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Santucci C, Alexandru M, Chen X, Mellerio JE, Karagiannis SN, Jacków-Malinowska J. Unravelling drivers of cutaneous squamous cell carcinoma in recessive dystrophic epidermolysis bullosa. Hum Immunol 2024; 85:110805. [PMID: 38703415 DOI: 10.1016/j.humimm.2024.110805] [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: 03/31/2024] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Abstract
Epidermolysis bullosa (EB) is an umbrella term for a group of rare inherited skin disorders characterised by mucocutaneous fragility. Patients suffer from blisters and chronic wounds that arise spontaneously or following minor mechanical trauma, often resulting in inflammation, scarring and fibrosis due to poor healing. The recessive form of dystrophic EB (RDEB) has a particularly severe phenotype and is caused by mutations in the COL7A1 gene, encoding the collagen VII protein, which is responsible for adhering the epidermis and dermis together. One of the most feared and devastating complications of RDEB is the development of an aggressive form of cutaneous squamous cell carcinoma (cSCC), which is the main cause of mortality in this patient group. However, pathological drivers behind the development and progression of RDEB-associated cSCC (RDEB-cSCC) remain somewhat of an enigma, and the evidence to date points towards a complex process. Currently, there is no cure for RDEB-cSCC, and treatments primarily focus on prevention, symptom management and support. Therefore, there is an urgent need for a comprehensive understanding of this cancer's pathogenesis, with the aim of facilitating the discovery of drug targets. This review explores the current knowledge of RDEB-cSCC, emphasising the important role of the immune system, genetics, fibrosis, and the tumour-promoting microenvironment, all ultimately intricately interconnected.
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Affiliation(s)
- Catherine Santucci
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London SE1 9RT, UK
| | - Madalina Alexandru
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London SE1 9RT, UK
| | - Xinyi Chen
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London SE1 9RT, UK
| | - Jemima E Mellerio
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London SE1 9RT, UK; St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
| | - Sophia N Karagiannis
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London SE1 9RT, UK; Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Cancer Centre, London SE1 9RT, UK
| | - Joanna Jacków-Malinowska
- St John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, Guy's Hospital, London SE1 9RT, UK.
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South AP, Laimer M, Gueye M, Sui JY, Eichenfield LF, Mellerio JE, Nyström A. Type VII Collagen Deficiency in the Oncogenesis of Cutaneous Squamous Cell Carcinoma in Dystrophic Epidermolysis Bullosa. J Invest Dermatol 2023; 143:2108-2119. [PMID: 37327859 DOI: 10.1016/j.jid.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/11/2023] [Accepted: 05/17/2023] [Indexed: 06/18/2023]
Abstract
Dystrophic epidermolysis bullosa is a rare genetic skin disorder caused by COL7A1 sequence variations that result in type VII collagen deficits and cutaneous and extracutaneous manifestations. One serious complication of dystrophic epidermolysis bullosa is cutaneous squamous cell carcinoma, a leading driver of morbidity and mortality, especially among patients with recessive dystrophic epidermolysis bullosa. Type VII collagen deficits alter TGFβ signaling and evoke multiple other cutaneous squamous cell carcinoma progression-promoting activities within epidermal microenvironments. This review examines cutaneous squamous cell carcinoma pathophysiology in dystrophic epidermolysis bullosa with a focus on known oncogenesis pathways at play and explores the idea that therapeutic type VII collagen replacement may reduce cutaneous squamous cell carcinoma risk.
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Affiliation(s)
- Andrew P South
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
| | - Martin Laimer
- Department of Dermatology and Allergology and EB House Austria, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | | | - Jennifer Y Sui
- Departments of Dermatology and Pediatrics, University of California San Diego School of Medicine, San Diego, California, USA; Division of Pediatric Dermatology, Rady Children's Hospital San Diego, San Diego, California, USA
| | - Lawrence F Eichenfield
- Departments of Dermatology and Pediatrics, University of California San Diego School of Medicine, San Diego, California, USA; Division of Pediatric Dermatology, Rady Children's Hospital San Diego, San Diego, California, USA
| | - Jemima E Mellerio
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Alexander Nyström
- Department of Dermatology, Medical Faculty, Medical Center, University of Freiburg, Freiburg, Germany; Freiburg Institute for Advanced Studies, Freiburg, Germany
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3
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Bonamonte D, Filoni A, De Marco A, Lospalluti L, Nacchiero E, Ronghi V, Colagrande A, Giudice G, Cazzato G. Squamous Cell Carcinoma in Patients with Inherited Epidermolysis Bullosa: Review of Current Literature. Cells 2022; 11:cells11081365. [PMID: 35456044 PMCID: PMC9027730 DOI: 10.3390/cells11081365] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 02/05/2023] Open
Abstract
Epidermolysis bullosa (EB) is a group of rare congenital diseases caused by mutations in structural proteins of the dermal/epidermal junction that are characterized by extreme epithelial fragility, which determines the formation of bullae and erosions either spontaneously or after local mechanical traumas. In EB patients, skin fragility leads to many possible complications and comorbidities. One of the most feared complications is the development of cutaneous squamous cell carcinomas (SCCs) that particularly in the dystrophic recessive EB subtype can be extremely aggressive and often metastatic. SCCs in EB patients generally arise more often in the extremities, where chronic blisters and scars are generally located. SCCs represent a big therapeutic challenge in the EB population. No standard of care exists for the treatment of SCC in these patients, and therapy is based on small case studies. Moreover, the pathogenesis of cSCC in EB patients is still unclear. Many theories have been indeed postulated in order to explain why cSCC behaves so much more aggressively in EB patients compared to the general population. cSCC in EB seems to be the result of many complex interactions among cancer cells, skin microenvironment, susceptibility to DNA mutations and host immune response. In this review, we analyze the different pathogenetic mechanisms of cSCC in EB patients, as well as new therapies for this condition.
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Affiliation(s)
- Domenico Bonamonte
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.B.); (A.F.); (A.D.M.); (L.L.)
| | - Angela Filoni
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.B.); (A.F.); (A.D.M.); (L.L.)
- Unit of Dermatology and Venerology, Perrino Hospital, 72100 Brindisi, Italy
| | - Aurora De Marco
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.B.); (A.F.); (A.D.M.); (L.L.)
| | - Lucia Lospalluti
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (D.B.); (A.F.); (A.D.M.); (L.L.)
| | - Eleonora Nacchiero
- Section of Plastic Surgery, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (E.N.); (V.R.); (G.G.)
| | - Valentina Ronghi
- Section of Plastic Surgery, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (E.N.); (V.R.); (G.G.)
