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Muacevic A, Adler JR, Marques Pinto G, Duarte B. Combination of Naltrexone and Isotretinoin for the Treatment of Darier Disease. Cureus 2023; 15:e33321. [PMID: 36741607 PMCID: PMC9894633 DOI: 10.7759/cureus.33321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 01/05/2023] Open
Abstract
Darier disease (DD) is an autosomal-dominant genodermatosis in which mutations in the ATP2A2 gene result in impaired intercellular adhesion and epidermal blistering. Treatment options usually rely on systemic retinoids, but a refractory disease is still a therapeutical challenge. Given the similarity of DD pathogenesis with Hailey-Hailey disease, concomitant treatment with low-dose-naltrexone (LDN) has been proposed. We present the case of a 34-year-old woman with a 20-year history of severe, biopsy-proven DD, previously treated with several unsuccessful topical and systemic treatments, including oral isotretinoin, cyclosporine, doxycycline, methotrexate, acitretin, and subcutaneous adalimumab. At presentation, she had widespread keratotic, crusted, brown papules on her trunk and proximal extremities. Treatment with oral LDN (4.5 mg/day in manipulated tablets) was then initiated while maintaining the current isotretinoin therapy. After three months, there was a nearly complete clearance of the lesions, and no adverse effects were reported.
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Ambur A, Zaidi A, Dunn C, Nathoo R. Impaired Calcium Signaling and Neuropsychiatric Disorders in Darier Disease: An Exploratory Review. Exp Dermatol 2022; 31:1302-1310. [PMID: 35801378 DOI: 10.1111/exd.14642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 11/28/2022]
Abstract
Darier (Darier-White) disease (DD) is an autosomal dominant skin disorder caused by pathogenic mutations in the ATP2A2 gene which encodes a calcium ATPase in the sarco-endoplasmic reticulum (SERCA2). Defects in the SERCA2 protein leads to an impairment of cellular calcium homeostasis, which in turn, triggers cell death pathways. There is a high prevalence of neuropsychiatric disorders in patients affected by this condition, namely intellectual disability, bipolar disorder, schizophrenia, and suicidality. Though these associations have been well-documented over the years, little has been discussed or investigated regarding the pathophysiological mechanisms. The goal of this article is to review the literature related to the most commonly associated neuropsychiatric disorders found in patients with DD, highlight the pathophysiological mechanisms underlying each condition, and examine potential interventions that may be of interest for future development. A literature search was performed using PubMed to access and review relevant articles published in the last 40 years. Keywords searched included Darier disease neuropsychiatric, Darier disease pathophysiology, SERCA2 central nervous system, SERCA 2 skin, ATP2A2 central nervous system, ATP2A2 skin, sphingosine-1-phosphate signaling skin, sphingosine-1-phosphate signaling central nervous system, P2X7 receptor skin, and P2X7 receptor central nervous system. Our search resulted in 2,692 articles, of which 61 articles were ultimately included in this review.
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Affiliation(s)
- Austin Ambur
- Department of Dermatology, Kansas City University
| | - Asma Zaidi
- Department of Basic Sciences, Kansas City University
| | - Charles Dunn
- Department of Dermatology, Kansas City University
| | - Rajiv Nathoo
- Department of Dermatology, Kansas City University
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3
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Sangalli L, Miller CS. Low Dose Naltrexone for Treatment of Burning Mouth Syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:e83-e88. [PMID: 35851249 DOI: 10.1016/j.oooo.2022.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The International Classification of Disease defines burning mouth syndrome (BMS) as a chronic intraoral burning sensation, with no identifiable local or systemic cause. Since current management is often unsatisfactory, the aim of this report is to describe a new treatment modality (i.e., low-dose naltrexone [LDN]). STUDY DESIGN A 62-year-old woman presented with the complaint of burning on the tongue of 3 years' duration. Existing comorbidities were fibromyalgia, irritable bowel syndrome, headache, and interstitial cystitis. Her reported pain intensity ranged from 2/10 (morning) to 8/10 (evening) on a numeric rating scale. With the diagnosis of BMS and hyposalivation, and in light of her current clonazepam use and fibromyalgia, a dry mouth protocol and LDN (3 mg) were prescribed. RESULTS After 1 month, her pain intensity decreased by 50%, with no pain upon awakening. After 2 months, the widespread pain associated with her chronic morbidities also reduced by 50%, and her headache disappeared. After adjusting LDN dose to 4.5 mg, the patient was stable at 6 months, with 50% reduction of widespread pain and 2/10 BMS pain, and no reported side effects. CONCLUSIONS These preliminary results suggest that LDN may be a feasible and effective treatment for BMS, especially in patients' refractory to traditional treatment.
