1
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An İ. Cutaneous findings and treatment responses of lipoid proteinosis patients. Int J Dermatol 2024. [PMID: 38876475 DOI: 10.1111/ijd.17331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVES Lipoid proteinosis (LP) is a rare autosomal recessive disorder characterized by the accumulation of hyaline-like material in the skin, oral mucosa, larynx, and brain. This study aimed to evaluate the dermatological findings and treatment responses of patients diagnosed with LP. METHODS This retrospective study included 41 patients diagnosed with LP at our clinic between May 2018 and January 2023. The diagnosis of LP was established in 22 patients by detecting mutations in the ECM1 gene. In comparison, in 19 patients, it was based on typical clinical findings and histopathological examination of lesioned skin. Clinical and demographic data such as dermatological findings, treatments received, and responses to treatment were recorded from patient files. RESULTS All patients exhibited skin thickening and acneiform scars. The most commonly observed additional dermatological findings were moniliform blepharosis (60.9%), varioliform scars (29.2%), waxy papules and plaques (24.3%), and blisters with crusts (19.5%). Verrucous lesions, diffuse yellow plaques, and scarring alopecia were observed in adult patients, while hypopigmented lesions and blisters with crusts were seen in the pediatric age group. The most frequently used treatments were acitretin (14.6%) and systemic steroids (9.7%). No improvement in skin lesions was observed in patients treated with acitretin, whereas complete resolution of blisters with crusts was noted in patients treated with systemic steroids. CONCLUSIONS In addition to the existing literature on dermatological manifestations of LP, hypopigmented lesions and atrophoderma vermiculatum-like lesions can also be observed in these patients. We believe that short-term systemic steroid therapy for vesiculobullous lesions can be considered for treatment. We think prospective studies with more patients and requiring long-term follow-up are needed regarding the effectiveness of acitretin treatment.
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Affiliation(s)
- İsa An
- Department of Dermatology, Şanlıurfa Training and Research Hospital, Şanlıurfa, Turkey
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2
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Taşdelen E, Sezer A, An I. A founder deletion in ECM1 of 1163 bp causes lipoid proteinosis in the southeast region of Turkiye. Am J Med Genet A 2024:e63782. [PMID: 38842389 DOI: 10.1002/ajmg.a.63782] [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: 03/14/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/07/2024]
Abstract
Lipoid proteinosis (LP) is an inherited disorder characterized by the accumulation of hyaline-like material in the skin, oral cavity, and larynx. The primary symptoms include hoarseness, restricted tongue movements, and various skin lesions. LP is caused by biallelic pathogenic variants in the ECM1 gene. We studied 20 patients from nine different families with LP, 19 of whom are from Şanlıurfa in the southeastern region of Turkiye. Overall, the clinical features of the patient cohort were consistent with those mentioned in the literature, except for one exhibited an atrophoderma vermiculatum-like lesion, which is atypical for LP. The clinical exome sequencing analysis revealed three different homozygous variants in the ECM1 gene (NM_004425). While c.1246C>T p.(Arg416*) on Exon 8 and c.806G>A p.(Cys269Tyr) on Exon 7 were detected in 1 patient each, an intragenic deletion of 1163 base-pairs including Exons 9 and 10 (c.1304 + 33_*300del) was identified in 18 patients from 7 unrelated families. The haplotype analysis of the deletion variant indicated a founder effect in the families from the Şanlıurfa province of Turkiye. Based on all this information, copy number variation analysis is recommended for patients with LP. In addition to this rare observation, this study represents the largest examination of the molecular spectrum of LP patients in Turkiye, alongside the clinical spectrum.
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Affiliation(s)
- Elifcan Taşdelen
- Department of Medical Genetics, Ankara Etlik City Hospital, Ankara, Turkey
- Department of Medical Genetics, Sanliurfa Education and Research Hospital, Sanliurfa, Turkey
| | - Abdullah Sezer
- Department of Medical Genetics, Ankara Etlik City Hospital, Ankara, Turkey
| | - Isa An
- Department of Dermatology, Sanliurfa Education and Research Hospital, Sanliurfa, Turkey
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3
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Cocchi C, Milanese A, Abdul-Messie L, Vestri AR, Longo L. Laryngeal features in Lipoid proteinosis: a systematic review and meta-analysis of individual participant data. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08713-x. [PMID: 38713291 DOI: 10.1007/s00405-024-08713-x] [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: 02/23/2024] [Accepted: 04/29/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Lipoid proteinosis (LP) or Urbach-Wiethe disease (OMIM 247100) is a rare syndrome characterised by early vocal folds infiltration and subsequent multi-organ involvement. LP is often unrecognised and its associated hoarseness is overlooked. The main objective of the study was to investigate hoarseness in LP and implement a diagnosis among otolaryngologists. METHODS PubMed/MEDLINE and OMIM databases were systematically searched. Authors concentrated the search on published articles starting from the discovery of the pathogenesis of LP by Hamada et al. in 2002. Only cases in which a diagnosis was reported both clinically and through biopsy and/or genetic molecular testing were included. Characteristics of the LP cases were extracted from each included study. Results were obtained through Generalized Estimating Equations. RESULTS The search strategy yielded 217 articles, of which 74 (34.1%) met the selection criteria. A total of 154 cases were included. Hoarseness was described in all LP cases and clearly stated as the onset symptom in 68.8%. The onset was on average at 19 months of age (CI: 3.00-20.00), while the mean age at diagnosis was 15 years (CI: 10.00-30.00). Therefore, the diagnostic delay amounted to 13.42 years (CI: 8.00-23.83). Hoarseness alone was responsible for an LP diagnosis in only 14.3% of cases. In 43.5% of cases, genetic analysis of the ECM1 gene was performed and exon 6 was the most frequently altered portion. CONCLUSION Analysing the largest number of published cases, the study underlined that hoarseness is the key symptom for diagnosing LP since early childhood, though frequently overlooked.
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Affiliation(s)
- Chiara Cocchi
- Department of Sense Organs, Sapienza University of Rome, 00185, Rome, Italy.
- Otorhinolaryngology Unit, Hesperia Hospital, 41125, Modena, Italy.
| | - Alberto Milanese
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy
| | | | - Anna Rita Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185, Rome, Italy
| | - Lucia Longo
- Department of Sense Organs, Sapienza University of Rome, 00185, Rome, Italy
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4
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Kimpo J, Abu-Ghanem S, Chen L. New onset dyspnea and stridor in an adolescent with Urbach-Wiethe disease. Pediatr Pulmonol 2024. [PMID: 38265163 DOI: 10.1002/ppul.26868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/18/2023] [Accepted: 01/01/2024] [Indexed: 01/25/2024]
Affiliation(s)
- James Kimpo
- Department of Pediatrics, Maimonides Children's Hospital, Brooklyn, New York, USA
| | - Sara Abu-Ghanem
- Division of Otolaryngology, Maimonides Health, Brooklyn, New York, USA
| | - Linda Chen
- Department of Pediatrics, Maimonides Children's Hospital, Brooklyn, New York, USA
- Division of Pediatric Pulmonary, Maimonides Children's Hospital, Brooklyn, New York, USA
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5
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Costa MDC, Aguiar EMG, Pascoaloti MIM, Dos Santos Campos CC, Sperandio FF, Gallottini M, de Castro ROM, de Carli ML. Multiple oral submucosal nodules in a young adult. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:397-403. [PMID: 37076379 DOI: 10.1016/j.oooo.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 04/21/2023]
Affiliation(s)
| | | | - Maria Inês Mantuani Pascoaloti
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Renato Ortolani Marcondes de Castro
- School of Medicine, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil; School of Medicine, Universidade Professor Edson Antônio Velano-UNIFENAS, Alfenas, Minas Gerais, Brazil
| | - Marina Lara de Carli
- School of Dentistry, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil.
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6
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Xu M, Zhou J, Yan J, Wang J. Identification of a Novel Mutation of Extracellular Matrix Protein 1 Gene in a Chinese Family with Lipoid Proteinosis. Clin Cosmet Investig Dermatol 2023; 16:1515-1519. [PMID: 37337569 PMCID: PMC10277017 DOI: 10.2147/ccid.s415682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
Lipoid proteinosis (LP) is a rare autosomal recessive disorder caused by mutations in extracellular matrix protein 1 (ECM1), a glycoprotein expressed in skin. Whole-exome sequencing (WES) was used to investigate two Chinese siblings with suggestive clinical features of LP. They shared one known (c.960G>A) and one novel (c.1081G>T) pathogenic variant in ECM1 gene, inherited from their unaffected parents. The novel mutation (c.1081G>T) led to a termination codon at position 361 and caused nonsense-mediated mRNA decay and lost the function. Our finding expands the genetic etiology spectrum of LP.