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Giuseppe Giudice
- Section of Plastic Surgery, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (E.N.); (V.R.); (G.G.)
| | - Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy;
- Correspondence: ; Tel.: +39-3405203641
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Dayal JHS, Mason SM, Salas-Alanis JC, McGrath JA, Taylor RG, Mellerio JE, Blyth K, South AP, Inman GJ. Heterogeneous addiction to transforming growth factor-beta signalling in recessive dystrophic epidermolysis bullosa-associated cutaneous squamous cell carcinoma. Br J Dermatol 2021; 184:697-708. [PMID: 32726455 DOI: 10.1111/bjd.19421] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recessive dystrophic epidermolysis bullosa (RDEB) is associated with a high mortality rate due to the development of life-threatening, metastatic cutaneous squamous cell carcinoma (cSCC). Elevated transforming growth factor-beta (TGF-β) signalling is implicated in cSCC development and progression in patients with RDEB. OBJECTIVES To determine the effect of exogenous and endogenous TGF-β signalling in RDEB cSCC with a view to assessing the potential of targeting TGF-β signalling for RDEB cSCC therapy. METHODS A panel of 11 patient-derived RDEB cSCC primary tumour keratinocyte cell lines (SCCRDEBs) were tested for their signalling and proliferation responses to exogenous TGF-β. Their responses to TGF-β receptor type-1 (TGFBR1) kinase inhibitors [SB-431542 and AZ12601011 (AZA01)] were tested using in vitro proliferation, clonogenicity, migration and three-dimensional invasion assays, and in vivo tumour xenograft assays. RESULTS All SCCRDEBs responded to exogenous TGF-β by activation of canonical SMAD signalling and proliferative arrest. Blocking endogenous signalling by treatment with SB-431542 and AZ12601011 significantly inhibited proliferation (seven of 11), clonogenicity (six of 11), migration (eight of 11) and invasion (six of 11) of SCCRDEBs. However, these TGFBR1 kinase inhibitors also promoted proliferation and clonogenicity in two of 11 SCCRDEB cell lines. Pretreatment of in vitro TGFBR1-addicted SCCRDEB70 cells with SB-431542 enhanced overall survival and reduced tumour volume in subcutaneous xenografts but had no effect on nonaddicted SCCRDEB2 cells in these assays. CONCLUSIONS Targeting TGFBR1 kinase activity may have therapeutic benefit in the majority of RDEB cSCCs. However, the potential tumour suppressive role of TGF-β signalling in a subset of RDEB cSCCs necessitates biomarker identification to enable patient stratification before clinical intervention.
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Affiliation(s)
- J H S Dayal
- Cancer Research UK Beatson Institute, Glasgow, UK
- Division of Cancer Research, Ninewells Hospital and Medical School, Jacqui Wood Cancer Centre, University of Dundee, Dundee, UK
| | - S M Mason
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - J C Salas-Alanis
- Department of Basic Sciences, Health Sciences Division, Universidad de Monterrey, Guadalupe, Nuevo León, México
| | - J A McGrath
- St John's Institute of Dermatology, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R G Taylor
- Division of Cancer Research, Ninewells Hospital and Medical School, Jacqui Wood Cancer Centre, University of Dundee, Dundee, UK
| | - J E Mellerio
- St John's Institute of Dermatology, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K Blyth
- Cancer Research UK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - A P South
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - G J Inman
- Cancer Research UK Beatson Institute, Glasgow, UK
- Division of Cancer Research, Ninewells Hospital and Medical School, Jacqui Wood Cancer Centre, University of Dundee, Dundee, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
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5
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Vanden Oever M, Muldoon D, Mathews W, Tolar J. Fludarabine modulates expression of type VII collagen during haematopoietic stem cell transplantation for recessive dystrophic epidermolysis bullosa. Br J Dermatol 2020; 185:380-390. [PMID: 33368156 DOI: 10.1111/bjd.19757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 12/16/2020] [Accepted: 12/19/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recessive dystrophic epidermolysis bullosa (RDEB) is a severe, complicated inherited blistering skin disease with few treatment options currently available. Recently, haematopoietic stem cell transplantation (HCT) has been used as an alternative therapy that can improve skin integrity, but it is not known if the preparative HCT regimen also contributes to the therapeutic response. OBJECTIVES To determine whether chemotherapy drugs used in the HCT preparative regimen influence type VII collagen (C7) expression, which is inherently reduced or absent in RDEB skin, and to explore the pathomechanisms of such responses, if present. METHODS Drugs from the HCT preparative regimen (busulfan, cyclophosphamide, ciclosporin A, fludarabine and mycophenolate) with inhibitors (PD98059, U0126, LY294002, SR11302, SIS3 and N-acetyl-l-cysteine) were added to normal human dermal and human RDEB fibroblasts. C7 expression was measured using reversetranscription polymerase chain reaction and immunoblotting. RESULTS We uncovered a previously unknown consequence of fludarabine whereby dermal fibroblasts exposed to fludarabine upregulate C7. This effect is mediated, in part, through activation of the mitogen-activated protein kinase/extracellular signal-regulated kinase, phosphoinositide 3-kinase/protein kinase B and transforming growth factor-β pathways. Activation of these pathways leads to activation of downstream transcription factors, including activator protein 1 (AP-1) and SMAD. Subsequently, both AP-1 and SMAD bind the COL7A1 promoter and increase COL7A1 expression. CONCLUSIONS Fludarabine influences the production of type VII collagen in RDEB fibroblasts.
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Affiliation(s)
- M Vanden Oever
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, USA
| | - D Muldoon
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA.,Stem Cell Institute, University of Minnesota, Minneapolis, MN, USA
| | - W Mathews
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - J 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
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6
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Reprogramming and Differentiation of Cutaneous Squamous Cell Carcinoma Cells in Recessive Dystrophic Epidermolysis Bullosa. Int J Mol Sci 2020; 22:ijms22010245. [PMID: 33383666 PMCID: PMC7795642 DOI: 10.3390/ijms22010245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/13/2020] [Accepted: 12/24/2020] [Indexed: 02/04/2023] Open
Abstract
The early onset and rapid progression of cutaneous squamous cell carcinoma (cSCC) leads to high mortality rates in individuals with recessive dystrophic epidermolysis bullosa (RDEB). Currently, the molecular mechanisms underlying cSCC development in RDEB are not well understood and there are limited therapeutic options. RDEB-cSCC arises through the accumulation of genetic mutations; however, previous work analyzing gene expression profiles have not been able to explain its aggressive nature. Therefore, we generated a model to study RDEB-cSCC development using cellular reprograming and re-differentiation technology. We compared RDEB-cSCC to cSCC that were first reprogrammed into induced pluripotent stem cells (RDEB-cSCC-iPSC) and then differentiated back to keratinocytes (RDEB-cSCC-iKC). The RDEB-cSCC-iKC cell population had reduced proliferative capacities in vitro and in vivo, suggesting that reprogramming and re-differentiation leads to functional changes. Finally, we performed RNA-seq analysis for RDEB-cSCC, RDEB-cSCC-iPSC, and RDEB-cSCC-iKC and identified different gene expression signatures between these cell populations. Taken together, this cell culture model offers a valuable tool to study cSCC and provides a novel way to identify potential therapeutic targets for RDEB-cSCC.
