg Top Life Sci 2019; 3:313-326. [DOI: 10.1042/etls20180148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/18/2019] [Accepted: 03/20/2019] [Indexed: 12/17/2022]
Abstract
Abstract
Genodermatoses constitute a clinically heterogeneous group of devastating genetic skin disorders. Currently, therapy options are largely limited to symptomatic treatments and although significant advances have been made in ex vivo gene therapy strategies, various limitations remain. However, the recent technical transformation of the genome editing field promises to overcome the hurdles associated with conventional gene addition approaches. In this review, we discuss the need for developing novel treatments and describe the current status of gene editing for genodermatoses, focusing on a severe blistering disease called epidermolysis bullosa (EB), for which significant progress has been made. Initial research utilized engineered nucleases such as transcription activator-like effector nucleases and meganucleases. However, over the last few years, clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) have upstaged older generation gene editing tools. We examine different strategies for CRISPR/Cas9 application that can be employed depending on the type and position of the mutation as well as the mode of its inheritance. Promising developments in the field of base editing opens new avenues for precise correction of single base substitutions, common in EB and other genodermatoses. We also address the potential limitations and challenges such as safety concerns and delivery efficiency. This review gives an insight into the future of gene editing technologies for genodermatoses.
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Zeng M, Zhou D, Alshehri F, Lara-Sáez I, Lyu Y, Creagh-Flynn J, Xu Q, A S, Zhang J, Wang W. Manipulation of Transgene Expression in Fibroblast Cells by a Multifunctional Linear-Branched Hybrid Poly(β-Amino Ester) Synthesized through an Oligomer Combination Approach. NANO LETTERS 2019; 19:381-391. [PMID: 30565945 DOI: 10.1021/acs.nanolett.8b04098] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Delivery of functional genetic materials into fibroblast cells to manipulate the transgene expression is of great significance in skin gene therapy. Despite numerous polymeric gene delivery systems having been developed, highly safe and efficient fibroblast gene transfection has not yet been achieved. Here, through a new linear oligomer combination strategy, linear poly(β-amino ester) oligomers are connected by the branching units, forming a new type of poly(β-amino ester). This new multifunctional linear-branched hybrid poly(β-amino ester) (LBPAE) shows high-performance fibroblast gene transfection. In human primary dermal fibroblasts (HPDFs) and mouse embryo fibroblasts (3T3s), ultrahigh transgene expression is achieved by LBPAE: up to 3292-fold enhancement in Gaussia luciferase (Gluc) expression and nearly 100% of green fluorescence protein expression are detected. Concurrently, LBPAE is of high in vitro biocompatibility. In depth mechanistic studies reveal that versatile LBPAE can navigate multiple extra- and intracellular barriers involved in the fibroblast gene transfection. More importantly, LBPAE can effectively deliver minicircle DNA encoding COL7A1 gene (a large and functional gene construct) to substantially upregulate the expression of type VII collagen (C7) in HPDFs, demonstrating its great potential in the treatment of C7-deficiency related genodermatoses such as recessive dystrophic epidermolysis bullosa.
