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Jebril W, Curman P, Andersson DC, Larsson H, Bachar-Wikstrom E, Cederlöf M, Wikstrom JD. Increased risk of cardiac arrhythmia in Hailey-Hailey disease patients. PLoS One 2024; 19:e0309482. [PMID: 39241028 PMCID: PMC11379163 DOI: 10.1371/journal.pone.0309482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 08/13/2024] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND Hailey-Hailey disease (HHD) is a rare autosomal dominant skin disease caused by mutations in the ATP2C1 gene, which encodes the secretory Ca2+/Mn2+-ATPase (SPCA1) pump in the Golgi apparatus. Although ATP2C1 is ubiquitously expressed in the body, possible extracutaneous manifestations of HHD are unknown. However, dysfunction of the Golgi apparatus not specifically coupled to ATP2C1 has been associated with heart disease. OBJECTIVE To investigate the association between HHD and common heart disease in a Swedish, population-based cohort. METHODS We conducted a population-based cohort study based on a linkage of Swedish nationwide registers to investigate the relationship between HHD and heart disease. We have been granted ethical approval from the Swedish Ethical Review Authority to conduct this study. The patients in this manuscript have given written informed consent to the publication of their case details. A total of 342 individuals with an ICD-10 diagnosis of HHD (Q82.8E) were identified and matched with randomly selected comparison individuals without HHD on a 1:100 ratio. Furthermore, in a separate clinical cohort we matched 23 HHD patients for age, sex, and BMI with control subjects to examine electrocardiogram parameters, electrolytes, and cardiovascular biomarkers. RESULTS Compared with individuals without HHD, individuals with HHD had an excess risk of arrhythmia (RR 1.4, CI 1.0-2.0), whereas no increased risks of myocardial infarction (RR 1.1, CI 0.6-1.7) or heart failure (RR 1.0, CI 0.6-1.6; Table 1) were found. We found no difference in ECG parameters, cardiovascular biomarkers, and electrolytes in the clinical subset. CONCLUSION This study reveals that HHD is associated with an increased risk of arrhythmia and represents the first data of any extracutaneous comorbidity in HHD. Thus, HHD may be a systemic disease. Our findings also shed light on the importance of the Golgi apparatus' Ca2+/Mn2+ homeostasis in common heart disease.
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Affiliation(s)
- William Jebril
- Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
| | - Philip Curman
- Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Daniel C Andersson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Cardiology Unit, Heart, Vascular and Neurology Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Henrik Larsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Etty Bachar-Wikstrom
- Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Martin Cederlöf
- Department of Medical Epidemiology and Biostatistics (Solna), Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Jakob D Wikstrom
- Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden
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Harmon RM, Ayers JL, McCarthy EF, Kowalczyk AP, Green KJ, Simpson CL. Pumping the Breaks on Acantholytic Skin Disorders: Targeting Calcium Pumps, Desmosomes, and Downstream Signaling in Darier, Hailey-Hailey, and Grover Disease. J Invest Dermatol 2024:S0022-202X(24)01925-0. [PMID: 39207315 DOI: 10.1016/j.jid.2024.06.1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 09/04/2024]
Abstract
Acantholytic skin disorders, by definition, compromise intercellular adhesion between epidermal keratinocytes. The root cause of blistering in these diseases traces back to direct disruption of adhesive cell-cell junctions, exemplified by autoantibody-mediated attack on desmosomes in pemphigus. However, genetic acantholytic disorders originate from more indirect mechanisms. Darier disease and Hailey-Hailey disease arise from mutations in the endoplasmic reticulum calcium pump, SERCA2, and the Golgi calcium/manganese pump, SPCA1, respectively. Though the disease-causing mutations have been known for nearly 25 years, the mechanistic linkage between dysregulation of intracellular ion stores and weakening of cell-cell junctions at the plasma membrane remains puzzling. The molecular underpinnings of a related idiopathic disorder, Grover disease, are even less understood. Due to an incomplete understanding of acantholytic pathology at the molecular level, these disorders lack proven, targeted treatment options, leaving patients with the significant physical and psychological burdens of chronic skin blistering, infections, and pain. This article aims to review what is known at the molecular, cellular, and clinical levels regarding these under-studied disorders and to highlight knowledge gaps and promising ongoing research. Armed with this knowledge, our goal is to aid investigators in defining essential questions about disease pathogenesis and to accelerate progress toward novel therapeutic strategies.