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Affiliation(s)
- Mengjun Xu
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Jiong Zhou
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Jianliang Yan
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Jianyou Wang
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
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7
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Alrusayyis DF, Alaraifi AK, Alhumaid S, Khan AL, Elkrim M. Late presentation of laryngeal lipoid proteinosis: a case report and review of the literature. J Surg Case Rep 2022; 2022:rjac360. [PMID: 35999820 PMCID: PMC9392577 DOI: 10.1093/jscr/rjac360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Abstract
Lipoid proteinosis (LP) is a rare autosomal-recessive disease characterized by the deposition of hyaline material infiltrating multiple body organs, including the larynx. The possible clinical presentations are wide-ranging. Laryngeal involvement results in dysphonia that is noted at birth or infantile years. The diagnosis is based on histological findings, and the management options vary depending on the severity of the symptoms. In this paper, we report an unusual case of LP with laryngeal involvement in an adult patient, along with a review of current literature.
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Affiliation(s)
- Danah F Alrusayyis
- College of Medicine, Imam Abdulrahman Bin Faisal University , Dammam , Saudi Arabia
| | - Abdulaziz K Alaraifi
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs , Riyadh , Saudi Arabia
| | - Salwa Alhumaid
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs , Riyadh , Saudi Arabia
| | - Abdul Latif Khan
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs , Riyadh , Saudi Arabia
| | - Mohammed Elkrim
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs , Riyadh , Saudi Arabia
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8
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Natella F, Guantario B, Ambra R, Ranaldi G, Intorre F, Burki C, Canali R. Human Metabolites of Hamaforton™ ( Hamamelis virginiana L. Extract) Modulates Fibroblast Extracellular Matrix Components in Response to UV-A Irradiation. Front Pharmacol 2022; 12:747638. [PMID: 34975471 PMCID: PMC8719534 DOI: 10.3389/fphar.2021.747638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022] Open
Abstract
Hamamelis virginiana L. a rich source of both condensed and hydrolyzable tannins, utilized to treat dermatological disorders. Since no experimental and clinical data is available for its use as oral formulation in skin related disorders, the purpose of this study was to investigate the effects of Hamaforton™ (Hamamelis virginiana extract) metabolites on gene dysregulation induced by ultraviolet A radiation in cultured human dermal fibroblasts. A combination of in vivo and ex vivo experimental designs has been exploited in order to take into account the polyphenol metabolic transformation that occurs in humans. 12 healthy volunteers received either a capsule of Hamaforton™ or a placebo in a randomized, blinded crossover trial. After Hamaforton™ ingestion, the kinetic of appearance of galloyl derivatives was measured in plasma. Then, in the ex vivo experiment, the serum isolated after supplementation was used as a source of Hamaforton™ metabolites to enrich the culture medium of dermal fibroblasts exposed to ultraviolet A radiation. Three different gallic acid metabolites (4-O-methyl gallic acid, 4-O-methyl gallic acid sulphate and trimethyl gallic acid glucuronide) were identified in volunteer plasma. While, ultraviolet A irradiation of dermal fibroblasts affected the expression of extracellular matrix genes, the presence of Hamaforton™ metabolites in the culture media did not affect the expression of most of those genes. However, the activation of the expression of 10 different genes involved in repair processes for the maintenance of skin integrity, suggest that the metabolites can play a role in damage recovery. To our knowledge, this is the first study that demonstrates the bioavailability of Hamaforton™ phenolic compounds, and the effects of its metabolites on cultured dermal fibroblast response to ultraviolet A irradiation.
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Affiliation(s)
- Fausta Natella
- Research Centre for Food and Nutrition, CREA-Consiglio per la Ricerca in Agricoltura e l'Analisi dell'Economia Agraria, Rome, Italy
| | - Barbara Guantario
- Research Centre for Food and Nutrition, CREA-Consiglio per la Ricerca in Agricoltura e l'Analisi dell'Economia Agraria, Rome, Italy
| | - Roberto Ambra
- Research Centre for Food and Nutrition, CREA-Consiglio per la Ricerca in Agricoltura e l'Analisi dell'Economia Agraria, Rome, Italy
| | - Giulia Ranaldi
- Research Centre for Food and Nutrition, CREA-Consiglio per la Ricerca in Agricoltura e l'Analisi dell'Economia Agraria, Rome, Italy
| | - Federica Intorre
- Research Centre for Food and Nutrition, CREA-Consiglio per la Ricerca in Agricoltura e l'Analisi dell'Economia Agraria, Rome, Italy
| | | | - Raffaella Canali
- Research Centre for Food and Nutrition, CREA-Consiglio per la Ricerca in Agricoltura e l'Analisi dell'Economia Agraria, Rome, Italy
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9
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Song J, Bustillo J, Meledathu S. An Unusual Pigmented Plaque in a Newborn. Pediatr Rev 2021; 42:122-126. [PMID: 34470891 DOI: 10.1542/pir.2018-0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jena Song
- Department of Internal Medicine and Pediatrics, Newark Beth Israel Medical Center and Children's of New Jersey, Newark, NJ
| | - Jose Bustillo
- Department of Internal Medicine and Pediatrics, Newark Beth Israel Medical Center and Children's of New Jersey, Newark, NJ
| | - Sherin Meledathu
- Department of Internal Medicine and Pediatrics, Newark Beth Israel Medical Center and Children's of New Jersey, Newark, NJ
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10
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Yilmaz K, An I, Sahin S, Sahutoglu T. Are the kidneys involved in lipoid proteinosis? Study of 22 patients. Int J Clin Pract 2021; 75:e14329. [PMID: 33999483 DOI: 10.1111/ijcp.14329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022] Open
Abstract
AIM Lipoid proteinosis (LP) is a systemic, progressive, rare genodermatosis that manifests in early life with mucocutaneous lesions. Kidney involvement has not been described before, hence we aimed to investigate kidney findings in LP patients. MATERIALS AND METHODS In this cross-sectional study, LP patients who were followed up and diagnosed with clinical, histopathological and radiological findings in the Dermatology outpatient clinic were invited to the Pediatric Nephrology Clinic. Biochemical, spot urine and 24-hour urine collection tests and ultrasound scans were scanned for the functional and anatomical status of the kidneys. Healthy controls who visited the Pediatric Nephrology Clinic during study periods for other reasons were invited to participate as the control group. RESULTS Data of 44 participants (22 LP patients, mean age 14.5 years and 22 healthy controls, mean age 14.3 years) were available for the analysis. Ultrasound scans revealed simple renal cysts in 68% of LP patients. The cysts were bilateral in 4 patients, while no cyst was detected in healthy controls. Biochemical parameters, proteinuria, and albuminuria were all within the normal reference range in both LP patients and healthy controls, whereas LP patients had statistically significant lower serum albumin and higher C-reactive protein levels than healthy controls. CONCLUSION Multiple simple renal cysts were detected in the majority of LP patients, and this finding could be part of the systemic involvement of the disease. Renal functions and biochemical parameters were within the normal reference range, but low serum albumin and high C-reactive protein levels in LP patients may be the signs of elevated systemic inflammation. Although more studies are needed to better define these findings, the presence of many simple renal cysts in LP patients was found to be the most important finding of this study.