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Affiliation(s)
- Ming Zeng
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
- Department of Dermatology , the First Affiliated Hospital of Anhui Medical University , Hefei 230022 , China
| | - Dezhong Zhou
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
- School of Chemical Engineering and Technology (SCET) , Xi'an Jiaotong University , Xi'an , Shaanxi , China
| | - Fatma Alshehri
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
| | - Irene Lara-Sáez
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
| | - Yuanning Lyu
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
| | - Jack Creagh-Flynn
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
| | - Qian Xu
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
| | - Sigen A
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
| | - Jing Zhang
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
| | - Wenxin Wang
- Charles Institute of Dermatology, School of Medicine , University College Dublin , Dublin 4 , Ireland
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24
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Counsell JR, Karda R, Diaz JA, Carey L, Wiktorowicz T, Buckley SMK, Ameri S, Ng J, Baruteau J, Almeida F, de Silva R, Simone R, Lugarà E, Lignani G, Lindemann D, Rethwilm A, Rahim AA, Waddington SN, Howe SJ. Foamy Virus Vectors Transduce Visceral Organs and Hippocampal Structures following In Vivo Delivery to Neonatal Mice. MOLECULAR THERAPY. NUCLEIC ACIDS 2018; 12:626-634. [PMID: 30081233 PMCID: PMC6082918 DOI: 10.1016/j.omtn.2018.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 07/06/2018] [Accepted: 07/08/2018] [Indexed: 12/16/2022]
Abstract
Viral vectors are rapidly being developed for a range of applications in research and gene therapy. Prototype foamy virus (PFV) vectors have been described for gene therapy, although their use has mainly been restricted to ex vivo stem cell modification. Here we report direct in vivo transgene delivery with PFV vectors carrying reporter gene constructs. In our investigations, systemic PFV vector delivery to neonatal mice gave transgene expression in the heart, xiphisternum, liver, pancreas, and gut, whereas intracranial administration produced brain expression until animals were euthanized 49 days post-transduction. Immunostaining and confocal microscopy analysis of injected brains showed that transgene expression was highly localized to hippocampal architecture despite vector delivery being administered to the lateral ventricle. This was compared with intracranial biodistribution of lentiviral vectors and adeno-associated virus vectors, which gave a broad, non-specific spread through the neonatal mouse brain without regional localization, even when administered at lower copy numbers. Our work demonstrates that PFV can be used for neonatal gene delivery with an intracranial expression profile that localizes to hippocampal neurons, potentially because of the mitotic status of the targeted cells, which could be of use for research applications and gene therapy of neurological disorders.
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Affiliation(s)
- John R Counsell
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK; Dubowitz Neuromuscular Centre, Molecular Neurosciences Section, Developmental Neurosciences Programme, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, 30 Guilford Street, London WC1N 1EH, UK
| | - Rajvinder Karda
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK
| | - Juan Antinao Diaz
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK
| | - Louise Carey
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK
| | - Tatiana Wiktorowicz
- Universität Würzburg, Institut für Virologie und Immunbiologie, Versbacher Str. 7, 97078 Würzburg, Germany
| | - Suzanne M K Buckley
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK
| | - Shima Ameri
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK
| | - Joanne Ng
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK
| | - Julien Baruteau
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK
| | - Filipa Almeida
- Reta Lila Weston Institute and Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Rohan de Silva
- Reta Lila Weston Institute and Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Roberto Simone
- Reta Lila Weston Institute and Department of Molecular Neuroscience, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Eleonora Lugarà
- Department of Clinical and Experimental Epilepsy, Queen Square House, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Gabriele Lignani
- Department of Clinical and Experimental Epilepsy, Queen Square House, UCL Institute of Neurology, London WC1N 3BG, UK
| | - Dirk Lindemann
- Universität Würzburg, Institut für Virologie und Immunbiologie, Versbacher Str. 7, 97078 Würzburg, Germany; Institute of Virology, Technische Universität Dresden, Dresden, Germany; Center for Regenerative Therapies Dresden (CRTD), Technische Universität Dresden, Dresden, Germany
| | - Axel Rethwilm
- Universität Würzburg, Institut für Virologie und Immunbiologie, Versbacher Str. 7, 97078 Würzburg, Germany
| | - Ahad A Rahim
- Department of Pharmacology, UCL School of Pharmacy, University College London, London WC1N 1AX, UK
| | - Simon N Waddington
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK; Wits/SAMRC Antiviral Gene Therapy Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Steven J Howe
- Gene Transfer Technology Group, EGA Institute for Women's Health, University College London, London WC1E 6HX, UK
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25
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Izmiryan A, Ganier C, Bovolenta M, Schmitt A, Mavilio F, Hovnanian A. Ex Vivo COL7A1 Correction for Recessive Dystrophic Epidermolysis Bullosa Using CRISPR/Cas9 and Homology-Directed Repair. MOLECULAR THERAPY-NUCLEIC ACIDS 2018; 12:554-567. [PMID: 30195791 PMCID: PMC6077132 DOI: 10.1016/j.omtn.2018.06.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/04/2018] [Accepted: 06/22/2018] [Indexed: 02/06/2023]
Abstract
Recessive dystrophic epidermolysis bullosa is a rare and severe genetic skin disease resulting in blistering of the skin and mucosa. Recessive dystrophic epidermolysis bullosa (RDEB) is caused by a wide variety of mutations in COL7A1-encoding type VII collagen, which is essential for dermal-epidermal adhesion. Here we demonstrate the feasibility of ex vivo COL7A1 editing in primary RDEB cells and in grafted 3D skin equivalents through CRISPR/Cas9-mediated homology-directed repair. We designed five guide RNAs to correct a RDEB causative null mutation in exon 2 (c.189delG; p.Leu64Trpfs*40). Among the site-specific guide RNAs tested, one showed significant cleavage activity in primary RDEB keratinocytes and in fibroblasts when delivered as integration-deficient lentivirus. Genetic correction was detected in transduced keratinocytes and fibroblasts by allele-specific highly sensitive TaqMan-droplet digital PCR (ddPCR), resulting in 11% and 15.7% of corrected COL7A1 mRNA expression, respectively, without antibiotic selection. Grafting of genetically corrected 3D skin equivalents onto nude mice showed up to 26% re-expression and normal localization of type VII collagen as well as anchoring fibril formation at the dermal-epidermal junction. Our study provides evidence that precise genome editing in primary RDEB cells is a relevant strategy to genetically correct COL7A1 mutations for the development of future ex vivo clinical applications.