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Hagino T, Nakano H, Saeki H, Kanda N. A Case of Darier's Disease with a Novel Missense Mutation in ATP2A2 Successfully Treated with Calcipotriol/Betamethasone Dipropionate Two-Compound Ointment. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:367-372. [PMID: 35283639 PMCID: PMC8906820 DOI: 10.2147/ccid.s354694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/22/2022] [Indexed: 11/23/2022]
Abstract
Darier’s disease (DD) is a rare autosomal dominant genodermatosis caused by mutations in the ATP2A2 gene, which encodes for the sarcoendoplasmic reticulum calcium ATPase type 2 isoform (SERCA2). In epidermal keratinocytes, the decrease in SERCA2 inhibits the transportation of desmosomal proteins to the plasma membrane, resulting in acantholysis and dyskeratosis. We present the first case of DD with a novel missense mutation in the ATP2A2 gene and successfully treated with calcipotriol/betamethasone dipropionate two-compound ointment. A 34-year-old Japanese woman presented with erythema and scales on the scalp and clusters of keratotic papules on the neck and groin. Similar symptoms were observed in her father, younger sister, and daughter. Histopathological examination revealed corps ronds in the granular layer and grains in the horny layer of the epidermis and acantholytic lacuna just above the basal layer. She was diagnosed with DD. A novel heterozygous missense mutation, c.616A>C (p.Asn206His), was detected in the ATP2A2 gene in both the patient and her daughter. The patient was treated with calcipotriol/betamethasone dipropionate two-compound ointment, which resulted in improvement of the skin eruption. This two-compound topical ointment may be a promising therapeutic strategy in the treatment for DD.
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Affiliation(s)
- Teppei Hagino
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - Hajime Nakano
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Bunkyo-Ku, Tokyo, Japan
| | - Naoko Kanda
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
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Hanna N, Lam M, Fleming P, Lynde C. Therapeutic Options for the Treatment of Darier's Disease: A Comprehensive Review of the Literature. J Cutan Med Surg 2021; 26:280-290. [PMID: 34841914 PMCID: PMC9125141 DOI: 10.1177/12034754211058405] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Darier's disease (also known as keratosis follicularis or dyskeratosis follicularis) is an autosomal dominant inherited disorder which manifests as hyperkeratotic greasy papules in the first or second decade of life. Aside from symptom management and behavioral modifications to avoid triggers, there are currently no validated treatments for Darier's disease (DD). However, a variety of treatments have been proposed in the literature including retinoids, steroids, vitamin D analogs, photodynamic therapy, and surgical excision. The purpose of this review article is to identify therapeutic options for treating DD and to outline the evidence underlying these interventions. A search was conducted in Medline for English language articles from inception to July 4, 2020. Our search identified a total of 474 nonduplicate studies, which were screened by title and abstract. Of these, 155 full text articles were screened against inclusion/exclusion criteria, and 113 studies were included in our review. We identified Grade B evidence for the following treatments of DD: oral acitretin, oral isotretinoin, systemic Vitamin A, topical tretinoin, topical isotretinoin, topical adapalene gel, topical 5-flououracil, topical calciptriol and tacalcitol (with sunscreen), grenz ray radiation, and x-ray radiation. All other evidence for treatments of DD consisted of case reports or case series, which is considered grade C evidence. Considering the quality and quantity of evidence, clinicians may consider initiating a trial of select topical or oral retinoids first in patients with localized or generalized DD, respectively.
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Affiliation(s)
- N Hanna
- 6363 Faculty of Medicine, University of Ottawa, ON, Canada
| | - M Lam
- 12362 Faculty of Medicine, McMaster University, Hamilton, ON, Canada
| | - P Fleming
- 7938 Division of Dermatology, University of Toronto, ON, Canada
| | - C Lynde
- 7938 Division of Dermatology, University of Toronto, ON, Canada.,Lynde Institute of Dermatology, Markham, ON, Canada
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Reddy S, Brahmbhatt H. A Narrative Review on the Usage of Surgical Skin Grafting, Acitretin, and Tacrolimus in the Treatment of Hailey-Hailey Disease. Cureus 2021; 13:e19704. [PMID: 34820247 PMCID: PMC8601507 DOI: 10.7759/cureus.19704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/22/2022] Open
Abstract
Hailey-Hailey disease is a rare genetic disease that causes irregular blistering. The irregular blistering is also usually accompanied by skin lesions in the affected skin area. The symptoms and signs of Hailey-Hailey disease differ from one case to another. There is no one standard treatment method for Hailey-Hailey disease. However, there are certain treatment methods that do show some promise. This review will analyze the use and fruitfulness of surgical skin grafting, tacrolimus, and acitretin in multiple settings to treat Hailey-Hailey disease. Surgical skin grafting is done by removing the epidermis and a portion of the dermis, if not all of the dermis, healthy skin from a different part of the body, and transplanting it to the damaged area of the body. Acitretin is a retinoid that is a derivative of vitamin A that reduces abnormal differentiation of keratinocytes and inflammation which prove useful for helping skin diseases. Tacrolimus is an immunosuppressive drug that works by limiting the activity of the immune system to prevent it from producing substances that contribute to the redness and dryness of the skin, making it a candidate to be used for Hailey-Hailey disease treatment. The understood results of tacrolimus, acitretin, and surgical skin grafting on Hailey-Hailey disease are very limited and should be given more attention by healthcare leaders to the potential outcomes of these treatments on patients who have Hailey-Hailey disease.
