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Cheng JR, Mao H, Hui HZ, Li S, Wan YF, Shi BJ. A recurrent missense mutation in the KRT16 gene causing pachyonychia congenita in a patient. Int J Dermatol 2024; 63:e47-e49. [PMID: 38093419 DOI: 10.1111/ijd.16975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024]
Affiliation(s)
- Jia-Rong Cheng
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China, Chongqing, P.R. China
- Guizhou University of Traditional Chinese Medicine, Guiyang, P.R. China
| | - Han Mao
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China, Chongqing, P.R. China
- Guizhou University of Traditional Chinese Medicine, Guiyang, P.R. China
| | - Hai-Zhen Hui
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China, Chongqing, P.R. China
| | - Sheng Li
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China, Chongqing, P.R. China
| | - Yuan-Fang Wan
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China, Chongqing, P.R. China
| | - Bing-Jun Shi
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China, Chongqing, P.R. China
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Wu AG, Lipner SR. Distinctions in the Management, Patient Impact, and Clinical Profiles of Pachyonychia Congenita Subtypes. Skin Appendage Disord 2021; 7:194-202. [PMID: 34055907 DOI: 10.1159/000513340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Pachyonychia congenita (PC) is a rare dermatosis that confers lifelong physical and emotional morbidities in affected patients. However, the clinical findings, treatments, and psychosocial impact of this disease have not been adequately described. The International PC Research Registry (IPCRR), a multinational initiative to collect data on PC patients, has allowed an opportunity to distinguish the salient features of this disease. We aimed to characterize the breadth and extent of nail disease, treatments, and quality of life in PC patients, and to describe any significant differences in clinical presentation or treatment of PC subtypes. Methods The most recent IPCRR patient survey data consisting of an 857-response questionnaire and a 102-response addendum were analyzed in a retrospective analysis. The survey data were collected as part of a multinational, multicenter initiative and comprise the largest representative population of PC to date. Participants (survey respondents) were included in the study based on questionnaire responses and a genetic confirmation of having a PC subtype. Results A total of 857 survey responses were collected. Genetic variations among PC subtypes influence nail disease onset and severity of symptoms. Nail disease negatively impacts patients' emotional health, especially during the adolescent and young adult years. Nail treatment tools vary little in terms of effectiveness and acquired infection rates. Conclusion and Discussion Patients with different PC subtypes have distinct clinical nail presentations and psychosocial impact. Genetic testing should be used to confirm PC diagnoses. Further characterization of PC, especially the rarer subtypes, may allow for more individualized patient education.
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Affiliation(s)
- Albert G Wu
- New York Medical College, New York, New York, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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Yoshida A, Yamamoto K, Ishida T, Omura T, Itoh T, Nishigori C, Sakane T, Yano I. Sunitinib decreases the expression of KRT6A and SERPINB1 in 3D human epidermal models. Exp Dermatol 2020; 30:337-346. [PMID: 33135264 DOI: 10.1111/exd.14230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 10/07/2020] [Accepted: 10/22/2020] [Indexed: 12/17/2022]
Abstract
Hand-foot skin reaction (HFSR) is a common side effect caused by several tyrosine kinase inhibitors, including sunitinib. However, the nature of the cornifying factors related to the molecular biological mechanisms underlying HFSR remains poorly understood. We used human keratinocyte models to investigate the key cornifying factors for dermatological and biological abnormalities induced by sunitinib. On the basis of the results of microarray analysis using the three-dimensional (3D) human epidermal model, keratin (KRT)6A, serine protease inhibitor (SERPIN)B1, KRT5, and SERPIN Kazal-type 6 were selected as candidate genes related to HFSR. Sunitinib treatment significantly decreased the expression of SERPINB1 and KRT6A in the immunohistochemical staining of the 3D epidermal model. In PSVK1 cells, but not in normal human epidermal keratinocyte cells, both of which are human normal keratinocyte cell lines, sunitinib decreased the expression of KRT6A with a concomitant decrease in levels of phosphorylated extracellular signal-regulated kinases (ERK)1/2 and phosphorylated p38 mitogen-activated protein kinase (MAPK). Inhibitors of the ERK and p38 MAPK signal pathways also significantly decreased KRT6A expression. Sunitinib-induced decrease in KRT6A expression was suppressed by the inhibition of glycogen synthase kinase-3β by enhancing ERK1/2 and p38 MAPK phosphorylation. Thus, sunitinib reduces the expression of KRT6A and SERPINB1 by inhibiting the ERK1/2 and p38 MAPK signalling pathways in the skin model. These changes in expression contribute to the pathology of HFSR.