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Affiliation(s)
- Araksya Izmiryan
- Laboratory of Genetic Skin Diseases, INSERM UMR 1163, Imagine Institute, 24 bd du Montparnasse, Paris, France; University Paris Descartes-Sorbonne Cité, Paris, France
| | - Clarisse Ganier
- Laboratory of Genetic Skin Diseases, INSERM UMR 1163, Imagine Institute, 24 bd du Montparnasse, Paris, France; University Paris Descartes-Sorbonne Cité, Paris, France
| | | | - Alain Schmitt
- Electronic Microscopy Facility, INSERM UMR 1016, Cochin Institute, Paris, France
| | - Fulvio Mavilio
- University Paris Descartes-Sorbonne Cité, Paris, France; Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy; Imagine Institute, Paris, France
| | - Alain Hovnanian
- Laboratory of Genetic Skin Diseases, INSERM UMR 1163, Imagine Institute, 24 bd du Montparnasse, Paris, France; University Paris Descartes-Sorbonne Cité, Paris, France; Department of Genetics, Necker Hospital for Sick Children, APHP, Paris, France.
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26
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Peking P, Koller U, Murauer EM. Functional therapies for cutaneous wound repair in epidermolysis bullosa. Adv Drug Deliv Rev 2018; 129:330-343. [PMID: 29248480 DOI: 10.1016/j.addr.2017.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/07/2017] [Accepted: 12/09/2017] [Indexed: 12/20/2022]
Abstract
Chronic wounding as a result of recurrent skin blistering in the painful genetic skin disease epidermolysis bullosa, may lead to life-threatening infections, increased risk of tumor formation, and other serious medical complications. Therefore, epidermolysis bullosa patients have an urgent need for optimal wound care and tissue regeneration. Therapeutic strategies using gene-, protein-, and cell-therapies are being developed to improve clinical symptoms, and some of them have already been investigated in early clinical trials. The most favorable options of functional therapies include gene replacement, gene editing, RNA targeting, and harnessing natural gene therapy. This review describes the current progress of the different approaches targeting autologous skin cells, and will discuss the benefits and challenges of their application.
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27
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Osborn MJ, Lees CJ, McElroy AN, Merkel SC, Eide CR, Mathews W, Feser CJ, Tschann M, McElmury RT, Webber BR, Kim CJ, Blazar BR, Tolar J. CRISPR/Cas9-Based Cellular Engineering for Targeted Gene Overexpression. Int J Mol Sci 2018; 19:E946. [PMID: 29565806 PMCID: PMC5979553 DOI: 10.3390/ijms19040946] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 12/27/2022] Open
Abstract
Gene and cellular therapies hold tremendous promise as agents for treating genetic disorders. However, the effective delivery of genes, particularly large ones, and expression at therapeutic levels can be challenging in cells of clinical relevance. To address this engineering hurdle, we sought to employ the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 system to insert powerful regulatory elements upstream of an endogenous gene. We achieved robust activation of the COL7A1 gene in primary human umbilical cord blood CD34⁺ hematopoietic stem cells and peripheral blood T-cells. CD34⁺ cells retained their colony forming potential and, in a second engineering step, we disrupted the T-cell receptor complex in T-cells. These cellular populations are of high translational impact due to their engraftment potential, broad circulatory properties, and favorable immune profile that supports delivery to multiple recipients. This study demonstrates the feasibility of targeted knock in of a ubiquitous chromatin opening element, promoter, and marker gene that doubles as a suicide gene for precision gene activation. This system merges the specificity of gene editing with the high level, sustained gene expression achieved with gene therapy vectors. We predict that this design concept will be highly transferrable to most genes in multiple model systems representing a facile cellular engineering platform for promoting gene expression.