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7
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Risk of Human Papillomavirus Infection in Cancer-Prone Individuals: What We Know. Viruses 2018; 10:v10010047. [PMID: 29361695 PMCID: PMC5795460 DOI: 10.3390/v10010047] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 02/06/2023] Open
Abstract
Human papillomavirus (HPV) infections cause a significant proportion of cancers worldwide, predominantly squamous cell carcinomas (SCC) of the mucosas and skin. High-risk HPV types are associated with SCCs of the anogenital and oropharyngeal tract. HPV oncogene activities and the biology of SCCs have been intensely studied in laboratory models and humans. What remains largely unknown are host tissue and immune-related factors that determine an individual's susceptibility to infection and/or carcinogenesis. Such susceptibility factors could serve to identify those at greatest risk and spark individually tailored HPV and SCC prevention efforts. Fanconi anemia (FA) is an inherited DNA repair disorder that is in part characterized by extreme susceptibility to SCCs. An increased prevalence of HPV has been reported in affected individuals, and molecular and functional connections between FA, SCC, and HPV were established in laboratory models. However, the presence of HPV in some human FA tumors is controversial, and the extent of the etiological connections remains to be established. Herein, we discuss cellular, immunological, and phenotypic features of FA, placed into the context of HPV pathogenesis. The goal is to highlight this orphan disease as a unique model system to uncover host genetic and molecular HPV features, as well as SCC susceptibility factors.
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8
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Watanabe M, Natsuga K, Shinkuma S, Shimizu H. Epidermal aspects of type VII collagen: Implications for dystrophic epidermolysis bullosa and epidermolysis bullosa acquisita. J Dermatol 2018; 45:515-521. [PMID: 29352483 DOI: 10.1111/1346-8138.14222] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 12/13/2017] [Indexed: 02/02/2023]
Abstract
Type VII collagen (COL7), a major component of anchoring fibrils in the epidermal basement membrane zone, has been characterized as a defective protein in dystrophic epidermolysis bullosa and as an autoantigen in epidermolysis bullosa acquisita. Although COL7 is produced and secreted by both epidermal keratinocytes and dermal fibroblasts, the role of COL7 with regard to the epidermis is rarely discussed. This review focuses on COL7 physiology and pathology as it pertains to epidermal keratinocytes. We summarize the current knowledge of COL7 production and trafficking, its involvement in keratinocyte dynamics, and epidermal carcinogenesis in COL7 deficiency and propose possible solutions to unsolved issues in this field.
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Affiliation(s)
- Mika Watanabe
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ken Natsuga
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoru Shinkuma
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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9
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Sans-DeSanNicolas L, Caratú G, Vidal-Cortés O, Sanchez-Redondo S, Ferrer B, Mancuso F, González-Sanchez E, Pérez-Alea M, McGrail K, Hernandez-Losa J, Bodet D, Vivancos A, Garcia-Patos V, Recio JA. Genetic Profiles of Squamous Cell Carcinomas Associated with Recessive Dystrophic Epidermolysis Bullosa Unveil NOTCH and TP53 Mutations and an Increased MYC Expression. J Invest Dermatol 2017; 138:1423-1427. [PMID: 29291383 DOI: 10.1016/j.jid.2017.12.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Lidia Sans-DeSanNicolas
- Biomedical Research in Melanoma-Animal Models and Cancer Laboratory, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Ginevra Caratú
- Cancer Genomics Group Translational Research Program, Vall d'Hebron Research Institute (VHIO), Barcelona, Spain
| | - Oriol Vidal-Cortés
- Biomedical Research in Melanoma-Animal Models and Cancer Laboratory, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Sara Sanchez-Redondo
- Biomedical Research in Melanoma-Animal Models and Cancer Laboratory, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Berta Ferrer
- Anatomy and Pathology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - Francesco Mancuso
- Cancer Genomics Group Translational Research Program, Vall d'Hebron Research Institute (VHIO), Barcelona, Spain
| | - Elena González-Sanchez
- Biomedical Research in Melanoma-Animal Models and Cancer Laboratory, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Mileidys Pérez-Alea
- Biomedical Research in Melanoma-Animal Models and Cancer Laboratory, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Kimberly McGrail
- Biomedical Research in Melanoma-Animal Models and Cancer Laboratory, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | | | - Domingo Bodet
- Dermatology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - Ana Vivancos
- Cancer Genomics Group Translational Research Program, Vall d'Hebron Research Institute (VHIO), Barcelona, Spain
| | | | - Juan Angel Recio
- Biomedical Research in Melanoma-Animal Models and Cancer Laboratory, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.
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10
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Webber BR, O’Connor KT, McElmurry RT, Durgin EN, Eide C, Lees CJ, Riddle MJ, Mathews W, Frank NY, Kluth MA, Ganss C, Moriarity BS, Frank MH, Osborn MJ, Tolar J. Rapid generation of Col7a1 -/- mouse model of recessive dystrophic epidermolysis bullosa and partial rescue via immunosuppressive dermal mesenchymal stem cells. J Transl Med 2017; 97:1218-1224. [PMID: 28892093 PMCID: PMC5623156 DOI: 10.1038/labinvest.2017.85] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/06/2017] [Accepted: 07/10/2017] [Indexed: 12/20/2022] Open
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is a debilitating and ultimately lethal blistering disease caused by mutations to the Col7a1 gene. Development of novel cell therapies for the treatment of RDEB would be fostered by having immunodeficient mouse models able to accept human cell grafts; however, immunodeficient models of many genodermatoses such as RDEB are lacking. To overcome this limitation, we combined the clustered regularly interspaced short palindromic repeats and associated nuclease (CRISPR/Cas9) system with microinjection into NOD/SCID IL2rγcnull (NSG) embryos to rapidly develop an immunodeficient Col7a1-/- mouse model of RDEB. Through dose optimization, we achieve F0 biallelic knockout efficiencies exceeding 80%, allowing us to quickly generate large numbers of RDEB NSG mice for experimental use. Using this strategy, we clearly demonstrate important strain-specific differences in RDEB pathology that could underlie discordant results observed between independent studies and establish the utility of this system in proof-of-concept human cellular transplantation experiments. Importantly, we uncover the ability of a recently identified skin resident immunomodulatory dermal mesenchymal stem cell marked by ABCB5 to reduce RDEB pathology and markedly extend the lifespan of RDEB NSG mice via reduced skin infiltration of inflammatory myeloid derivatives.