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Affiliation(s)
- Kenan Yilmaz
- Department of Pediatric Nephrology, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Isa An
- Department of Dermatology, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Suleyman Sahin
- Department of Pediatric Urology, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Tuncay Sahutoglu
- Department of Nephrology, Mehmet Akif Inan Training and Research Hospital, Sanlıurfa, Turkey
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11
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Hulsman AM, Terburg D, Roelofs K, Klumpers F. Roles of the bed nucleus of the stria terminalis and amygdala in fear reactions. HANDBOOK OF CLINICAL NEUROLOGY 2021; 179:419-432. [PMID: 34225979 DOI: 10.1016/b978-0-12-819975-6.00027-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The bed nucleus of the stria terminalis (BNST) plays a critical modulatory role in driving fear responses. Part of the so-called extended amygdala, this region shares many functions and connections with the substantially more investigated amygdala proper. In this chapter, we review contributions of the BNST and amygdala to subjective, behavioral, and physiological aspects of fear. Despite the fact that both regions are together involved in each of these aspects of fear, they appear complimentary in their contributions. Specifically, the basolateral amygdala (BLA), through its connections to sensory and orbitofrontal regions, is ideally poised for fast learning and controlling fear reactions in a variety of situations. The central amygdala (CeA) relies on BLA input and is particularly important for adjusting physiological and behavioral responses under acute threat. In contrast, the BNST may profit from more extensive striatal and dorsomedial prefrontal connections to drive anticipatory responses under more ambiguous conditions that allow more time for planning. Thus current evidence suggests that the BNST is ideally suited to play a critical role responding to distant or ambiguous threats and could thereby facilitate goal-directed defensive action.
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Affiliation(s)
- Anneloes M Hulsman
- Experimental Psychopathology & Treatment, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; Affective Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - David Terburg
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Karin Roelofs
- Experimental Psychopathology & Treatment, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; Affective Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Floris Klumpers
- Experimental Psychopathology & Treatment, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; Affective Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands.
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12
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Yukkaldıran A, An İ, Erdoğan O. Evaluation of cochlear involvement and hearing function in lipoid proteinosis patients. J Cosmet Dermatol 2020; 20:2259-2263. [PMID: 33174327 DOI: 10.1111/jocd.13839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/29/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lipoid proteinosis (LP) is a rare genodermatosis involving amorphous hyaline accumulation in the skin, oral mucosa, larynx, mucous membranes, and viscera. AIMS In this study, we aimed to investigate the effects of hyaline accumulation on cochlear function and hearing in LP patients. PATIENTS/METHODS In this prospective study, 20 patients who were followed up with a diagnosis of LP between October 2016 and April 2020 in our clinic and 20 healthy individuals of the same age and gender, as a control group, were included. Pure-tone audiometry, tympanometry, and distortion-product otoacoustic emission tests of the patient and control groups were performed. The audiological results of the LP and control groups were compared statistically. RESULTS In the comparison of air-conduction thresholds between groups in pure-tone audiometry, hearing thresholds in the patient group were found to be higher than the control group at frequencies of 250, 4000, 6000, and 8000 Hz for the right ear, and 500 and 4000 Hz for the left ear. In the comparison of signal-noise responses between groups in distortion-product otoacoustic emission (DP-OAE) test, signal-noise responses in the right and left ear at frequencies of 1000, 2000, 4000, and 6000 Hz were lower in the patient group than in the control group. CONCLUSION We found that the cochlear functions of patients with LP were affected due to the increase in hearing thresholds and decreased signal-noise responses. We think that LP patients are candidates for hearing loss in their later life.
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Affiliation(s)
- Ahmet Yukkaldıran
- Department of Otorhinolaryngology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - İsa An
- Department of Dermatology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Osman Erdoğan
- Department of Otorhinolaryngology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
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13
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Agarwal P, Jagati A, Vadher P, Chaudhari M. Lipoid Proteinosis: Curious Case of Two Siblings! Indian Dermatol Online J 2020; 11:639-640. [PMID: 32832462 PMCID: PMC7413457 DOI: 10.4103/idoj.idoj_611_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/17/2020] [Accepted: 04/17/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Pooja Agarwal
- Smt SCL General Hospital, Saraspur, Ahmedabad, Gujarat, India
| | - Ashish Jagati
- Smt SCL General Hospital, Saraspur, Ahmedabad, Gujarat, India
| | - Priyanka Vadher
- Post Graduate Resident, Smt SCL General Hospital, Ahmedabad, Gujarat, India
| | - Malay Chaudhari
- Smt SCL General Hospital, Saraspur, Ahmedabad, Gujarat, India
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14
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Lourenço AG, Araújo VC, Passador-Santos F, Sperandio M, Neville BW, Dorta RG. Lipoid Proteinosis: A Rare Disease In Pediatric Dentistry. Braz Dent J 2020; 31:186-189. [PMID: 32556019 DOI: 10.1590/0103-6440202003054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 11/27/2019] [Indexed: 11/22/2022] Open
Abstract
This report describes the diagnostic process of a rare disorder in a Brazilian female child. The patient presented initially as a 7-year-old with multiple whitish submucosal nodules of a fibrous consistency in the lower lip, but with an inconclusive pathology report. When she turned 9 years of age, she presented with exacerbation of the original clinical findings, which then involved the upper lip, buccal mucosa, tongue and lingual frenulum. In addition, dermatological lesions were noted on the child's limbs and face, as well as a hoarse voice. Histopathological examination of the buccal mucosa revealed dense connective tissue with hyaline foci, which were positive with periodic acid-Schiff (PAS) staining and resistant to diastase digestion. Clinical and histopathological findings led to the diagnosis of a rare genetic disease with fewer than 300 reported cases - lipoid proteinosis. Magnetic resonance imaging revealed calcium deposits in her amygdaloid region of the brain, and nasopharyngolaryngoscopy revealed lesions in her vocal cords. The patient currently is stable and under multidisciplinary follow-up, but no treatment has been recommended to date.
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Affiliation(s)
- Alan Grupioni Lourenço
- Department of Basic and Oral Biology, School of Dentistry of Ribeirão Preto, Ribeirão Preto, SP, Brazil.,Department of Oral Pathology, São Leopoldo Mandic, Campinas, SP, Brazil
| | | | | | - Marcelo Sperandio
- Department of Oral Pathology, São Leopoldo Mandic, Campinas, SP, Brazil
| | - Brad Wesley Neville
- Division of Oral Pathology, Department of Stomatology, Medical University of South Carolina, Charleston, SC, USA
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15
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Ghazawi FM, Proulx ESC, Jafarian F. A novel nonsense mutation in exon 9 in the extracellular matrix protein 1 gene associated with lipoid proteinosis: A case report. SAGE Open Med Case Rep 2019; 7:2050313X19850359. [PMID: 31205714 PMCID: PMC6537054 DOI: 10.1177/2050313x19850359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lipoid proteinosis is a rare autosomal recessive genodermatosis that is caused by
loss-of-function mutations in the extracellular matrix protein 1 gene. This
study identifies a novel nonsense mutation in exon 9 of the extracellular matrix
protein 1 gene associated with lipoid proteinosis, contributing to recent
advances in our understanding of the molecular genetics underlying this disease.
It is important to identify the mutations in the extracellular matrix protein 1
gene that are associated with lipoid proteinosis and how these affect protein
function. Understanding the molecular basis for such genetic disorders may lead
to novel therapeutic approaches for treating hereditary genodermatoses.
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Affiliation(s)
- Feras M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, ON, Canada
| | - Etienne Saint-Cyr Proulx
- Hôpital de la Cité-de-la-Santé, Laval, QC, Canada.,Innovaderm Research Inc., Montreal, QC, Canada
| | - Fatemeh Jafarian
- Division of Pediatric Dermatology, McGill University Health Center, Montreal Children's Hospital, Montreal, QC, Canada
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Lipoid Proteinosis: A Rare Cause of Hoarseness. J Voice 2019; 33:155-158. [DOI: 10.1016/j.jvoice.2017.05.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/25/2017] [Accepted: 05/26/2017] [Indexed: 11/22/2022]
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Terburg D, Scheggia D, Triana Del Rio R, Klumpers F, Ciobanu AC, Morgan B, Montoya ER, Bos PA, Giobellina G, van den Burg EH, de Gelder B, Stein DJ, Stoop R, van Honk J. The Basolateral Amygdala Is Essential for Rapid Escape: A Human and Rodent Study. Cell 2018; 175:723-735.e16. [PMID: 30340041 PMCID: PMC6198024 DOI: 10.1016/j.cell.2018.09.028] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/30/2018] [Accepted: 09/14/2018] [Indexed: 11/02/2022]
Abstract
Rodent research delineates how the basolateral amygdala (BLA) and central amygdala (CeA) control defensive behaviors, but translation of these findings to humans is needed. Here, we compare humans with natural-selective bilateral BLA lesions to rats with a chemogenetically silenced BLA. We find, across species, an essential role for the BLA in the selection of active escape over passive freezing during exposure to imminent yet escapable threat (Timm). In response to Timm, BLA-damaged humans showed increased startle potentiation and BLA-silenced rats demonstrated increased startle potentiation, freezing, and reduced escape behavior as compared to controls. Neuroimaging in humans suggested that the BLA reduces passive defensive responses by inhibiting the brainstem via the CeA. Indeed, Timm conditioning potentiated BLA projections onto an inhibitory CeA pathway, and pharmacological activation of this pathway rescued deficient Timm responses in BLA-silenced rats. Our data reveal how the BLA, via the CeA, adaptively regulates escape behavior from imminent threat and that this mechanism is evolutionary conserved across rodents and humans.