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Affiliation(s)
- Mark J Osborn
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
- Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455, USA.
- Center for Genome Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
- Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
- Asan-Minnesota Institute for Innovating Transplantation, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Christopher J Lees
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Amber N McElroy
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Sarah C Merkel
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Cindy R Eide
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Wendy Mathews
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Colby J Feser
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Madison Tschann
- Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Ron T McElmury
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Beau R Webber
- Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455, USA.
- Department of Pediatrics, Division of Hematology, Oncology, and Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Chong Jai Kim
- Asan-Minnesota Institute for Innovating Transplantation, University of Minnesota, Minneapolis, MN 55455, USA.
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 138-736, Korea.
| | - Bruce R Blazar
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
- Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455, USA.
- Center for Genome Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Jakub Tolar
- Department of Pediatrics, Division of Blood and Marrow Transplantation, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
- Stem Cell Institute, University of Minnesota, Minneapolis, MN 55455, USA.
- Center for Genome Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
- Asan-Minnesota Institute for Innovating Transplantation, University of Minnesota, Minneapolis, MN 55455, USA.
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28
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Qasim W, Zhan H, Samarasinghe S, Adams S, Amrolia P, Stafford S, Butler K, Rivat C, Wright G, Somana K, Ghorashian S, Pinner D, Ahsan G, Gilmour K, Lucchini G, Inglott S, Mifsud W, Chiesa R, Peggs KS, Chan L, Farzeneh F, Thrasher AJ, Vora A, Pule M, Veys P. Molecular remission of infant B-ALL after infusion of universal TALEN gene-edited CAR T cells. Sci Transl Med 2018; 9:9/374/eaaj2013. [PMID: 28123068 DOI: 10.1126/scitranslmed.aaj2013] [Citation(s) in RCA: 623] [Impact Index Per Article: 103.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/13/2016] [Accepted: 01/03/2017] [Indexed: 12/17/2022]
Abstract
Autologous T cells engineered to express chimeric antigen receptor against the B cell antigen CD19 (CAR19) are achieving marked leukemic remissions in early-phase trials but can be difficult to manufacture, especially in infants or heavily treated patients. We generated universal CAR19 (UCART19) T cells by lentiviral transduction of non-human leukocyte antigen-matched donor cells and simultaneous transcription activator-like effector nuclease (TALEN)-mediated gene editing of T cell receptor α chain and CD52 gene loci. Two infants with relapsed refractory CD19+ B cell acute lymphoblastic leukemia received lymphodepleting chemotherapy and anti-CD52 serotherapy, followed by a single-dose infusion of UCART19 cells. Molecular remissions were achieved within 28 days in both infants, and UCART19 cells persisted until conditioning ahead of successful allogeneic stem cell transplantation. This bridge-to-transplantation strategy demonstrates the therapeutic potential of gene-editing technology.