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Affiliation(s)
- Beau R. Webber
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Kyle T. O’Connor
- Masonic Cancer Center at the University of Minnesota, Mouse Genetics Laboratory Shared Resource, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ron T. McElmurry
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Elise N. Durgin
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Cindy Eide
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Christopher J. Lees
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Megan J. Riddle
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Wendy Mathews
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Natasha Y. Frank
- Department of Medicine, Boston VA Healthcare System, West Roxbury, Massachusetts, USA,Division of Genetics, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Mark A. Kluth
- Rheacell GmbH & Co. KG, Heidelberg, Germany,Ticeba GmbH, Heidelberg, Germany
| | - Christoph Ganss
- Rheacell GmbH & Co. KG, Heidelberg, Germany,Ticeba GmbH, Heidelberg, Germany
| | - Branden S. Moriarity
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA,Center for Genome Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Markus H. Frank
- Transplant Research Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA,Harvard Skin Disease Research Center, Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA,School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia,Harvard Stem Cell Institute, Harvard University, Cambridge, Massachusetts, USA
| | - Mark J. Osborn
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA,Center for Genome Engineering, University of Minnesota, Minneapolis, Minnesota, USA,Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA,Asan-Minnesota Institute for Innovating Transplantation, Seoul, Republic of Korea
| | - Jakub Tolar
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota Medical School, Minneapolis, Minnesota, USA,Center for Genome Engineering, University of Minnesota, Minneapolis, Minnesota, USA,Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA,Asan-Minnesota Institute for Innovating Transplantation, Seoul, Republic of Korea,Correspondence to: Jakub Tolar, Pediatric BMT, 420 Delaware St SE, MMC 366, Minneapolis, MN 55455; 612-626-6723;
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11
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Guerra L, Odorisio T, Zambruno G, Castiglia D. Stromal microenvironment in type VII collagen-deficient skin: The ground for squamous cell carcinoma development. Matrix Biol 2017; 63:1-10. [PMID: 28126522 DOI: 10.1016/j.matbio.2017.01.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 12/18/2022]
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is a skin fragility disease caused by mutations that affect the function and/or the amount of type VII collagen (C7), the major component of anchoring fibrils. Hallmarks of RDEB are unremitting blistering and chronic wounds leading to tissue fibrosis and scarring. Nearly all patients with severe RDEB develop highly metastatic squamous cell carcinomas (SCC) which are the main cause of death. Accumulating evidence from a murine RDEB model and human RDEB cells demonstrates that lack of C7 also directly alters the wound healing process. Non-healing RDEB wounds are characterized by increased inflammation, high transforming growth factor-β1 (TGF-β1) levels and activity, and are heavily populated by myofibroblasts responsible for enhanced fibrogenesis and matrix stiffness. These changes make the RDEB stroma a microenvironment prone to cancer initiation, where cells with features of cancer-associated fibroblasts are found. Here, we discuss recent knowledge on microenvironment alterations in RDEB, highlighting possible therapeutic targets to prevent and/or delay fibrosis and SCC development.
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Affiliation(s)
- Liliana Guerra
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Teresa Odorisio
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Via dei Monti di Creta 104, 00167 Rome, Italy
| | - Giovanna Zambruno
- Genetic and Rare Diseases Research Area and Dermatology Unit, Bambino Gesù Children's Hospital-IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Daniele Castiglia
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, Via dei Monti di Creta 104, 00167 Rome, Italy.
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Progress toward Treatment and Cure of Epidermolysis Bullosa: Summary of the DEBRA International Research Symposium EB2015. J Invest Dermatol 2016; 136:352-358. [PMID: 26802230 PMCID: PMC4724642 DOI: 10.1016/j.jid.2015.10.050] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Epidermolysis bullosa (EB), a group of complex heritable blistering diseases, is the topic of triennial research meetings organized by DEBRA International, the umbrella of patient advocacy organizations. The DEBRA 2015 Research Conference, held in May 2015, brought together investigators and clinicians from around the world working at the forefront of EB research. Discussing the state-of-the-art approaches from a wide range of disciplines, there was a palpable excitement at this conference brought about by the optimism about applying new sequencing techniques, genome editing, protein replacement, autologous and allogeneic stem cell therapy, innovations in cancer biology, revertant mosaicism and iPSC techniques, all of which are aimed at developing new therapies for EB. Many in the field who have participated in EB research for many years were especially enthusiastic and felt that, possibly for the first time, the field seems uniquely poised to bring these new tools to effectively tackle EB using multiple complementary approaches towards improved quality of life and eventually a cure for patients suffering from EB, a currently intractable disease.
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Pourreyron C, Chen M, McGrath JA, Salas-Alanis JC, South AP, Leigh IM. High levels of type VII collagen expression in recessive dystrophic epidermolysis bullosa cutaneous squamous cell carcinoma keratinocytes increases PI3K and MAPK signalling, cell migration and invasion. Br J Dermatol 2016; 170:1256-65. [PMID: 24641191 DOI: 10.1111/bjd.12715] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Epidermolysis bullosa is a group of inherited skin fragility diseases varying in severity from mild scarring to infant mortality. Great efforts are being undertaken to develop therapeutic strategies to treat the more pernicious forms of this disease, particularly those associated with recessive, loss-of-function mutations. In such cases significant effort is directed toward delivering recombinant protein at levels sufficient to demonstrate clinical benefit. Recessive dystrophic epidermolysis bullosa (RDEB) predisposes patients to a high incidence of life-threatening cutaneous squamous cell carcinoma (cSCC). Mutations in the gene encoding type VII collagen, COL7A1, are the sole cause of this disease and conflicting reports concerning type VII collagen and COL7A1 in carcinogenesis exist. OBJECTIVES To investigate potential oncogenic effects of expressing recombinant type VII collagen in patient cells. METHODS We used retroviral transduction to introduce type VII collagen into keratinocytes derived from patients with and without RDEB. RESULTS Retroviral expression of type VII collagen in cSCC keratinocytes established from patients with RDEB resulted in increased cell adhesion, migration and invasion coupled with a concurrent increase in PI3K and MAPK signalling. CONCLUSIONS Our data suggest caution when formulating strategies where delivery of type VII collagen is likely to exceed levels seen under normal physiological conditions in a patient group with a higher inherent risk of developing skin cancer.