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Affiliation(s)
- David Terburg
- Department of Psychology, Utrecht University, Utrecht, the Netherlands; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Diego Scheggia
- Center for Psychiatric Neuroscience, Lausanne University and University Hospital Center, Lausanne, Switzerland
| | - Rodrigo Triana Del Rio
- Center for Psychiatric Neuroscience, Lausanne University and University Hospital Center, Lausanne, Switzerland
| | - Floris Klumpers
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Alexandru Cristian Ciobanu
- Center for Psychiatric Neuroscience, Lausanne University and University Hospital Center, Lausanne, Switzerland
| | - Barak Morgan
- Global Risk Governance Program, Institute for Safety Governance and Criminology, Law Faculty, University of Cape Town, Cape Town, South Africa
| | | | - Peter A Bos
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
| | - Gion Giobellina
- Center for Psychiatric Neuroscience, Lausanne University and University Hospital Center, Lausanne, Switzerland
| | - Erwin H van den Burg
- Center for Psychiatric Neuroscience, Lausanne University and University Hospital Center, Lausanne, Switzerland
| | - Beatrice de Gelder
- Department of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Ron Stoop
- Center for Psychiatric Neuroscience, Lausanne University and University Hospital Center, Lausanne, Switzerland.
| | - Jack van Honk
- Department of Psychology, Utrecht University, Utrecht, the Netherlands; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
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Krause A, Seymour H, Ramsay M. Common and Founder Mutations for Monogenic Traits in Sub-Saharan African Populations. Annu Rev Genomics Hum Genet 2018; 19:149-175. [DOI: 10.1146/annurev-genom-083117-021256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review highlights molecular genetic studies of monogenic traits where common pathogenic mutations occur in black families from sub-Saharan Africa. Examples of founder mutations have been identified for oculocutaneous albinism, cystic fibrosis, Fanconi anemia, and Gaucher disease. Although there are few studies from Africa, some of the mutations traverse populations across the continent, and they are almost all different from the common mutations observed in non-African populations. Myotonic dystrophy is curiously absent among Africans, and nonsyndromic deafness does not arise from mutations in GJB2 and GJB7. Locus heterogeneity is present for Huntington disease, with two common triplet expansion loci in Africa, HTT and JPH3. These findings have important clinical consequences for diagnosis, treatment, and genetic counseling in affected families. We currently have just a glimpse of the molecular etiology of monogenic diseases in sub-Saharan Africa, a proverbial “ears of the hippo” situation.
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Affiliation(s)
- Amanda Krause
- Division of Human Genetics, National Health Laboratory Service, and Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Heather Seymour
- Division of Human Genetics, National Health Laboratory Service, and Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Michèle Ramsay
- Division of Human Genetics, National Health Laboratory Service, and Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Afshar B, Sadeghi A, Amani M, Ali Asgari A. Esophageal Aperistalsis in a Patient with Lipoid Proteinosis. Middle East J Dig Dis 2018; 10:55-58. [PMID: 29682250 PMCID: PMC5903930 DOI: 10.15171/mejdd.2017.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 10/12/2018] [Indexed: 11/12/2022] Open
Abstract
Lipoid proteinosis is a rare disorder with autosomal recessive inheritance, characterized
by progressive deposition of hyaline material in the skin, mucous membrane, and different
organs of the body, resulting in a multitude of clinical manifestations. A 34-year-old woman
presented with hoarseness, dysphagia, eyelid beeding, and acneiform scars on the facial skin
and extremities. The patient was diagnosed clinically as having lipoid proteinosis, which was
confirmed by laryngeal biopsy. The objective of the present report is to describe this rare entity.
This case report also illustrates that lipoid proteinosis may show protean clinical features and
yet may remain undiagnosed for many years.
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Affiliation(s)
- Behrooz Afshar
- Shahid Beheshti General Hospital, Department of Internal Medicine, Hamadan University of Medical Science, Hamadan, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amani
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ali Asgari
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Abdelmaksoud A. Lipoid proteinosis: towards predictive clinical clues. Clin Exp Dermatol 2017; 43:320-321. [PMID: 29214664 DOI: 10.1111/ced.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 11/28/2022]
Affiliation(s)
- A Abdelmaksoud
- Mansoura Dermatology, Venerology and Leprology Hospital, 5-Amien Alsamanoudy Street, from AbdelsalamAaref Street, Mansoura, Egypt
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Lipoid proteinosis: A clinical and molecular study in Egyptian patients. Gene 2017; 628:308-314. [PMID: 28720532 DOI: 10.1016/j.gene.2017.07.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/17/2017] [Accepted: 07/10/2017] [Indexed: 11/20/2022]
Abstract
Lipoid proteinosis (LP) is an autosomal recessive disorder caused by the loss of function of ECM1 gene. Clinical features include varying degrees of skin thickening, hoarseness of voice and less frequently neuropsychiatric abnormalities. Twelve patients from ten unrelated families with a clinical diagnosis of lipoid proteinosis were enrolled in this study. Extraction of DNA samples of the 12 patients and their parents from peripheral blood by standard methods was performed. Polymerase chain reaction (PCR) amplification of the ECM1 gene was conducted using eight pairs of primers spanning over the 10 exons and splice junctions. Patients exhibited a variety of clinical manifestations with skin affection and hoarseness of voice being the consistent feature. We identified five novel homozygous insertion, small deletion, missense, and splice site mutations as well as two homozygous previously published splice site mutation c.70+1G>C in intron 1 and c.1305-2A>G in intron 8. The specific mutations were: c.10_11insC in exon 1, c.690_691delAG in exon 6, c.734G>A in exon 7, c.1286_1287delAA in exon 8 and c.1393-1G>T in intron 9. The novel mutations c.1393-1G>T and c.10_11insC occurred in three (30%) and two (20%) unrelated patients of the studied families, respectively. Further studies may designate an increased frequency of these mutations among Egyptian LP patients. Identification of pathogenic ECM1 mutations is important for accurate diagnosis and proper genetic counseling.
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Izadi F, Mahjoubi F, Farhadi M, Kalayinia S, Bidmeshkipour A, Tavakoli MM, Samanian S. Extracellular matrix protein 1 gene (ECM1) mutations in nine Iranian families with lipoid proteinosis. Indian J Med Res 2017; 143:303-7. [PMID: 27241643 PMCID: PMC4892076 DOI: 10.4103/0971-5916.182620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background & objectives: Lipoid proteinosis (LP) is an autosomal recessive disease. Clinical characteristics of this disease are hoarse voice, scarring of the skin, brain calcifications, and eyelid papules (moniliform blepharosis). Mutations in the ECM1 gene on 1q21.2 are responsible for this disease. This study was conducted to investigate the mutation spectrum of ECM1 gene in nine Iranian families having at least one LP patient diagnosed clinically. Methods: The entire ECM1 gene was screened using PCR and direct sequencing in nine Iranian families with 12 suspected LP patients who were referred to the clinic, along with their parents and siblings. Thirty healthy individuals were included as controls. Results: In only one patient a homozygous G>A transition at nucleotide c.806 in exon 7 was detected. A G>A substitution at nucleotide 1243 in exon 8 that changes glycine (GGT) to serine (AGT) was observed in most of our patients. Furthermore, in one patient there was a change in the sequence of intron 8, the A>T transition in nucleotide 4307. In addition, in two cases (one patient and one healthy mother with affected child) there was a C (4249) deletion in intron 8. Interpretation & conclusions: Our results indicate that although mutation in ECM1gene is responsible for lipoid proteinosis, it is likely that this is not the only gene causing this disease and probably other genes may be involved in the pathogenesis of the LP disease.