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Affiliation(s)
- Waseem Qasim
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK. .,Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Hong Zhan
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Sujith Samarasinghe
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Stuart Adams
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Persis Amrolia
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK.,Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Sian Stafford
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Katie Butler
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Christine Rivat
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Gary Wright
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Kathy Somana
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Sara Ghorashian
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Danielle Pinner
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Gul Ahsan
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Kimberly Gilmour
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Giovanna Lucchini
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Sarah Inglott
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - William Mifsud
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Robert Chiesa
- Great Ormond Street Hospital National Health Service Trust, London WC1N 1LE, UK
| | - Karl S Peggs
- Cancer Institute, University College London, London WC1E 6DD, UK
| | - Lucas Chan
- Division of Cancer Studies, Department of Haematological Medicine, King's College London, London SE5 9NU, UK
| | - Farzin Farzeneh
- Division of Cancer Studies, Department of Haematological Medicine, King's College London, London SE5 9NU, UK
| | - Adrian J Thrasher
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Ajay Vora
- Sheffield Children's Hospital, Sheffield S10 2TH, UK
| | - Martin Pule
- Cancer Institute, University College London, London WC1E 6DD, UK
| | - Paul Veys
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
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29
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Inside out: regenerative medicine for recessive dystrophic epidermolysis bullosa. Pediatr Res 2018; 83:318-324. [PMID: 29593249 DOI: 10.1038/pr.2017.244] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 09/14/2017] [Indexed: 02/07/2023]
Abstract
Epidermolysis bullosa is classified as a genodermatosis, an inherited genetic skin disorder that results in severe, chronic skin blistering with painful and life-threatening complications. Although there is currently no cure for epidermolysis bullosa, concurrent advances in gene and stem cell therapies are converging toward combinatorial therapies that hold the promise of clinically meaningful and lifelong improvement. Recent studies using hematopoietic stem cells and mesenchymal stromal/stem cells to treat epidermolysis bullosa have demonstrated the potential for sustained, effective management of the most severe cases. Furthermore, advances in the use of gene therapy and gene-editing techniques, coupled with the development of induced pluripotent stem cells from patients with epidermolysis bullosa, allow for autologous therapies derived from a renewable population of cells that are patient-specific. Here we describe emerging treatments for epidermolysis bullosa and other genodermatoses, along with a discussion of their benefits and limitations as effective therapies.
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30
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Therapies for genetic extracellular matrix diseases of the skin. Matrix Biol 2017; 71-72:330-347. [PMID: 29274938 DOI: 10.1016/j.matbio.2017.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/15/2017] [Accepted: 12/19/2017] [Indexed: 12/26/2022]
Abstract
A specialized, highly developed dermal extracellular matrix (ECM) provides the skin with its unique mechano-resilient properties and is vital for organ function. Accordingly, genetically acquired deficiency of dermal ECM proteins or proteins essential for the post-translational modification and homeostasis of the dermal ECM, results in diseases affecting the skin. Some of these diseases are lethal or lead to severe complications for the affected individuals. At present limited efficient and evidence-based treatment options exist for genetic ECM diseases of the skin. There is thus a high unmet medical need, creating an urgent demand to develop improved care for these diseases. Here, by drawing examples from the wealth of research on epidermolysis bullosa, we present the current status of biological and small molecule therapies for genetic ECM diseases with skin manifestations. We discuss challenges, and using existing data to propose strategies and future directions allowing development of more efficacious therapies and advancement of them into clinical practice.
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31
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Peking P, Koller U, Duarte B, Murillas R, Wolf S, Maetzig T, Rothe M, Kocher T, García M, Brachtl G, Schambach A, Larcher F, Reichelt J, Bauer JW, Murauer EM. An RNA-targeted therapy for dystrophic epidermolysis bullosa. Nucleic Acids Res 2017; 45:10259-10269. [PMID: 28973459 PMCID: PMC5737646 DOI: 10.1093/nar/gkx669] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/20/2017] [Indexed: 11/14/2022] Open
Abstract
Functional impairment or complete loss of type VII collagen, caused by mutations within COL7A1, lead to the severe recessive form of the skin blistering disease dystrophic epidermolysis bullosa (RDEB). Here, we successfully demonstrate RNA trans-splicing as an auspicious repair option for mutations located in a wide range of exons by fully converting an RDEB phenotype in an ex vivo pre-clinical mouse model based on xenotransplantation. Via a self-inactivating (SIN) lentiviral vector a 3' RNA trans-splicing molecule, capable of replacing COL7A1 exons 65-118, was delivered into type VII collagen deficient patient keratinocytes, carrying a homozygous mutation in exon 80 (c.6527insC). Following vector integration, protein analysis of an isolated corrected single cell clone showed secretion of the corrected type VII collagen at similar levels compared to normal keratinocytes. To confirm full phenotypic and long-term correction in vivo, patches of skin equivalents expanded from the corrected cell clone were grafted onto immunodeficient mice. Immunolabelling of 12 weeks old skin specimens showed strong expression of human type VII collagen restricted to the basement membrane zone. We demonstrate that the RNA trans-splicing technology combined with a SIN lentiviral vector is suitable for an ex vivo molecular therapy approach and thus adaptable for clinical application.