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Affiliation(s)
- C Pourreyron
- Division of Cancer Research, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, U.K
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14
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Martins VL, Caley MP, Moore K, Szentpetery Z, Marsh ST, Murrell DF, Kim MH, Avari M, McGrath JA, Cerio R, Kivisaari A, Kähäri VM, Hodivala-Dilke K, Brennan CH, Chen M, Marshall JF, O'Toole EA. Suppression of TGFβ and Angiogenesis by Type VII Collagen in Cutaneous SCC. J Natl Cancer Inst 2016; 108:djv293. [PMID: 26476432 DOI: 10.1093/jnci/djv293] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 09/22/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Individuals with severe generalized recessive dystrophic epidermolysis bullosa (RDEB), an inherited blistering disorder caused by mutations in the COL7A1 gene, develop unexplained aggressive squamous cell carcinomas (SCC). Here we report that loss of type VII collagen (Col7) in SCC results in increased TGFβ signaling and angiogenesis in vitro and in vivo. METHODS Stable knockdown (KD) of Col7 was established using shRNA, and cells were used in a mouse xenograft model. Angiogenesis was assessed by immunohistochemistry, endothelial tube-forming assays, and proteome arrays. Mouse and zebrafish models were used to examine the effect of recombinant Col7 on angiogenesis. Findings were confirmed in anonymized, archival human tissue: RDEB SCC tumors, non-EB SCC tumors, RDEB skin, normal skin; and two human RDEB SCC cell lines. The TGFβ pathway was examined using immunoblotting, immunohistochemistry, biochemical inhibition, and siRNA. All statistical tests were two-sided. RESULTS Increased numbers of cross-cut blood vessels were observed in Col7 KD compared with control xenografts (n = 4 to 7 per group) and in RDEB tumors (n = 21) compared with sporadic SCC (n = 24, P < .001). Recombinant human Col7 reversed the increased SCC angiogenesis in Col7 KD xenografts in vivo (n = 7 per group, P = .04). Blocking the interaction between α2β1 integrin and Col7 increased TGFB1 mRNA expression 1.8-fold and p-Smad2 levels two-fold. Increased TGFβ signaling and VEGF expression were observed in Col7 KD xenografts (n = 4) compared with control (n = 4) and RDEB tumors (TGFβ markers, n = 6; VEGF, n = 17) compared with sporadic SCC (TGFβ markers, n = 6; VEGF, n = 21). Inhibition of TGFβ receptor signaling using siRNA resulted in decreased endothelial cell tube formation (n = 9 per group, mean tubes per well siC = 63.6, SD = 17.1; mean tubes per well siTβRII = 29.7, SD = 6.1, P = .02). CONCLUSIONS Type VII collagen suppresses TGFβ signaling and angiogenesis in cutaneous SCC. Patients with RDEB SCC may benefit from anti-angiogenic therapy.
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Affiliation(s)
- V L Martins
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - M P Caley
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - K Moore
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - Z Szentpetery
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - S T Marsh
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - D F Murrell
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - M H Kim
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - M Avari
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - J A McGrath
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - R Cerio
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - A Kivisaari
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - V M Kähäri
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - K Hodivala-Dilke
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - C H Brennan
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - M Chen
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - J F Marshall
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC)
| | - E A O'Toole
- Centre for Cell Biology and Cutaneous Research, Blizard Institute (VLM, MPC, ZS, STM, MA, RC, EOT), Barts Cancer Institute (KM, KHD, JFM), Barts and the London School of Medicine and Dentistry and School of Biological and Chemical Sciences (CHB), Queen Mary University of London, London, UK; Department of Dermatology, St George Hospital, University of NSW, Sydney, NSW, Australia (DFM, MHK); St John's Institute of Dermatology, Kings College London (Guys Campus), London, UK (JAM); Department of Dermatology and MediCity Research Laboratory, University of Turku, and Turku University Hospital, Turku, Finland (AK, VMK); Department of Dermatology, University of Southern California, Los Angeles, CA (MC).
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15
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From marrow to matrix: novel gene and cell therapies for epidermolysis bullosa. Mol Ther 2015; 23:987-992. [PMID: 25803200 DOI: 10.1038/mt.2015.47] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 03/11/2015] [Indexed: 12/22/2022] Open
Abstract
Epidermolysis bullosa encompasses a group of inherited connective tissue disorders that range from mild to lethal. There is no cure, and current treatment is limited to palliative care that is largely ineffective in treating the systemic, life-threatening pathology associated with the most severe forms of the disease. Although allogeneic cell- and protein-based therapies have shown promise, both novel and combinatorial approaches will undoubtedly be required to totally alleviate the disorder. Progress in the development of next-generation therapies that synergize targeted gene-correction and induced pluripotent stem cell technologies offers exciting prospects for personalized, off-the-shelf treatment options that could avoid many of the limitations associated with current allogeneic cell-based therapies. Although no single therapeutic avenue has achieved complete success, each has substantially increased our collective understanding of the complex biology underlying the disease, both providing mechanistic insights and uncovering new hurdles that must be overcome.
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16
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Brown A, Tantcheva-Poor I, Eming SA. [Parallels between wound healing, chronic inflammatory skin diseases and neoplasia: clinical aspects]. Hautarzt 2014; 65:934-43. [PMID: 25318704 DOI: 10.1007/s00105-014-3524-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Chronic wounds, scars, burns and recalcitrant chronic inflammatory skin lesions can give rise to malignancy. These neoplasias are usually squamous cell carcinomas but basal cell carcinomas can also develop. Tumorigenesis is a severe complication of chronic ulcers as well as certain inflammatory skin diseases; early diagnosis is critical for prognosis. This article describes parallels between wound healing, chronic inflammatory skin diseases and carcinogenesis and provides advice on practical aspects of diagnosis and therapy.
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Affiliation(s)
- A Brown
- Klinik und Poliklinik für Dermatologie und Venerologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
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17
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O'Toole EA. Type VII collagen and squamous cell carcinoma. Br J Dermatol 2014; 170:1215. [PMID: 24947149 DOI: 10.1111/bjd.12868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- E A O'Toole
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4AT, U.K.
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18
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Vanden Oever MJ, Tolar J. Advances in understanding and treating dystrophic epidermolysis bullosa. F1000PRIME REPORTS 2014; 6:35. [PMID: 24860657 PMCID: PMC4017907 DOI: 10.12703/p6-35] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Epidermolysis bullosa is a group of inherited disorders that can be both systemic and life-threatening. Standard treatments for the most severe forms of this disorder, typically limited to palliative care, are ineffective in reducing the morbidity and mortality due to complications of the disease. Emerging therapies—such as the use of allogeneic cellular therapy, gene therapy, and protein therapy—have all shown promise, but it is likely that several approaches will need to be combined to realize a cure. For recessive dystrophic epidermolysis bullosa, each particular therapeutic approach has added to our understanding of type VII collagen (C7) function and the basic biology surrounding the disease. The efficacy of these therapies and the mechanisms by which they function also give us insight into developing future strategies for treating this and other extracellular matrix disorders.