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Affiliation(s)
- Ayaka Yoshida
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan.,Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | | | - Tomohiro Omura
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Tomoo Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chikako Nishigori
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiyasu Sakane
- Department of Pharmaceutical Technology, Kobe Pharmaceutical University, Kobe, Japan
| | - Ikuko Yano
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
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4
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Dev T, Mahajan VK, Sethuraman G. Hereditary Palmoplantar Keratoderma: A Practical Approach to the Diagnosis. Indian Dermatol Online J 2019; 10:365-379. [PMID: 31334055 PMCID: PMC6615398 DOI: 10.4103/idoj.idoj_367_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The ridged skin of the palms and soles has several unique features: (i) presence of dermatoglyphics created by alternating ridges and grooves forming a unique pattern, (ii) presence of the highest density of eccrine sweat glands and absence of pilosebaceous units, and (iii) differential expression of keratins compared to the glabrous skin. These features explain the preferential localization of palmoplantar keratoderma (PPK) and several of its characteristic clinical features. PPK develops as a compensatory hyperproliferation of the epidermis and excessive production of stratum corneum in response to altered cornification of the palmoplantar skin due to mutations in the genes encoding several of the proteins involved in it. PPK can manifest as diffuse, focal, striate, or punctate forms per se or as a feature of several dermatological or systemic diseases. There is a wide genetic and phenotypic heterogeneity in hereditary PPK, due to which reaching an accurate diagnosis only on the basis of clinical features may be sometimes challenging for the clinicians in the absence of molecular studies. Nevertheless, recognizing the clinical patterns of keratoderma, extent of involvement, degree of mutilation, and associated appendageal and systemic involvement may help in delineating different forms. Molecular studies, despite high cost, are imperative for accurate classification, recognizing clinical patterns in resource poor settings is important for appropriate diagnosis, genetic counseling, and management. This review intends to develop a practical approach for clinical diagnosis of different types of hereditary PPK with reasonable accuracy.
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Affiliation(s)
- Tanvi Dev
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Gomathy Sethuraman
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
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5
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Bochner R, Samuelov L, Sarig O, Li Q, Adase CA, Isakov O, Malchin N, Vodo D, Shayevitch R, Peled A, Yu BD, Fainberg G, Warshauer E, Adir N, Erez N, Gat A, Gottlieb Y, Rogers T, Pavlovsky M, Goldberg I, Shomron N, Sandilands A, Campbell LE, MacCallum S, McLean WHI, Ast G, Gallo RL, Uitto J, Sprecher E. Calpain 12 Function Revealed through the Study of an Atypical Case of Autosomal Recessive Congenital Ichthyosis. J Invest Dermatol 2017; 137:385-393. [DOI: 10.1016/j.jid.2016.07.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/14/2016] [Accepted: 07/18/2016] [Indexed: 12/26/2022]
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6
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Armengot-Carbo M, Hernández-Martín Á, Torrelo A. The Role of Filaggrin in the Skin Barrier and Disease Development. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2014.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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7
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Winge MCG, Bradley M, Björck E. Impaired wound healing and cheilitis in a Pachyonychia congenita K6a family. J Eur Acad Dermatol Venereol 2014; 29:185-7. [PMID: 24708461 DOI: 10.1111/jdv.12386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M C G Winge
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine L8:02, Karolinska Institutet, Stockholm, Sweden; Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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8
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Armengot-Carbo M, Hernández-Martín Á, Torrelo A. The role of filaggrin in the skin barrier and disease development. ACTAS DERMO-SIFILIOGRAFICAS 2014; 106:86-95. [PMID: 24674607 DOI: 10.1016/j.ad.2013.10.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 08/17/2013] [Accepted: 10/13/2013] [Indexed: 12/30/2022] Open
Abstract
Filaggrin is a structural protein that is fundamental in the development and maintenance of the skin barrier. The function of filaggrin and its involvement in various cutaneous and extracutaneous disorders has been the subject of considerable research in recent years. Mutations in FLG, the gene that encodes filaggrin, have been shown to cause ichthyosis vulgaris, increase the risk of atopic dermatitis and other atopic diseases, and exacerbate certain conditions. The present article reviews the current knowledge on the role of filaggrin in the skin barrier, FLG mutations, and the consequences of filaggrin deficiency.