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Affiliation(s)
- Patricia Peking
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology, University Hospital of the Paracelsus Medical University Salzburg, Austria
| | - Ulrich Koller
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology, University Hospital of the Paracelsus Medical University Salzburg, Austria
| | - Blanca Duarte
- Epithelial Biomedicine Division, CIEMAT-CIBERER, Department of Bioengineering, UC3M, Madrid, Spain
| | - Rodolfo Murillas
- Epithelial Biomedicine Division, CIEMAT-CIBERER, Department of Bioengineering, UC3M, Madrid, Spain
| | - Susanne Wolf
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Tobias Maetzig
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Michael Rothe
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany
| | - Thomas Kocher
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology, University Hospital of the Paracelsus Medical University Salzburg, Austria
| | - Marta García
- Epithelial Biomedicine Division, CIEMAT-CIBERER, Department of Bioengineering, UC3M, Madrid, Spain
| | - Gabriele Brachtl
- Institute for Experimental and Clinical Cell Therapy, Core Facility for Flow Cytometry, SCI-TRECS, Paracelsus Medical University, Salzburg, Austria
| | - Axel Schambach
- Institute of Experimental Hematology, Hannover Medical School, Hannover, Germany.,Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Fernando Larcher
- Epithelial Biomedicine Division, CIEMAT-CIBERER, Department of Bioengineering, UC3M, Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
| | - Julia Reichelt
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology, University Hospital of the Paracelsus Medical University Salzburg, Austria
| | - Johann W Bauer
- Department of Dermatology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - Eva M Murauer
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology, University Hospital of the Paracelsus Medical University Salzburg, Austria
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32
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The Molecular Revolution in Cutaneous Biology: Emerging Landscape in Genomic Dermatology: New Mechanistic Ideas, Gene Editing, and Therapeutic Breakthroughs. J Invest Dermatol 2017; 137:e123-e129. [PMID: 28411843 DOI: 10.1016/j.jid.2016.08.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 07/25/2016] [Accepted: 08/04/2016] [Indexed: 01/20/2023]
Abstract
Stunning technological advances in genomics have led to spectacular breakthroughs in the understanding of the underlying defects, biological pathways and therapeutic targets of skin diseases leading to new therapeutic interventions. Next-generation sequencing has revolutionized the identification of disease-causing genes and has a profound impact in deciphering gene and protein signatures in rare and frequent skin diseases. Gene addition strategies have shown efficacy in junctional EB and in recessive dystrophic EB (RDEB). TALENs and Cripsr/Cas9 have emerged as highly efficient new tools to edit genomic sequences to creat new models and to correct or disrupt mutated genes to treat human diseases. Therapeutic approaches have not been limited to DNA modification and strategies at the mRNA, protein and cellular levels have also emerged, some of which have already proven clinical efficacy in RDEB. Improved understanding of the pathogenesis of skin disorders has led to the development of specific drugs or repurposing of existing medicines as in basal cell nevus syndrome, alopecia areata, melanoma and EB simplex. These discoveries pave the way for improved targeted personalized medicine for rare and frequent diseases. It is likely that a growing number of orphan skin diseases will benefit from combinatory new therapies in a near future.
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Qian W, Wang Y, Li RF, Zhou X, Liu J, Peng DZ. Prolonged Integration Site Selection of a Lentiviral Vector in the Genome of Human Keratinocytes. Med Sci Monit 2017; 23:1116-1122. [PMID: 28255155 PMCID: PMC5347986 DOI: 10.12659/msm.903094] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Lentiviral vectors have been successfully used for human skin cell gene transfer studies. Defining the selection of integration sites for retroviral vectors in the host genome is crucial in risk assessment analysis of gene therapy. However, genome-wide analyses of lentiviral integration sites in human keratinocytes, especially after prolonged growth, are poorly understood. Material/Methods In this study, 874 unique lentiviral vector integration sites in human HaCaT keratinocytes after long-term culture were identified and analyzed with the online tool GTSG-QuickMap and SPSS software. Results The data indicated that lentiviral vectors showed integration site preferences for genes and gene-rich regions. Conclusions This study will likely assist in determining the relative risks of the lentiviral vector system and in the design of a safe lentiviral vector system in the gene therapy of skin diseases.