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Affiliation(s)
- Robert M Harmon
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
| | - Jessica L Ayers
- Molecular Medicine and Mechanisms of Disease PhD Program, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA; Department of Dermatology, University of Washington, Seattle, Washington, USA; Institute for Stem Cell & Regenerative Medicine, University of Washington, Seattle, Washington, USA
| | - Erin F McCarthy
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Andrew P Kowalczyk
- Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA; Department of Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Kathleen J Green
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Cory L Simpson
- Department of Dermatology, University of Washington, Seattle, Washington, USA; Institute for Stem Cell & Regenerative Medicine, University of Washington, Seattle, Washington, USA.
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Curman P, Jebril W, Larsson H, Bachar-Wikstrom E, Cederlöf M, Wikstrom JD. Darier disease is associated with neurodegenerative disorders and epilepsy. Sci Rep 2024; 14:7109. [PMID: 38531956 DOI: 10.1038/s41598-024-57779-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 03/21/2024] [Indexed: 03/28/2024] Open
Abstract
Darier disease (DD) is a rare monogenetic skin disorder with limited data on its potential association with neurological disorders. This study aimed to investigate the association between DD and neurological disorders, specifically Parkinson's disease, dementias, and epilepsy. Using Swedish national registers in a period spanning between 1977 and 2013, 935 individuals with DD were compared with up to 100 comparison individuals each, randomly selected from the general population based on birth year, sex, and county of residence at the time of the first diagnosis of DD. Individuals with DD had increased risks of being diagnosed with Parkinson's disease (RR 2.1, CI 1.1; 4.4), vascular dementia (RR 2.1, CI 1.0; 4.2), and epilepsy, (RR 2.5, CI 1.8; 3.5). No association of DD with other dementias were detected. This study demonstrates a new association between DD and neurodegenerative disorders and epilepsy, underlining the need for increased awareness, interdisciplinary collaboration, and further research to understand the underlying mechanisms. Early identification and management of neurological complications in DD patients could improve treatment strategies and patient outcomes. The findings also highlight the role of SERCA2 in the pathophysiology of neurological disorders, offering new targets for future research and potentials for novel treatments.
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Affiliation(s)
- Philip Curman
- Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Dermato-Venereology Clinic, Karolinska University Hospital, Eugeniavägen 3, 17164, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - William Jebril
- Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
- Dermato-Venereology Clinic, Karolinska University Hospital, Eugeniavägen 3, 17164, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Etty Bachar-Wikstrom
- Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | - Martin Cederlöf
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Jakob D Wikstrom
- Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.
- Dermato-Venereology Clinic, Karolinska University Hospital, Eugeniavägen 3, 17164, Stockholm, Sweden.
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Ettinger M, Burner T, Sharma A, Chang YT, Lackner A, Prompsy P, Deli IM, Traxler J, Wahl G, Altrichter S, Langer R, Tsai YC, Varkhande SR, Schoeftner LC, Iselin C, Gratz IK, Kimeswenger S, Guenova E, Hoetzenecker W. Th17-associated cytokines IL-17 and IL-23 in inflamed skin of Darier disease patients as potential therapeutic targets. Nat Commun 2023; 14:7470. [PMID: 37978298 PMCID: PMC10656568 DOI: 10.1038/s41467-023-43210-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023] Open
Abstract
Darier disease (DD) is a rare, inherited multi-organ disorder associated with mutations in the ATP2A2 gene. DD patients often have skin involvement characterized by malodorous, inflamed skin and recurrent, severe infections. Therapeutic options are limited and inadequate for the long-term management of this chronic disease. The aim of this study was to characterize the cutaneous immune infiltrate in DD skin lesions in detail and to identify new therapeutic targets. Using gene and protein expression profiling assays including scRNA sequencing, we demonstrate enhanced expression of Th17-related genes and cytokines and increased numbers of Th17 cells in six DD patients. We provide evidence that targeting the IL-17/IL-23 axis in a case series of three DD patients with monoclonal antibodies is efficacious with significant clinical improvement. As DD is a chronic, relapsing disease, our findings might pave the way toward additional options for the long-term management of skin inflammation in patients with DD.