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Odorisio T, Di Salvio M, Orecchia A, Di Zenzo G, Piccinni E, Cianfarani F, Travaglione A, Uva P, Bellei B, Conti A, Zambruno G, Castiglia D. Monozygotic twins discordant for recessive dystrophic epidermolysis bullosa phenotype highlight the role of TGF-β signalling in modifying disease severity. Hum Mol Genet 2014; 23:3907-22. [DOI: 10.1093/hmg/ddu102] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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20
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Progress in Epidermolysis bullosa research: summary of DEBRA International Research Conference 2012. J Invest Dermatol 2013; 133:2121-6. [PMID: 23949764 DOI: 10.1038/jid.2013.127] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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Ng YZ, Pourreyron C, Salas-Alanis JC, Dayal JHS, Cepeda-Valdes R, Yan W, Wright S, Chen M, Fine JD, Hogg FJ, McGrath JA, Murrell DF, Leigh IM, Lane EB, South AP. Fibroblast-derived dermal matrix drives development of aggressive cutaneous squamous cell carcinoma in patients with recessive dystrophic epidermolysis bullosa. Cancer Res 2012; 72:3522-34. [PMID: 22564523 DOI: 10.1158/0008-5472.can-11-2996] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with the genetic skin blistering disease recessive dystrophic epidermolysis bullosa (RDEB) develop aggressive cutaneous squamous cell carcinoma (cSCC). Metastasis leading to mortality is greater in RDEB than in other patient groups with cSCC. Here we investigate the dermal component in RDEB using mRNA expression profiling to compare cultured fibroblasts isolated from individuals without cSCC and directly from tumor matrix in RDEB and non-RDEB samples. Although gene expression of RDEB normal skin fibroblasts resembled that of cancer-associated fibroblasts, RDEB cancer-associated fibroblasts exhibited a distinct and divergent gene expression profile, with a large proportion of the differentially expressed genes involved in matrix and cell adhesion. RDEB cancer-associated fibroblasts conferred increased adhesion and invasion to tumor and nontumor keratinocytes. Reduction of COL7A1, the defective gene in RDEB, in normal dermal fibroblasts led to increased type XII collagen, thrombospondin-1, and Wnt-5A, while reexpression of wild type COL7A1 in RDEB fibroblasts decreased type XII collagen, thrombospondin-1, and Wnt-5A expression, reduced tumor cell invasion in organotypic culture, and restricted tumor growth in vivo. Overall, our findings show that matrix composition in patients with RDEB is a permissive environment for tumor development, and type VII collagen directly regulates the composition of matrix proteins secreted by dermal and cancer-associated fibroblasts.
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Affiliation(s)
- Yi-Zhen Ng
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
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Huang L, Wong YP, Burd A. A novel homozygous splice site mutation in COL7A1 in a Chinese patient with severe recessive dystrophic epidermolysis bullosa and squamous cell carcinoma. Int J Dermatol 2010; 50:52-6. [DOI: 10.1111/j.1365-4632.2010.04642.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Squamous cell carcinomas (SCCs) are highly aggressive in patients with epidermolysis bullosa (EB). Non-ultraviolet-related SCCs are the leading cause of death in patients with recessive dystrophic EB, particularly recessive dystrophic EB-generalized severe subtype (RDEB-GS). The mechanism of SCC development in patients with RDEB continues to be investigated and several theories have been reported in the literature.
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Affiliation(s)
- Supriya S Venugopal
- Department of Dermatology, St George Hospital, University of New South Wales, Kogarah, Sydney, NSW, Australia
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25
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Liy-Wong C, Cepeda-Valdes R, Salas-Alanis JC. Epidermolysis bullosa care in Mexico. Dermatol Clin 2010; 28:393-4, xiii. [PMID: 20447510 DOI: 10.1016/j.det.2010.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Epidermolysis bullosa (EB) in Mexico continues to be a rare genodermatosis that is still unknown for most of the health care professionals in the country. The spirit of DebRA MEXICO was born in 1994 when the Mexican health care team started to see patients with the main purpose to provide medical care, genetic counseling, and advice to patients with EB and their families; to promote collaboration and exchange information among people with EB; to research and find new therapeutic approaches; and finally, to diffuse knowledge and raise awareness of the issues of EB in general public and health care professionals.
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Affiliation(s)
- Carmen Liy-Wong
- Department of Dermatology, Hospital Universitario Dr Jose E. Gonzalez UANL, Monterrey, Nuevo León, México
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Abstract
PURPOSE OF REVIEW This review highlights key findings, both clinical and basic, that have been published in the field of inherited epidermolysis bullosa within the past few years. RECENT FINDINGS New epidermolysis bullosa phenotypes, genotypes and modes of transmission have been identified, resulting in a revised classification system. Detailed evidence-based data are now available on the risk of extracutaneous complications in each of the major epidermolysis bullosa subtypes. Studies are now underway to try to better explain the biological aggressiveness of squamous cell carcinomas arising in epidermolysis bullosa skin. Cell and animal models have been refined and used to ascertain the feasibility of gene replacement therapy, stem cell transplantation, and treatment with injected allogeneic fibroblasts or recombinant type VII collagen. As a result, clinical trials are now being pursued to test each of these in humans. SUMMARY Epidermolysis bullosa is caused by mutations in at least 14 genes, leading to a broad spectrum of entities, each of which has its own relative risk for the development of specific extracutaneous complications and/or premature death. Intensive research, both basic and clinical, is bringing us closer to more effective treatments and possibly even a cure.
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Abstract
Inherited epidermolysis bullosa encompasses dozens of diseases characterized by mechanical fragility of the skin, blister formation, and abnormal wound healing. Most of the more severe subtypes are associated with clinically significant extracutaneous complications. Some subtypes may lead to death, even in early infancy. Over the past two decades substantial advances have been made to our understanding of the underlying molecular basis for each member of this protean group of diseases. Research has now shifted toward the identification of therapeutic interventions, to include gene therapy, recombinant protein infusions, intradermal injection of allogeneic fibroblasts, and stem cell transplantation, that might eventually lead to a definitive cure for this disease. Other developing therapies being explored are directed toward the enhancement of wound healing and the prevention of potentially life-threatening skin cancers in these patients.