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Affiliation(s)
- Farzad Izadi
- ENT & HNS Research Center, Hazart Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Frouzandeh Mahjoubi
- Medical Biotechnology Institute, National Institute of Genetic Engineering & Biotechnology (NIGEB), Tehran, Iran
| | - Mohammad Farhadi
- Department & Research Center of Otolaryngology Head & Neck Surgery, Hazrat Rasool Hospital, Tehran University of Medical Sciences & Health Care Services, Tehran, Iran
| | | | | | - Mohammad Moein Tavakoli
- Department & Research Center of Otolaryngology Head & Neck Surgery, Hazrat Rasool Hospital, Tehran University of Medical Sciences & Health Care Services, Tehran, Iran
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Lipoidoproteinosis o enfermedad de Urbach-Wiethe: a propósito de un nuevo caso con afectación cerebral. Neurologia 2017; 32:125-127. [DOI: 10.1016/j.nrl.2015.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/22/2015] [Accepted: 04/08/2015] [Indexed: 11/18/2022] Open
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25
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Lipoid proteinosis or Urbach-Wiethe disease: description of a new case with cerebral involvement. NEUROLOGÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.nrleng.2015.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Frenkel B, Vered M, Taicher S, Yarom N. Lipoid proteinosis unveiled by oral mucosal lesions: a comprehensive analysis of 137 cases. Clin Oral Investig 2016; 21:2245-2251. [DOI: 10.1007/s00784-016-2017-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/22/2016] [Indexed: 11/29/2022]
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Koen N, Fourie J, Terburg D, Stoop R, Morgan B, Stein D, van Honk J. Translational neuroscience of basolateral amygdala lesions: Studies of urbach-wiethe disease. J Neurosci Res 2016; 94:504-12. [DOI: 10.1002/jnr.23731] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 11/12/2022]
Affiliation(s)
- N. Koen
- Department of Psychiatry and Mental Health; University of Cape Town; Cape Town South Africa
- Medical Research Council Unit on Anxiety and Stress Disorders; Stellenbosch South Africa
| | - J. Fourie
- Department of Psychiatry and Mental Health; University of Cape Town; Cape Town South Africa
| | - D. Terburg
- Department of Psychiatry and Mental Health; University of Cape Town; Cape Town South Africa
- Department of Psychology; Utrecht University; Utrecht The Netherlands
| | - R. Stoop
- Center for Psychiatric Neuroscience, Department of Psychiatry; Lausanne University and University Hospital; Lausanne Switzerland
| | - B. Morgan
- Department of Public Law; University of Cape Town; Cape Town South Africa
- DST-NRF Centre of Excellence in Human Development, DVC Research Office; University of Witwatersrand; Johannesburg South Africa
- Global Risk Governance Programme, Faculty of Law; University of Cape Town; Cape Town South Africa
| | - D.J. Stein
- Department of Psychiatry and Mental Health; University of Cape Town; Cape Town South Africa
- Medical Research Council Unit on Anxiety and Stress Disorders; Stellenbosch South Africa
| | - J. van Honk
- Department of Psychology; Utrecht University; Utrecht The Netherlands
- Institute of Infectious Disease and Molecular Medicine and Department of Psychiatry; University of Cape Town; Cape Town South Africa
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Rey LK, Kohlhase J, Möllenhoff K, Dekomien G, Epplen JT, Hoffjan S. A Novel ECM1 Splice Site Mutation in Lipoid Proteinosis: Case Report plus Review of the Literature. Mol Syndromol 2016; 7:26-31. [PMID: 27194970 DOI: 10.1159/000444615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 12/20/2022] Open
Abstract
Lipoid proteinosis (LP) is an autosomal recessive genodermatosis known to be caused by mutations in ECM1. Nonsense and missense mutations are the most common variations in LP. Up to date, only 6 splice site mutations have been observed. We report on a 26-year-old female LP patient from a Turkish consanguineous family carrying a novel homozygous splice site mutation in intron 8 of the ECM1 gene and summarize the current knowledge on ECM1 mutations and possible genotype-phenotype correlations.
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Affiliation(s)
- Linda K Rey
- Departments of Human Genetics, University Witten/Herdecke, Witten, Germany; Departments of Center for Rare Diseases Ruhr (CeSER), Bochum, Germany
| | | | - Katrin Möllenhoff
- Departments of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Germany; Departments of Center for Rare Diseases Ruhr (CeSER), Bochum, Germany
| | - Gabriele Dekomien
- Departments of Human Genetics, University Witten/Herdecke, Witten, Germany; Departments of Center for Rare Diseases Ruhr (CeSER), Bochum, Germany
| | - Jörg T Epplen
- Departments of Human Genetics, University Witten/Herdecke, Witten, Germany; Departments of Center for Rare Diseases Ruhr (CeSER), Bochum, Germany; Departments of Faculty of Health, University Witten/Herdecke, Witten, Germany
| | - Sabine Hoffjan
- Departments of Human Genetics, University Witten/Herdecke, Witten, Germany; Departments of Center for Rare Diseases Ruhr (CeSER), Bochum, Germany
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Luo XY, Li Q, Tan Q, Yang H, Xiang J, Miao JK, Wang H. Treatment of lipoid proteinosis with acitretin in two patients from two unrelated Chinese families with novel nonsense mutations of the ECM1 gene. J Dermatol 2016; 43:804-7. [PMID: 26778481 DOI: 10.1111/1346-8138.13261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 11/10/2015] [Indexed: 11/28/2022]
Abstract
Lipoid proteinosis is a rare recessive genetic disorder caused by loss-of-function mutations to chromosome 1 at 1q21, the extracellular matrix protein 1 (ECM1) gene. Two children with lipoid proteinosis were reported from two unrelated Chinese families, both manifesting with a typical hoarse voice, white acne-like atrophic lesions and scarring on the skin, and beaded papules around the eyelids. The diagnosis had been confirmed by laboratory tests, skin biopsy and laryngoscope examination. Genomic DNA sequencing was performed for both children and their family members. The two children were treated with acitretin for 6 months and followed up for 1 year. Genomic DNA sequencing of the ECM1 gene showed a novel homozygous nonsense mutation of C1522>T (p.R508X) at exon 10 in one patient, and a novel compound heterozygote for a nonsense/frame-shift combination of mutations of R281X/1596delG at exons 7 and 10 in the other patient. The symptom of hoarse voice was improved by 6-month treatment with acitretin, while there was no improvement in the skin lesions. These results demonstrated that acitretin treatment may have efficacy for some of patients with lipoid proteinosis, with superior effect on laryngeal symptoms than skin lesions. However, the conclusive therapeutic effect and underlying mechanisms remain to be further investigated.
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Affiliation(s)
- Xiao-Yan Luo
- Department of Dermatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
| | - Qiu Li
- Department of Dermatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
| | - Qi Tan
- Department of Dermatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
| | - Huan Yang
- Department of Dermatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
| | - Juan Xiang
- Department of Dermatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
| | - Jing-Kun Miao
- Department of Dermatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
| | - Hua Wang
- Department of Dermatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China
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Youssefian L, Vahidnezhad H, Daneshpazhooh M, Abdollahzadeh S, Talari H, Khoshnevisan A, Chams-Davatchi C, Mobasher R, Li Q, Uitto J, Akhondzadeh S, Tabrizi M. Lipoid proteinosis: phenotypic heterogeneity in Iranian families with c.507delT mutation in ECM1. Exp Dermatol 2014; 24:220-2. [PMID: 25529926 DOI: 10.1111/exd.12620] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 11/29/2022]
Abstract
Lipoid proteinosis (LP) is a rare autosomal recessive genodermatosis caused by loss-of-function mutations in the ECM1 gene, and previous studies have noted phenotypic variability. In this study, we examined 12 patients representing three Iranian families for clinical manifestations and genotyped them for mutations in ECM1. LP was diagnosed with characteristic mucocutaneous and neurologic manifestations. Five patients were also subjected to magnetic resonance imaging (MRI)/computed tomography (CT) scan of the central nervous system. DNA was isolated from peripheral blood from patients and their clinically unaffected relatives, and mutations in ECM1 were sought by PCR-based amplification of all exons and flanking intronic sequences, followed by bidirectional Sanger sequencing. Significant phenotypic variability in this multisystem disorder, including presence of convulsions and epilepsy in about half of the patients was noted. In most cases, this was associated with calcifications in the brain detected by MRI/CT scans. Genotyping of the affected individuals in three families from the central region of Iran revealed presence of homozygous c.507delT mutation in ECM1, reflecting the observed consanguinity in these families. This large cohort revealed extensive phenotypic variability in individuals with the same mutation in ECM1. This observation suggests a role for genetic and epigenetic as well as environmental modulation of the phenotype. Identification of mutations allows screening of unaffected individuals for presence or absence of this mutation in extended LP families, with implications for genetic counseling.