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Affiliation(s)
- Wei Qian
- Institute of Burn Research, Southwest Hospital and Tissue Engineering Research Unit, State Key Laboratory of Trauma, Burns, and Combined Injury, 3rd Military Medical University, Chongqing, China (mainland)
| | - Yong Wang
- Institute of Burn Research, Southwest Hospital and Tissue Engineering Research Unit, State Key Laboratory of Trauma, Burns, and Combined Injury, 3rd Military Medical University, Chongqing, China (mainland)
| | - Rui-Fu Li
- Institute of Burn Research, Southwest Hospital and Tissue Engineering Research Unit, State Key Laboratory of Trauma, Burns, and Combined Injury, 3rd Military Medical University, Chongqing, China (mainland)
| | - Xin Zhou
- Institute of Burn Research, Southwest Hospital and Tissue Engineering Research Unit, State Key Laboratory of Trauma, Burns, and Combined Injury, 3rd Military Medical University, Chongqing, China (mainland)
| | - Jing Liu
- Institute of Burn Research, Southwest Hospital and Tissue Engineering Research Unit, State Key Laboratory of Trauma, Burns, and Combined Injury, 3rd Military Medical University, Chongqing, China (mainland)
| | - Dai-Zhi Peng
- Institute of Burn Research, Southwest Hospital and Tissue Engineering Research Unit, State Key Laboratory of Trauma, Burns, and Combined Injury, 3rd Military Medical University, Chongqing, China (mainland)
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Webber BR, Osborn MJ, McElroy AN, Twaroski K, Lonetree CL, DeFeo AP, Xia L, Eide C, Lees CJ, McElmurry RT, Riddle MJ, Kim CJ, Patel DD, Blazar BR, Tolar J. CRISPR/Cas9-based genetic correction for recessive dystrophic epidermolysis bullosa. NPJ Regen Med 2016; 1. [PMID: 28250968 PMCID: PMC5328670 DOI: 10.1038/npjregenmed.2016.14] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is a severe disorder caused by mutations to the COL7A1 gene that deactivate production of a structural protein essential for skin integrity. Haematopoietic cell transplantation can ameliorate some of the symptoms; however, significant side effects from the allogeneic transplant procedure can occur and unresponsive areas of blistering persist. Therefore, we employed genome editing in patient-derived cells to create an autologous platform for multilineage engineering of therapeutic cell types. The clustered regularly interspaced palindromic repeats (CRISPR)/Cas9 system facilitated correction of an RDEB-causing COL7A1 mutation in primary fibroblasts that were then used to derive induced pluripotent stem cells (iPSCs). The resulting iPSCs were subsequently re-differentiated into keratinocytes, mesenchymal stem cells (MSCs) and haematopoietic progenitor cells using defined differentiation strategies. Gene-corrected keratinocytes exhibited characteristic epithelial morphology and expressed keratinocyte-specific genes and transcription factors. iPSC-derived MSCs exhibited a spindle morphology and expression of CD73, CD90 and CD105 with the ability to undergo adipogenic, chondrogenic and osteogenic differentiation in vitro in a manner indistinguishable from bone marrow-derived MSCs. Finally, we used a vascular induction strategy to generate potent definitive haematopoietic progenitors capable of multilineage differentiation in methylcellulose-based assays. In totality, we have shown that CRISPR/Cas9 is an adaptable gene-editing strategy that can be coupled with iPSC technology to produce multiple gene-corrected autologous cell types with therapeutic potential for RDEB.