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Affiliation(s)
- Jo-David Fine
- Department of Medicine (Dermatology), Vanderbilt University School of Medicine, National Epidermolysis Bullosa Registry, Nashville, TN, USA.
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Chung HJ, Uitto J. Type VII collagen: the anchoring fibril protein at fault in dystrophic epidermolysis bullosa. Dermatol Clin 2010; 28:93-105. [PMID: 19945621 DOI: 10.1016/j.det.2009.10.011] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Type VII collagen is a major component of the anchoring fibrils of the dermal-epidermal adhesion on the dermal side at the lamina densa/papillary dermis interface. Dystrophic epidermolysis bullosa (DEB) emerged as a candidate for type VII collagen mutations becausing anchoring fibrils were shown to be morphologically altered, reduced in number, or completely absent in patients with different forms of DEB. Circulating autoantibodies recognize type VII collagen epitopes in epidermolysis bullosa acquisita. The suggestion that type VII collagen is required for human epidermal tumorigenesis relates to the increasing numbers of life-threatening complications associated with developing squamous cell carcinomas because of the extended life span of affected individuals with recessive DEB.
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Affiliation(s)
- Hye Jin Chung
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College, and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, 233 South 10th Street, Suite 450 BLSB, Philadelphia, PA 19107, USA
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Ko MS, Marinkovich MP. Role of dermal-epidermal basement membrane zone in skin, cancer, and developmental disorders. Dermatol Clin 2010; 28:1-16. [PMID: 19945611 DOI: 10.1016/j.det.2009.10.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The dermal-epidermal basement membrane zone is an important epithelial and stromal interface, consisting of an intricately organized collection of intracellular, transmembrane, and extracellular matrix proteins. The basement membrane zone has several main functions including acting as a permeability barrier, forming an adhesive interface between epithelial cells and the underlying matrix, and controlling cellular organization and differentiation. This article identifies key molecular players of the dermal-epidermal membrane zone, and highlights recent research studies that have identified structural and functional roles of these components in the context of various blistering, neoplastic, and developmental syndromes.
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Affiliation(s)
- Myung S Ko
- Program in Epithelial Biology, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA 94305, USA
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South AP, O'Toole EA. Understanding the pathogenesis of recessive dystrophic epidermolysis bullosa squamous cell carcinoma. Dermatol Clin 2010; 28:171-8. [PMID: 19945632 DOI: 10.1016/j.det.2009.10.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patients with recessive dystrophic epidermolysis bullosa develop numerous life-threatening skin cancers. The reasons for this remain unclear. Parallels exist with other scarring skin conditions, such as Marjolin ulcer. We summarize observational and experimental data and discuss proposed theories for the development of such aggressive skin cancers. A context-driven situation seems to be emerging, but more focused research is required to elucidate the pathogenesis of epidermolysis bullosa-associated squamous cell carcinoma.
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Affiliation(s)
- Andrew P South
- Centre For Oncology and Molecular Medicine, Ninewell's Hospital and Medical School, Dundee, DD1 9SY, UK.
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Dammak A, Zribi J, Boudaya S, Mseddi M, Meziou TJ, Masmoudi A, Ellouze Z, Keskes H, Turki H. Squamous cell carcinoma complicating recessive dystrophic epidermolysis bullosa-Hallopeau-Siemens: a report of four cases. Int J Dermatol 2009; 48:588-91. [PMID: 19538366 DOI: 10.1111/j.1365-4632.2009.04006.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recessive dystrophic epidermolysis bullosa (RDEB), an autosomal-recessive genodermatosis, is one of the more severe forms of the epidermolysis bullosa dystrophica group, and is characterized by generalized blistering of the skin and mucous membranes. Cutaneous squamous cell carcinoma is one of the most serious complications of this disease. METHODS We report four patients (three females and one male), two of whom were under 20 years of age, suffering from RDEB-Hallopeau-Siemens. RESULTS All patients developed well-differentiated squamous cell carcinoma. No metastases were detected. All cases were treated surgically. Fatal evolution was noted in one patient. A second tumor was detected in another patient during the follow-up period. No further tumors or metastases were observed in the other patients. CONCLUSIONS Regular clinical and histologic examination of any nodular lesions or non healing ulcers of all patients suffering from RDEB-Hallopeau-Siemens to detect an early malignancy is recommended.
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Affiliation(s)
- Anis Dammak
- Dermatology Department, Hedi Chaker Hospital, Sfax, Tunisia.
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Martins VL, Vyas JJ, Chen M, Purdie K, Mein CA, South AP, Storey A, McGrath JA, O'Toole EA. Increased invasive behaviour in cutaneous squamous cell carcinoma with loss of basement-membrane type VII collagen. J Cell Sci 2009; 122:1788-99. [PMID: 19435799 DOI: 10.1242/jcs.042895] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Type VII collagen (ColVII) is the main component of anchoring fibrils, attachment structures within the lamina densa of the basement membrane that are responsible for attachment of the epidermis to the dermis in skin. Mutations in the human ColVII gene, COL7A1, cause the severe inherited blistering disorder recessive dystrophic epidermolysis bullosa (RDEB) affecting skin and mucosae, associated with a greatly increased risk of skin cancer. In this study, we examined the effect of loss of ColVII on squamous cell carcinoma (SCC) tumourigenesis using RNAi in a 3D organotypic skin model. Our findings suggest that loss of ColVII promotes SCC migration and invasion as well as regulating cell differentiation with evidence for concomitant promotion of epithelial-mesenchymal transition (EMT). Immunostaining of RDEB skin and a tissue array of sporadic cutaneous SCCs confirmed that loss of ColVII correlates with decreased involucrin expression in vivo. Gene-expression-array data and immunostaining demonstrated that loss of ColVII increases expression of the chemokine ligand-receptor CXCL10-CXCR3 and downstream-associated PLC signalling, which might contribute to the increased metastatic potential of SCCs with reduced or absent ColVII expression. Together, these findings may explain the aggressive behaviour of SCCs in RDEB patients and may also be relevant to non-RDEB skin cancer, as well as other tumours from organs where ColVII is expressed.