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Affiliation(s)
- Leila Youssefian
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Dermatology and Cutaneous Biology, The Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Gastrointestinal involvement in lipoid proteinosis: a ten-year follow-up of a brazilian female patient. Case Rep Med 2014; 2014:952038. [PMID: 25045357 PMCID: PMC4089944 DOI: 10.1155/2014/952038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 06/09/2014] [Indexed: 11/17/2022] Open
Abstract
Lipoid proteinosis is a rare autosomal recessive disease characterized by the deposition of hyaline material in the skin and internal organs. The main clinical features are hoarseness and typical skin lesions. In this report we describe the endoscopic and radiologic findings in a Brazilian female patient presenting extensive gastrointestinal involvement and the evolution of the detected lesions in ten years of follow-up. Initial upper endoscopy and colonoscopy showed a similar pattern of multiple yellowish nodules throughout the esophagus, stomach, duodenum, and colons. Histological analysis confirmed the diagnosis of lipoid proteinosis. In addition, small bowel follow through demonstrated numerous well defined, round, small filling defects throughout the jejunum. Ten years later, the esophageal lesions remained the same, but none of the previous alterations were detected in the stomach, duodenum, and colons. In conclusion, lipoid proteinosis may affect all gastrointestinal organs with the same pattern of macroscopic and microscopic lesions. Some lesions may regress with increasing age.
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Zhang R, Liu Y, Xue Y, Wang Y, Wang X, Shi S, Cai T, Wang Q. Treatment of lipoid proteinosis due to the p.C220G mutation in ECM1, a major allele in Chinese patients. J Transl Med 2014; 12:85. [PMID: 24708644 PMCID: PMC4021827 DOI: 10.1186/1479-5876-12-85] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 03/29/2014] [Indexed: 12/03/2022] Open
Abstract
Background Lipoid proteinosis (LP) is known to be resulted from mutations of the extracellular matrix protein 1 gene (ECM1). However, no effective or sustained therapeutic methods to alleviate LP symptoms have been reported. Methods Here, we report a 12-year-old boy with LP and recurrent anaphylaxis. The laboratory and histopathological investigations were adopted to confirm the diagnosis, and gene sequencing was performed. We treated this patient with glucocorticoid for three years to relieve the patient’s lipid metabolism disorder and symptoms related to LP and anaphylaxis. Results The Laboratory and histopathological investigations showed a lipid metabolism disorder and anaphylaxis in the patient. A homozygous missense mutation p.C220G of ECM1 was identified by Sanger sequencing, which is a major allele in Chinese patients with LP. Notably, after three years’ treatment, the symptoms such as skin lesions, stiff oral mucosa and hoarse voice in the patient were significantly relieved or recovered. Conclusions Our report may provide a potentially effective therapeutic approach for the first time to other LP patients who are experiencing recurrent anaphylaxis and/or chronic inflammation.
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Affiliation(s)
| | | | | | | | | | | | - Tao Cai
- State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, P,R, China.
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Bakry OA, Samaka RM, Houla NS, Basha MA. Two Egyptian cases of lipoid proteinosis successfully treated with acitretin. J Dermatol Case Rep 2014; 8:29-34. [PMID: 24748909 DOI: 10.3315/jdcr.2014.1168] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/18/2013] [Indexed: 01/17/2023]
Abstract
BACKGROUND Lipoid proteinosis (Urbach-Wiethe disease) is a rare progressive autosomal recessive disorder, characterized histologically by deposition of periodic acid Schiff-positive, diastase resistant, hyaline-like material into the skin, upper aerodigestive tract, and internal organs. MAIN OBSERVATION We report two cases of lipoid proteinosis. A 2-year-old girl presented with vesiculobullous skin lesions on her face, trunk, extremities and scalp, inability to protrude the tongue and hoarseness of voice that appeared few months after birth. The other case is a 4-year-old girl, who presented with waxy papules on face and trunk, hoarseness of voice and enlarged lips and tongue. The lesions healed leaving pitted scars in both cases. Based on clinical, histopathological and laryngoscopy findings, lipoid proteinosis was diagnosed in both cases. Acitretin was started in a dose of 0.5 mg/kg/day in every child. Complete remission of cutaneous lesions and improvement of the hoarseness was observed after one year. CONCLUSION Acitretin may be benificial for treatment of mucosal and cutaneous lesions in lipoid proteinosis.
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Affiliation(s)
- Ola Ahmed Bakry
- Department of Dermatology, Andrology and S.T.Ds, Faculty of Medicine, Menoufiya University, Shebin El Kom, Menoufiya, Egypt
| | - Rehab Monir Samaka
- Department of Pathology, Faculty of Medicine, Menoufiya University, Shebin El Kom, Menoufiya, Egypt
| | - Nanees Shawky Houla
- Department of Pathology, Faculty of Medicine, Menoufiya University, Shebin El Kom, Menoufiya, Egypt
| | - Mohamed Ahmed Basha
- Department of Dermatology, Andrology and S.T.Ds, Faculty of Medicine, Menoufiya University, Shebin El Kom, Menoufiya, Egypt
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Nasir M, Rahman SB, Sieber CMK, Mir A, Latif A, Ahmad N, Malik SA, Hameed A. Identification of recurrent c.742G>T nonsense mutation in ECM1 in Pakistani families suffering from lipoid proteinosis. Mol Biol Rep 2014; 41:2085-92. [PMID: 24413997 DOI: 10.1007/s11033-014-3057-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 01/04/2014] [Indexed: 11/28/2022]
Abstract
Lipoid proteinosis (LP) is one of the rare, recessive autosomal disorders clinically characterized by widespread deposition of hyaline-like material in the skin, mucosa and viscera. Classical features include beaded eyelid papules, laryngeal infiltration and hoarseness of voice caused by pathogenic mutations in the ECM1 gene located on 1q21.2. In present study ethnically different, three consanguineous Pakistani families with typical cutaneous features of LP were analysed to investigate the underlying molecular basis. PCR based linkage analysis using microsatellite markers localized the families to locus 1q21.2, harboring ECM1 gene. To identify the mutation in the candidate gene (ECM1), Sanger sequencing was carried out. All the families were found to carry c.742 G>T nonsense mutation in exon 7 of the ECM1 gene that resulted in a truncated ECM1 protein containing 247 amino acids instead of 540 (p.E248X). To further investigate the impact and importance of mutation in LP pathogenesis we applied different bioinformatics tools. In silico studies has predicted lack of functional domains and 65 % shorter ECM1 mutant protein. It is the first report of recurrence mutation from Pakistan as c.742G>T nonsense mutation was found in three ethnically different Pakistani families with LP. Study strengthens the conclusion that c.742G>T mutation is the pathological cause of LP. Furthermore, data also support the fact that exon 7 is one of the most common hot spots of pathological mutations in ECM1. The absence of functional domains and truncated sequence most likely contribute to the lack of ECM1 function and thereby influence several aspects of dermal homeostasis that leads to LP pathogenesis.
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Affiliation(s)
- Muhammad Nasir
- Institute of Biomedical & Genetic Engineering, 24-Mauve Area, G-9/1, Islamabad, Pakistan,
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37
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Acitretin treatment for lipoid proteinosis. Case Rep Dermatol Med 2012; 2012:324506. [PMID: 23259080 PMCID: PMC3505959 DOI: 10.1155/2012/324506] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 07/10/2012] [Indexed: 11/25/2022] Open
Abstract
Lipoid proteinosis (LP) is a rare, autosomal-recessive disease characterized by the hoarseness and widespread cutaneous scarring, more prominent on sun-exposed areas. Yellow-white plaques can be seen on oral mucosa and on the skin among depressed scars. Histological evaluation of the affected sites shows accumulation of hyaline-like material in dermis and disruption of basement membrane. Although LP is compatible with normal life expectancy, involvement of upper respiratory tract may endanger patient's life, especially in the case of a respiratory tract infection. Involvement of central nervous system has also been reported, but its clinical importance is obscure. Due to the rarity of LP, a definite therapeutical approach is not established. In this paper we describe a 21-year-old LP patient who was treated with acitretin for six months. Although the outcome with cutaneous lesions was not satisfactory, her hoarseness was significantly improved.