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Affiliation(s)
- Beau R Webber
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Mark J Osborn
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, USA.,Center for Genome Engineering, University of Minnesota, Minneapolis, MN, USA.,Asan-Minnesota Institute for Innovating Transplantation, Seoul, Republic of Korea
| | - Amber N McElroy
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Kirk Twaroski
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Cara-Lin Lonetree
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Anthony P DeFeo
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Lily Xia
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Cindy Eide
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Christopher J Lees
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Ron T McElmurry
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Megan J Riddle
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Chong Jai Kim
- Asan-Minnesota Institute for Innovating Transplantation, Seoul, Republic of Korea
| | - Dharmeshkumar D Patel
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Bruce R Blazar
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, USA
| | - Jakub Tolar
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, USA.,Asan-Minnesota Institute for Innovating Transplantation, Seoul, Republic of Korea
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Nyström A, Bornert O, Kühl T. Cell therapy for basement membrane-linked diseases. Matrix Biol 2016; 57-58:124-139. [PMID: 27609402 DOI: 10.1016/j.matbio.2016.07.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/02/2016] [Accepted: 07/07/2016] [Indexed: 12/14/2022]
Abstract
For most disorders caused by mutations in genes encoding basement membrane (BM) proteins, there are at present only limited treatment options available. Genetic BM-linked disorders can be viewed as especially suited for treatment with cell-based therapy approaches because the proteins that need to be restored are located in the extracellular space. In consequence, complete and permanent engraftment of cells does not necessarily have to occur to achieve substantial causal therapeutic effects. For these disorders cells can be used as transient vehicles for protein replacement. In addition, it is becoming evident that BM-linked genetic disorders are modified by secondary diseases mechanisms. Cell-based therapies have also the ability to target such disease modifying mechanisms. Thus, cell therapies can simultaneously provide causal treatment and symptomatic relief, and accordingly hold great potential for treatment of BM-linked disorders. However, this potential has for most applications and diseases so far not been realized. Here, we will present the state of cell therapies for BM-linked diseases. We will discuss use of both pluripotent and differentiated cells, the limitation of the approaches, their challenges, and the way forward to potential wider implementation of cell therapies in the clinics.
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Affiliation(s)
- Alexander Nyström
- Department of Dermatology, Medical Center - University of Freiburg, Freiburg, Germany.
| | - Olivier Bornert
- Department of Dermatology, Medical Center - University of Freiburg, Freiburg, Germany
| | - Tobias Kühl
- Department of Dermatology, Medical Center - University of Freiburg, Freiburg, Germany
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Jacków J, Titeux M, Portier S, Charbonnier S, Ganier C, Gaucher S, Hovnanian A. Gene-Corrected Fibroblast Therapy for Recessive Dystrophic Epidermolysis Bullosa using a Self-Inactivating COL7A1 Retroviral Vector. J Invest Dermatol 2016; 136:1346-1354. [DOI: 10.1016/j.jid.2016.02.811] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 02/12/2016] [Accepted: 02/26/2016] [Indexed: 12/16/2022]
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Kühl T, Mezger M, Hausser I, Guey LT, Handgretinger R, Bruckner-Tuderman L, Nyström A. Collagen VII Half-Life at the Dermal-Epidermal Junction Zone: Implications for Mechanisms and Therapy of Genodermatoses. J Invest Dermatol 2016; 136:1116-1123. [PMID: 26899947 DOI: 10.1016/j.jid.2016.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/29/2016] [Accepted: 02/03/2016] [Indexed: 12/18/2022]
Abstract
The tissue half-life of proteins largely determines treatment frequency of non-gene-editing-based therapies targeting the cause of genodermatoses. Surprisingly, such knowledge is missing for a vast number of proteins involved in pathologies. The dermal-epidermal junction zone is believed to be a rather static structure, but to our knowledge no detailed analysis of the stability of proteins within this zone has been performed. Here, we addressed the in vivo half-life of collagen type VII using genetic ablation of its expression and therapeutic introduction of exogenous collagen VII in a preclinical model. A similar in vivo stability of collagen VII was observed in the skin, tongue, and esophagus, with a half-life of about 1 month. Collagen VII expressed by intradermally injected mesenchymal stromal cells also exhibited a similar half-life. Our study provides key information needed for the development of protein replacement or cell-based therapies for dystrophic epidermolysis bullosa caused by genetic deficiency of collagen VII. Moreover, by showing what we define as an intermediate half-life of collagen VII, our study challenges the view of the dermal-epidermal junction zone as a static structure with very slow turnover.
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Affiliation(s)
- Tobias Kühl
- Department of Dermatology, Medical Center-University of Freiburg, 79104 Freiburg, Germany
| | - Markus Mezger
- University Children's Hospital, Department of General Paediatrics, Oncology/Haematology, Eberhard Karls University, 72076 Tuebingen, Germany
| | - Ingrid Hausser
- EM lab, Institute of Pathology, University Clinic Heidelberg, 69120 Heidelberg, Germany
| | | | - Rupert Handgretinger
- University Children's Hospital, Department of General Paediatrics, Oncology/Haematology, Eberhard Karls University, 72076 Tuebingen, Germany
| | | | - Alexander Nyström
- Department of Dermatology, Medical Center-University of Freiburg, 79104 Freiburg, Germany.
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