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Affiliation(s)
- Vera L Martins
- Centre for Cutaneous Research, Cancer Research UK Skin Tumour Laboratory, Institute of Cell and Molecular Science, William Harvey Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AT, UK
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Fine JD, Johnson LB, Weiner M, Li KP, Suchindran C. Epidermolysis bullosa and the risk of life-threatening cancers: the National EB Registry experience, 1986-2006. J Am Acad Dermatol 2008; 60:203-11. [PMID: 19026465 DOI: 10.1016/j.jaad.2008.09.035] [Citation(s) in RCA: 263] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 06/13/2008] [Accepted: 09/19/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Case series have demonstrated that potentially lethal cutaneous squamous cell carcinomas arise in patients with recessive dystrophic epidermolysis bullosa (RDEB), although the magnitude of this risk is undefined. METHODS Systematic case finding and data collection were performed throughout the continental United States (1986-2002) by the National EB Registry on 3280 EB patients to determine cumulative and conditional risks for squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and malignant melanoma (MM) within each major EB subtype, as well as the cumulative risk of death from each tumor. Study design was cross-sectional, with a nested randomly sampled longitudinal subcohort (N = 450). RESULTS SCCs arose primarily in RDEB, especially the Hallopeau-Siemens subtype (RDEB-HS), first beginning in adolescence. Less frequently, SCCs occurred in junctional EB (JEB). Cumulative risks rose steeply in RDEB-HS, from 7.5% by age 20 to 67.8%, 80.2%, and 90.1% by ages 35, 45, and 55, respectively. In Herlitz JEB, the risk was 18.2% by age 25. SCC deaths occurred only in RDEB, with cumulative risks in RDEB-HS of 38.7%, 70.0%, and 78.7% by ages 35, 45, and 55, respectively. MM arose in RDEB-HS, with a cumulative risk of 2.5% by age 12. BCCs arose almost exclusively in the most severe EB simplex subtype (Dowling-Meara) (cumulative risk = 43.6% by age 55). LIMITATIONS Mutational analyses were performed on only a minority of enrollees in the National EB Registry, preventing evaluation of the possible influence of specific genotypes on the risk of developing or dying from cutaneous SCCs. CONCLUSIONS SCC is the most serious complication of EB within adults, especially those with RDEB-HS. By mid-adulthood, nearly all will have had at least one SCC, and nearly 80% will have died of metastatic SCC despite aggressive surgical resection. When compared with SCCs arising within the normal population, the remarkably high risk of occurrence of and then death from SCCs among RDEB patients suggests likely differences in pathogenesis. Additional studies of EB-derived tumors and SCC cell lines may not only provide new insights into the mechanisms of carcinogenesis but also means whereby these particular tumors may be prevented or more effectively treated.
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Affiliation(s)
- Jo-David Fine
- National Epidermolysis Bullosa Registry, Nashville, Tennessee, USA.
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Rokunohe A, Nakano H, Aizu T, Kaneko T, Nakajima K, Ikenaga S, Matsuzaki Y, Murai T, Tamai K, Sawamura D. Significance of sentinel node biopsy in the management of squamous cell carcinoma arising from recessive dystrophic epidermolysis bullosa. J Dermatol 2008; 35:336-40. [PMID: 18578710 DOI: 10.1111/j.1346-8138.2008.00479.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The most life-threatening complication developing in patients with recessive dystrophic epidermolysis bullosa (RDEB) is squamous cell carcinoma (SCC). To improve patient prognosis, early detection of regional lymph node metastasis is required. Herein, we report a patient diagnosed with non-Hallopeau-Siemens RDEB who developed SCC on the left foot with inguinal lymph node swelling. Use of the sentinel node biopsy (SNB) technique favorably minimized defective damage to the inguinal region in this case. Genetic analysis identified one novel COL7A1 mutation, a maternal c.238G > C (p.A80P) and one previously reported mutation, a paternal c.3631C > T (p.Q1211X). A published work review demonstrated that no COL7A1 mutations specific for SCC development in RDEB have previously been identified. It remains unclear if SNB in combination with gene diagnosis is beneficial for the management of SCC in RDEB patients, however, because of the limited number of case reports. To address this issue, COL7A1 mutational analysis should be performed in as many cases of RDEB as possible.
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Affiliation(s)
- Akiko Rokunohe
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Chino T, Tamai K, Yamazaki T, Otsuru S, Kikuchi Y, Nimura K, Endo M, Nagai M, Uitto J, Kitajima Y, Kaneda Y. Bone marrow cell transfer into fetal circulation can ameliorate genetic skin diseases by providing fibroblasts to the skin and inducing immune tolerance. THE AMERICAN JOURNAL OF PATHOLOGY 2008; 173:803-14. [PMID: 18688022 DOI: 10.2353/ajpath.2008.070977] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Recent studies have shown that skin injury recruits bone marrow-derived fibroblasts (BMDFs) to the site of injury to accelerate tissue repair. However, whether uninjured skin can recruit BMDFs to maintain skin homeostasis remains uncertain. Here, we investigated the appearance of BMDFs in normal mouse skin after embryonic bone marrow cell transplantation (E-BMT) with green fluorescent protein-transgenic bone marrow cells (GFP-BMCs) via the vitelline vein, which traverses the uterine wall and is connected to the fetal circulation. At 12 weeks of age, mice treated with E-BMT were observed to have successful engraftment of GFP-BMCs in hematopoietic tissues accompanied by induction of immune tolerance against GFP. We then investigated BMDFs in the skin of the same mice without prior injury and found that a significant number of BMDFs, which generate matrix proteins both in vitro and in vivo, were recruited and maintained after birth. Next, we performed E-BMT in a dystrophic epidermolysis bullosa mouse model (col7a1(-/-)) lacking type VII collagen in the cutaneous basement membrane zone. E-BMT significantly ameliorated the severity of the dystrophic epidermolysis bullosa phenotype in neonatal mice. Type VII collagen was deposited primarily in the follicular basement membrane zone in the vicinity of the BMDFs. Thus, gene therapy using E-BMT into the fetal circulation may offer a potential treatment option to ameliorate genetic skin diseases that are characterized by fibroblast dysfunction through the introduction of immune-tolerated BMDFs.
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Affiliation(s)
- Takenao Chino
- Division of Gene Therapy Science, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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Rodeck U, Uitto J. Recessive dystrophic epidermolysis bullosa-associated squamous-cell carcinoma: an enigmatic entity with complex pathogenesis. J Invest Dermatol 2007; 127:2295-6. [PMID: 17853916 DOI: 10.1038/sj.jid.5700939] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Expression of either collagen VII or the noncollagenous (NC1) fragment derived from it has been suggested to be indispensable for the development of squamous-cell carcinomas (SCCs) in patients affected by recessive dystrophic epidermolysis bullosa (RDEB). This view is challenged here by the observation that SCCs do develop in RDEB patients lacking expression of collagen VII altogether. The aggressive behavior of RDEB-associated SCCs remains unexplained.
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Affiliation(s)
- Ulrich Rodeck
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College, and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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Kirsner RS, Hu S. Recessive Dystrophic Epidermolysis Bullosa and Squamous-Cell Carcinoma: the Role of Type VII Collagen. J Invest Dermatol 2007. [DOI: 10.1038/sj.jid.5701086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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