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Izadi F, Mahjoubi F, Farhadi M, Tavakoli MM, Samanian S. A novel missense mutation in exon 7 of the ECM1 gene in an Iranian lipoid proteinosis patient. GENETICS AND MOLECULAR RESEARCH 2012; 11:3955-60. [PMID: 23212332 DOI: 10.4238/2012.november.14.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Lipoid proteinosis (LP) is a rare autosomal recessive disorder. Classical clinical features include warty skin infiltration, papules on the eyelids, skin scarring, as well as extracutaneous abnormalities such as hoarseness of the voice, epilepsy, and neuropsychiatric abnormalities. A defect in the ECM1 gene is responsible for this disease. A 21-year-old female patient from consanguineous parents (first cousins) was referred to our clinic with many symptoms of LP, such as hoarse voice from infancy, diffuse acneiform scars on her face, and hyperkeratosis on her knees and elbows. The entire ECM1 gene was screened using PCR and sequencing. A novel missense mutation was found in exon 7 of this patient. We report a novel missense mutation in exon 7 of the ECM1 gene found in an Iranian LP patient that causes a C269Y amino acid exchange.
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Affiliation(s)
- F Izadi
- ENT-Head and Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
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39
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Stephan F, Moutran R, Maatouk I, Sleilaty F, Abadjian G, Haddad A. Hyalinosis cutis et mucosae manifests in different features in two sisters. Int J Dermatol 2012; 52:843-5. [PMID: 22835157 DOI: 10.1111/j.1365-4632.2011.05266.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Farid Stephan
- Department of Dermatology, Hôtel-Dieu de France, Beirut, Lebanon
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40
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Salih MA, Abu-Amero KK, Alrasheed S, Alorainy IA, Liu L, McGrath JA, Van Maldergem L, Al-Faky YH, AlSuhaibani AH, Oystreck DT, Bosley TM. Molecular and neurological characterizations of three Saudi families with lipoid proteinosis. BMC MEDICAL GENETICS 2011; 12:31. [PMID: 21349189 PMCID: PMC3050790 DOI: 10.1186/1471-2350-12-31] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 02/24/2011] [Indexed: 01/14/2023]
Abstract
Background Lipoid proteinosis is a rare autosomal recessive disease characterized by cutaneous and mucosal lesions and hoarseness appearing in early childhood. It is caused by homozygous or compound heterozygous mutations in the ECM1 gene. The disease is largely uncharacterized in Arab population and the mutation(s) spectrum in the Arab population is largely unknown. We report the neurologic and neuroradiologic characteristics and ECM1 gene mutations of seven individuals with lipoid proteinosis (LP) from three unrelated consanguineous families. Methods Clinical, neurologic, and neuro-ophthalmologic examinations; skin histopathology; brain CT and MRI; and sequencing of the fullECM1 gene. Results All seven affected individuals had skin scarring and hoarseness from early childhood. The two children in Family 1 had worse skin involvement and worse hoarseness than affected children of Families 2 and 3. Both children in Family 1 were modestly mentally retarded, and one had typical calcifications of the amygdalae on CT scan. Affected individuals in Families 2 and 3 had no grossneurologic, neurodevelopmental, or neuroimaging abnormalities. Skin histopathology was compatible with LP in all three families. Sequencing the full coding region of ECM1 gene revealed two novel mutationsin Family 1 (c.1300-1301delAA) and Family 2 (p.Cys269Tyr) and in Family 3 a previously described 1163 bp deletion starting 34 bp into intron 8. Conclusions These individuals illustrate the neurologic spectrum of LP, including variable mental retardation, personality changes, and mesial temporal calcificationand imply that significant neurologic involvement may be somewhat less common than previously thought. The cause of neurologic abnormalities was not clear from either neuroimaging or from what is known about ECM1 function. The severity of dermatologic abnormalities and hoarseness generally correlated with neurologic abnormalities, with Family 1 being somewhat more affected in all spheres than the other two families. Nevertheless, phenotype-genotype correlation was not obvious, possibly because of difficulty quantifying the neurologic phenotype and because of genetic complexity.
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Affiliation(s)
- Mustafa A Salih
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Samdani AJ, Azhar A, Shahid SM, Nawab SN, Shaikh R, Qader SA, Mansoor Q, Khoso BK, Ismail M. Homozygous frame shift mutation in ECM1 gene in two siblings with lipoid proteinosis. J Dermatol Case Rep 2010; 4:66-70. [PMID: 21886756 DOI: 10.3315/jdcr.2010.1056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 12/23/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND The extracellular matrix protein 1 (ECM1) is a glycoprotein, expressed in skin and other tissues. Loss-of-function mutation in ECM1 causes a rare autosomal recessive disorder called lipoid proteinosis. Lipoid proteinosis is presented by varying degrees of skin scars, beaded papules along the eyelid margins, variable signs of hoarseness of voice and respiratory disorders. More than 250 cases of this disorder have been described in the literature, but occurrence of lipoid proteinosis in siblings is very rare. This study was designed to investigate the possible mutation causing lipoid proteinosis in a Pakistani family and to elaborate the scope of possible genetic changes, causing the genodermatosis in Pakistan. MAIN OBSERVATIONS In this study, two siblings (12 and 9-years sisters) were presented with scaly itchy lesions on whole body, hoarse voice and macroglossia. Their deceased father had similar clinical manifestations but mother and younger brother were unaffected. Blood samples from clinically affected and unaffected family members were collected with informed consent. The coding region of ECM1 gene containing 10 exons were amplified and sequenced. Both the affected siblings were shown to have homozygous frame shift mutation by deletion of the nucleotide T at 507, codon 169, exon 6. This resulted in a frame shift from codon 169 and appearance of a premature stop codon at 177, causing formation of a mutated protein (176 amino acids) instead of normal ECM1 protein (540 amino acids). CONCLUSION A case of homozygous 62-bp insertion in ECM1 gene causing lipoid proteinosis has been reported in another Pakistani family. The current study presents a homozygous frame shift mutation supporting an unusual function of ECM1 protein and broadens the spectrum of disease-linked mutations in this rare case of genodermatosis in this region.
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Affiliation(s)
- Azam J Samdani
- Department of Dermatology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
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Merregaert J, Van Langen J, Hansen U, Ponsaerts P, El Ghalbzouri A, Steenackers E, Van Ostade X, Sercu S. Phospholipid scramblase 1 is secreted by a lipid raft-dependent pathway and interacts with the extracellular matrix protein 1 in the dermal epidermal junction zone of human skin. J Biol Chem 2010; 285:37823-37. [PMID: 20870722 DOI: 10.1074/jbc.m110.136408] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We examined the interaction of ECM1 (extracellular matrix protein 1) using yeast two-hybrid screening and identified the type II transmembrane protein, PLSCR1 (phospholipid scramblase 1), as a binding partner. This interaction was then confirmed by in vitro and in vivo co-immunoprecipitation experiments, and additional pull-down experiments with GST-tagged ECM1a fragments localized this interaction to occur within the tandem repeat region of ECM1a. Furthermore, immunohistochemical staining revealed a partial overlap of ECM1 and PLSCR1 in human skin at the basal epidermal cell layer. Moreover, in human skin equivalents, both proteins are expressed at the basal membrane in a dermal fibroblast-dependent manner. Next, immunogold electron microscopy of ultrathin human skin sections showed that ECM1 and PLSCR1 co-localize in the extracellular matrix, and using antibodies against ECM1 or PLSCR1 cross-linked to magnetic immunobeads, we were able to demonstrate PLSCR1-ECM1 interaction in human skin extracts. Furthermore, whereas ECM1 is secreted by the endoplasmic/Golgi-dependent pathway, PLSCR1 release from HaCaT keratinocytes occurs via a lipid raft-dependent mechanism, and is deposited in the extracellular matrix. In summary, we here demonstrate that PLSCR1 interacts with the tandem repeat region of ECM1a in the dermal epidermal junction zone of human skin and provide for the first time experimental evidence that PLSCR1 is secreted by an unconventional secretion pathway. These data suggest that PLSCR1 is a multifunctional protein that can function both inside and outside of the cell and together with ECM1 may play a regulatory role in human skin.