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Affiliation(s)
- M Armengot-Carbo
- Servicio de Dermatología, Hospital Infantil Niño Jesús, Madrid, España.
| | | | - A Torrelo
- Servicio de Dermatología, Hospital Infantil Niño Jesús, Madrid, España
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9
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Cooper DN, Krawczak M, Polychronakos C, Tyler-Smith C, Kehrer-Sawatzki H. Where genotype is not predictive of phenotype: towards an understanding of the molecular basis of reduced penetrance in human inherited disease. Hum Genet 2013; 132:1077-130. [PMID: 23820649 PMCID: PMC3778950 DOI: 10.1007/s00439-013-1331-2] [Citation(s) in RCA: 417] [Impact Index Per Article: 37.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 06/15/2013] [Indexed: 02/06/2023]
Abstract
Some individuals with a particular disease-causing mutation or genotype fail to express most if not all features of the disease in question, a phenomenon that is known as 'reduced (or incomplete) penetrance'. Reduced penetrance is not uncommon; indeed, there are many known examples of 'disease-causing mutations' that fail to cause disease in at least a proportion of the individuals who carry them. Reduced penetrance may therefore explain not only why genetic diseases are occasionally transmitted through unaffected parents, but also why healthy individuals can harbour quite large numbers of potentially disadvantageous variants in their genomes without suffering any obvious ill effects. Reduced penetrance can be a function of the specific mutation(s) involved or of allele dosage. It may also result from differential allelic expression, copy number variation or the modulating influence of additional genetic variants in cis or in trans. The penetrance of some pathogenic genotypes is known to be age- and/or sex-dependent. Variable penetrance may also reflect the action of unlinked modifier genes, epigenetic changes or environmental factors. At least in some cases, complete penetrance appears to require the presence of one or more genetic variants at other loci. In this review, we summarize the evidence for reduced penetrance being a widespread phenomenon in human genetics and explore some of the molecular mechanisms that may help to explain this enigmatic characteristic of human inherited disease.
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Affiliation(s)
- David N. Cooper
- Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4XN UK
| | - Michael Krawczak
- Institute of Medical Informatics and Statistics, Christian-Albrechts University, 24105 Kiel, Germany
| | | | - Chris Tyler-Smith
- The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SA UK
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Abstract
The discovery, in 2006, that loss-of-function mutations in the filaggrin (FLG) gene are the cause of ichthyosis vulgaris-the most common disorder of keratinization-and also a strong genetic risk factor for atopic eczema, marked a significant breakthrough in the understanding of eczema pathogenesis. Subsequent investigations of the role of FLG-null mutations have identified a series of significant associations with atopic disease phenotypes, including atopic asthma, allergic rhinitis, and peanut allergy. However, many questions remain to be answered in relation to the precise mechanisms by which deficiency of an intracellular protein expressed primarily in the differentiating epidermis may contribute to the development of cutaneous and systemic pathology. This review aims to highlight the key milestones in filaggrin research over the past 25 years, to discuss the mechanistic, clinical, and therapeutic implications, and to consider possible future directions for ongoing investigation.