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Affiliation(s)
- Monika Ettinger
- Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria
- Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Teresa Burner
- Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Anshu Sharma
- Department of Biosciences and Molecular Biology, University of Salzburg, Salzburg, Austria
| | - Yun-Tsan Chang
- Department of Dermatology, University of Lausanne and Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Angelika Lackner
- Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Pacôme Prompsy
- Department of Dermatology, University of Lausanne and Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Isabella M Deli
- Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria
| | - Judith Traxler
- Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria
| | - Gerald Wahl
- Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria
| | - Sabine Altrichter
- Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria
- Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Rupert Langer
- Institute of Pathology and Molecular Pathology, Kepler University Hospital Linz, Linz, Austria
- Institute of Pathology and Molecular Pathology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Yi-Chien Tsai
- Department of Dermatology, University of Lausanne and Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Suraj R Varkhande
- Department of Biosciences and Molecular Biology, University of Salzburg, Salzburg, Austria
| | - Leonie C Schoeftner
- Department of Biosciences and Molecular Biology, University of Salzburg, Salzburg, Austria
| | - Christoph Iselin
- Department of Dermatology, University of Lausanne and Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Iris K Gratz
- Department of Biosciences and Molecular Biology, University of Salzburg, Salzburg, Austria
| | - Susanne Kimeswenger
- Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria
| | - Emmanuella Guenova
- Department of Dermatology, University of Lausanne and Faculty of Biology and Medicine, Lausanne, Switzerland
- Department of Dermatology, Hospital 12 de octubre, Medical school, University Complutense, Madrid, Spain
| | - Wolfram Hoetzenecker
- Department of Dermatology and Venereology, Kepler University Hospital Linz, Linz, Austria.
- Department of Dermatology and Venereology, Medical Faculty, Johannes Kepler University Linz, Linz, Austria.
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Guenin S, Lebwohl M. Bexarotene use in refractory Darier's disease. Int J Dermatol 2023; 62:e587-e589. [PMID: 37381738 DOI: 10.1111/ijd.16763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/24/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Sophie Guenin
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Mark Lebwohl
- The Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
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Svarcbahs R, Blossom SM, Baffoe-Bonnie HS, Trychta KA, Greer LK, Pickel J, Henderson MJ, Harvey BK. Atransgenic mouse line for assaying tissue-specific changes in endoplasmic reticulum proteostasis. Transgenic Res 2023; 32:209-221. [PMID: 37133648 DOI: 10.1007/s11248-023-00349-7] [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: 12/19/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
Maintenance of calcium homeostasis is important for proper endoplasmic reticulum (ER) function. When cellular stress conditions deplete the high concentration of calcium in the ER, ER-resident proteins are secreted into the extracellular space in a process called exodosis. Monitoring exodosis provides insight into changes in ER homeostasis and proteostasis resulting from cellular stress associated with ER calcium dysregulation. To monitor cell-type specific exodosis in the intact animal, we created a transgenic mouse line with a Gaussia luciferase (GLuc)-based, secreted ER calcium-modulated protein, SERCaMP, preceded by a LoxP-STOP-LoxP (LSL) sequence. The Cre-dependent LSL-SERCaMP mice were crossed with albumin (Alb)-Cre and dopamine transporter (DAT)-Cre mouse lines. GLuc-SERCaMP expression was characterized in mouse organs and extracellular fluids, and the secretion of GLuc-SERCaMP in response to cellular stress was monitored following pharmacological depletion of ER calcium. In LSL-SERCaMP × Alb-Cre mice, robust GLuc activity was observed only in the liver and blood, whereas in LSL-SERCaMP × DAT-Cre mice, GLuc activity was seen in midbrain dopaminergic neurons and tissue samples innervated by dopaminergic projections. After calcium depletion, we saw increased GLuc signal in the plasma and cerebrospinal fluid collected from the Alb-Cre and DAT-Cre crosses, respectively. This mouse model can be used to investigate the secretion of ER-resident proteins from specific cell and tissue types during disease pathogenesis and may aid in the identification of therapeutics and biomarkers of disease.
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Affiliation(s)
- Reinis Svarcbahs
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Sarah M Blossom
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Helena S Baffoe-Bonnie
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Kathleen A Trychta
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Lacey K Greer
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - James Pickel
- Transgenic Technology Core, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Mark J Henderson
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
- National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, MD, 20850, USA
| | - Brandon K Harvey
- Cellular Stress and Inflammation Section, Intramural Research Program, National Institute On Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA.
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