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Affiliation(s)
- Joseph Merregaert
- Laboratory of Molecular Biotechnology, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
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Nasir M, Latif A, Ajmal M, Ismail M, Hameed A. A novel homozygous 62-bp insertion inECM1causes lipoid proteinosis in a multigeneration Pakistani family. Br J Dermatol 2009; 161:688-90. [PMID: 19519837 DOI: 10.1111/j.1365-2133.2009.09275.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M Nasir
- Institute of Biomedical and Genetic Engineering, Islamabad, Pakistan
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44
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Gonçalves FG, de Melo MB, de L Matos V, Barra FR, Figueroa RE. Amygdalae and striatum calcification in lipoid proteinosis. AJNR Am J Neuroradiol 2009; 31:88-90. [PMID: 19696137 DOI: 10.3174/ajnr.a1699] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Lipoid proteinosis is a rare genodermatosis characterized by multisystem involvement due to intracellular deposition of an amorphous hyaline material. Lipoid proteinosis is caused by mutations in the ECM1 gene. In many patients, skin and mucosa abnormalities are the first manifestation. When the CNS is affected, a wide variety of neurologic abnormalities may be present. The hallmark findings are calcifications, mostly occurring in the amygdalae, hippocampus, parahippocampal gyrus, or even the striatum. Present in half of the patients, moniliform blepharosis is considered a pathognomonic finding. In the other half of patients imaging could assist in the diagnosis. The authors present a series of 3 cases of lipoid proteinosis with brief clinical data and imaging findings.
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Affiliation(s)
- F G Gonçalves
- Departamento de Radiologia do Hospital Universitário da Universidade de Brasília, Brasília, DF, Brazil.
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45
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Abstract
Lipoid proteinosis is a rare disorder with autosomal recessive inheritance, characterized by progressive deposition of hyaline material in the skin, mucous membrane, and different organs of the body, resulting in a multitude of clinical manifestations. A 62-year-old male presented with hoarseness of voice since infancy, eyelid beading, and generalized acneiform scars on the facial skin and extremities, and yellowish papules on his tongue and buccal mucose. The patient was diagnosed clinically as a case of Lipoid proteinosis, which was confirmed by skin and mucosal biopsy. The objective of the present work is to describe this rare entity, with approximately 250 cases found in medical literature. This case report also illustrates that Lipoid proteinosis may show protean clinical features and yet may remain undiagnosed for many years. This report will hopefully spawn further studies that will lead to early diagnosis.
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Affiliation(s)
- Roopa Shamsundar Rao
- Department of Oral Pathology, M. S. Ramaiah Dental College, Bangalore, Karnataka, India
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46
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Wang XP, Huo J, Liu Y, Wang WJ, Xu QQ, Ma JH, An JG, Wang JM, Xiao SX. A Chinese family with lipoid proteinosis resulting from a homozygous missense mutation in the extracellular matrix protein 1 gene. J Eur Acad Dermatol Venereol 2009; 23:1336-8. [PMID: 19368610 DOI: 10.1111/j.1468-3083.2009.03207.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Interaction of extracellular matrix protein 1 with extracellular matrix components: ECM1 is a basement membrane protein of the skin. J Invest Dermatol 2008; 128:1397-408. [PMID: 18200062 DOI: 10.1038/sj.jid.5701231] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The extracellular matrix protein 1 (ECM1) is a secreted glycoprotein, which plays an important role in the structural and functional biology of the skin as demonstrated by the identification of loss-of-function mutations in ECM1 as cause of the genodermatosis lipoid proteinosis, characterized by reduplication of the skin basement membrane and hyalinization of the underlying dermis. To search for binding partner(s) of ECM1, we tested the in vitro binding activity of ECM1a, a major isoform of four ECM1 splice variants, to different skin extracellular matrix proteins (such as laminin 332, collagen type IV, and fibronectin) and polysaccharides (such as hyaluronan, heparin, and chondroitin sulfate A) with solid-phase binding assay. We demonstrated that ECM1a utilizes different regions to bind to a variety of extracellular matrix components. Ultrastructurally, ECM1 is a basement membrane protein in human skin and is part of network-like suprastructures containing perlecan, collagen type IV, and laminin 332 as constituents. Furthermore, ECM1a enhanced the binding of collagen IV to laminin 332 dose-dependently, showing its involvement in the dermal-epidermal junction and interstitial dermis and making the functional link to the pathophysiology of lipoid proteinosis. To our knowledge, this is previously unreported.
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Chan I, Liu L, Hamada T, Sethuraman G, McGrath JA. The molecular basis of lipoid proteinosis: mutations in extracellular matrix protein 1. Exp Dermatol 2007; 16:881-90. [PMID: 17927570 DOI: 10.1111/j.1600-0625.2007.00608.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Ien Chan
- Genetic Skin Disease Group, St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, The Guy's, King's College and St Thomas' School of Medicine, London, UK
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Uchida T, Hayashi H, Inaoki M, Miyamoto T, Fujimoto W. A failure of mucocutaneous lymphangiogenesis may underlie the clinical features of lipoid proteinosis. Br J Dermatol 2007; 156:152-7. [PMID: 17199583 DOI: 10.1111/j.1365-2133.2006.07583.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Lipoid proteinosis (LiP) (OMIM 247100) is a rare autosomal recessive disease caused by loss of function mutations in the extracellular matrix protein 1 gene, ECM1, on chromosome 1q21. LiP is characterized clinically by hoarseness in early infancy, followed by waxy papules and plaques on the face and body along with pox-like and acneiform scars. We studied a 20-year-old Japanese woman with LiP. She was born of consanguineous parents. Biopsy specimens obtained from a nodule on the elbow were used for histopathology, immunohistology and electron microscopy. Exons 6 and 7 of ECM1 were amplified by polymerase chain reaction (PCR) from genomic DNA from the proband, her parents, her brother and an unrelated person. PCR products were sequenced to detect the mutation. Histopathological examination revealed an irregular mass of calcium beneath deposits of a hyaline material in the dermis. Immunofluorescence double staining showed that the CD31-positive microvascular density was increased but that staining for the lymphatic-specific hyaluronan receptor LYVE-1 was drastically diminished in lesional compared with nonlesional skin of the patient and with normal skin. Electron microscopy revealed marked concentric reduplication of basal laminae not only around blood vessels but also around solitary dermal cells positive for Weibel-Palade bodies scattered in the hyaline material. Sequencing of the PCR products revealed a homozygous frameshift mutation, 507delT, in exon 6. This led to a premature stop codon 23 bp downstream. The results of immunopathological and ultrastructural characterization suggest that a failure of mucocutaneous lymphangiogenesis may underlie the clinical features of LiP. Identification of mutation 507delT in a Japanese patient with LiP further supports the thesis that this mutation represents a recurrent mutation in ECM1 in patients with LiP. To our knowledge, this case represents the first report of calcinosis cutis occurring in LiP.
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Affiliation(s)
- T Uchida
- Department of Dermatology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
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Fujimoto N, Terlizzi J, Aho S, Brittingham R, Fertala A, Oyama N, McGrath JA, Uitto J. Extracellular matrix protein 1 inhibits the activity of matrix metalloproteinase 9 through high-affinity protein/protein interactions. Exp Dermatol 2006; 15:300-7. [PMID: 16512877 DOI: 10.1111/j.0906-6705.2006.00409.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Extracellular matrix protein 1 (ECM1), an approximately 85-kDa glycoprotein with broad tissue distribution, harbors mutations in lipoid proteinosis (LP), a heritable disease characterized by reduplication of basement membranes and hyalinization of dermis, associated with neurologic disorders. The mechanisms leading from ECM1 mutations to LP phenotype are unknown. In this study, we explored ECM1 protein-protein interactions utilizing yeast two-hybrid genetic screen of human placental library, which identified nine interacting proteins, including matrix metalloproteinase 9 (MMP9). The interactions were confirmed by beta-galactosidase assay with isolated clones and by co-immunoprecipitation which narrowed the interacting segment in ECM1 to the C-terminal tandem repeat 2 (amino acids 236-361). This peptide segment also inhibited MMP9 activity in a gelatin-based ELISA assay. We propose that ECM1-mediated reduction in MMP9 proteolytic activity may have relevance to pathogenesis of LP.
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Affiliation(s)
- Norihiro Fujimoto
- Department of Dermatology and Cutaneous Biology, Jefferson Medical College, Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
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