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Affiliation(s)
- Sara J Brown
- Dermatology and Genetic Medicine, Division of Molecular Medicine, University of Dundee, Dundee, UK
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Keratin 16-null mice develop palmoplantar keratoderma, a hallmark feature of pachyonychia congenita and related disorders. J Invest Dermatol 2012; 132:1384-91. [PMID: 22336941 PMCID: PMC3326191 DOI: 10.1038/jid.2012.6] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Keratin 16 (KRT16 in human, Krt16 in mouse), a type I intermediate filament protein, is constitutively expressed in epithelial appendages and is induced in the epidermis upon wounding and other stressors. Mutations altering the coding sequence of KRT16 cause Pachyonychia Congenita (PC), a rare autosomal dominant disorder characterized by hypertrophic nail dystrophy, oral leukokeratosis, and palmoplantar keratoderma (PPK). PPK associated with PC are extremely painful and compromise patient mobility, making them the most debilitating PC symptom. In this study, we show that, although inherited in a recessive fashion, the inactivation of Krt16 in mice consistently causes oral lesions as well as PPK-like hyperkeratotic calluses on Krt16−/− front and hind paws, which severely compromise the animals’ ability to walk. Our findings call into question the view that PC-related PPK arise exclusively as a gain-of-function on the account of dominantly acting mutated keratins, and highlight the key role of modifiers in the clinical heterogeneity of PC symptoms.
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Affiliation(s)
- Alan D Irvine
- National Children's Research Centre and Department of Paediatric Dermatology, Our Lady's Children's Hospital, and Trinity College, Dublin, United Kingdom
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Common JEA, Brown SJ, Haines RL, Goh CSM, Chen H, Balakrishnan A, Munro CS, Tan AWH, Tan HH, Tang MBY, Lane EB. Filaggrin null mutations are not a protective factor for acne vulgaris. J Invest Dermatol 2011; 131:1378-80. [PMID: 21326297 PMCID: PMC3094589 DOI: 10.1038/jid.2011.23] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Wilson NJ, Leachman SA, Hansen CD, McMullan AC, Milstone LM, Schwartz ME, McLean WI, Hull PR, Smith FJ. A Large Mutational Study in Pachyonychia Congenita. J Invest Dermatol 2011; 131:1018-24. [DOI: 10.1038/jid.2011.20] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Keratin gene mutations in disorders of human skin and its appendages. Arch Biochem Biophys 2010; 508:123-37. [PMID: 21176769 DOI: 10.1016/j.abb.2010.12.019] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 12/16/2010] [Indexed: 11/21/2022]
Abstract
Keratins, the major structural protein of all epithelia are a diverse group of cytoskeletal scaffolding proteins that form intermediate filament networks, providing structural support to keratinocytes that maintain the integrity of the skin. Expression of keratin genes is usually regulated by differentiation of the epidermal cells within the stratifying squamous epithelium. Amongst the 54 known functional keratin genes in humans, about 22 different genes including, the cornea, hair and hair follicle-specific keratins have been implicated in a wide range of hereditary diseases. The exact phenotype of each disease usually reflects the spatial expression level and the types of mutated keratin genes, the location of the mutations and their consequences at sub-cellular levels as well as other epigenetic and/or environmental factors. The identification of specific pathogenic mutations in keratin disorders formed the basis of our understanding that led to re-classification, improved diagnosis with prognostic implications, prenatal testing and genetic counseling in severe keratin genodermatoses. Molecular defects in cutaneous keratin genes encoding for keratin intermediate filaments (KIFs) causes keratinocytes and tissue-specific fragility, accounting for a large number of genetic disorders in human skin and its appendages. These diseases are characterized by keratinocytes fragility (cytolysis), intra-epidermal blistering, hyperkeratosis, and keratin filament aggregation in severely affected tissues. Examples include epidermolysis bullosa simplex (EBS; K5, K14), keratinopathic ichthyosis (KPI; K1, K2, K10) i.e. epidermolytic ichthyosis (EI; K1, K10) and ichthyosis bullosa of Siemens (IBS; K2), pachyonychia congenita (PC; K6a, K6b, K16, K17), epidermolytic palmo-plantar keratoderma (EPPK; K9, (K1)), monilethrix (K81, K83, K86), ectodermal dysplasia (ED; K85) and steatocystoma multiplex. These keratins also have been identified to have roles in apoptosis, cell proliferation, wound healing, tissue polarity and remodeling. This review summarizes and discusses the clinical, ultrastructural, molecular genetics and biochemical characteristics of a broad spectrum of keratin-related genodermatoses, with special clinical emphasis on EBS, EI and PC. We also highlight current and emerging model tools for prognostic future therapies. Hopefully, disease modeling and in-depth understanding of the molecular pathogenesis of the diseases may lead to the development of novel therapies for several hereditary cutaneous diseases.
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