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Timoney L, Bunker CB. Prurigo excoriée treated with low dose naltrexone. BMJ Case Rep 2021; 14:e243773. [PMID: 34799388 PMCID: PMC8606756 DOI: 10.1136/bcr-2021-243773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 11/03/2022] Open
Abstract
A 53-year-old woman presented with a 25-year history of acne excoriée and prurigo excoriée. Her symptoms began in 1988 coinciding with her husband's death from a brain tumour when she was 27. The pruritus affected her quality of life and disturbed her sleep. She had scarring on her face and body resulting from persistent scratching. The pruritus proved refractory to treatment despite a multi-modal treatment approach including multiple topicals, phototherapy and systemic agents such as isotretinoin, antibiotics, anxiolytic agents and neuromodulators. She was extremely frustrated that various treatments had been ineffective at controlling the itch-scratch cycle. She was commenced on low dose naltrexone (LDN), 3 mg nocte, and she became itch free within a few weeks. She reports that the LDN has had a beneficial impact on her quality of life.
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Affiliation(s)
- Leonard Timoney
- Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Christopher B Bunker
- Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
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8
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Rogner DF, Lammer J, Zink A, Hamm H. Morbus Darier und Morbus Hailey‐Hailey: Stand 2021. J Dtsch Dermatol Ges 2021; 19:1478-1502. [PMID: 34661362 DOI: 10.1111/ddg.14619_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/28/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Danielle Franziska Rogner
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum Rechts der Isar, Technische Universität München
| | - Judith Lammer
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum Rechts der Isar, Technische Universität München
| | - Alexander Zink
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum Rechts der Isar, Technische Universität München
| | - Henning Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg
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9
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Rogner DF, Lammer J, Zink A, Hamm H. Darier and Hailey-Hailey disease: update 2021. J Dtsch Dermatol Ges 2021; 19:1478-1501. [PMID: 34661345 DOI: 10.1111/ddg.14619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/28/2021] [Indexed: 01/16/2023]
Abstract
The autosomal-dominant genodermatoses Darier disease and Hailey-Hailey disease present special challenges to dermatologists. Despite their similar pathogenesis featuring impaired adhesion of suprabasal keratinocytes as a result of defective ATPases in epidermal calcium channels, the two diseases differ considerably in clinical presentation and therapeutic options. Darier disease is characterized by reddish brown, keratotic papules in seborrheic and intertriginous areas, which may coalesce into extensive lesions. Individuals affected with Hailey-Hailey disease primarily develop intertriginous papulovesicles and small blisters, which often evolve into erythematous plaques with erosions and painful fissures. Quality of life is significantly reduced because of complaints (itch, burning sensation, pain), body malodor and chronicity. Therapeutic options remain limited. Antiseptics and intermittent topical corticosteroids are a cornerstone of therapy, and systemic anti-infective treatment is often required in cases of superinfection. Ablative surgical interventions such as dermabrasion and CO2 laser surgery can lead to long-term remissions in intertriginous Hailey-Hailey disease, while temporary relief may also be achieved by intralesional injections of botulinum toxin. Of the systemic medications available for Darier disease, acitretin, which is approved for this purpose, has the best supporting evidence. The efficacy of immunosuppressants and immune modulators is inconsistent. Low-dose naltrexone produces more satisfactory results in Hailey-Hailey than Darier disease. The present CME article summarizes current knowledge of the two dermatoses, taking recent developments into account.
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Affiliation(s)
- Danielle Franziska Rogner
- Hospital and Clinic for Dermatology and Allergology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Judith Lammer
- Hospital and Clinic for Dermatology and Allergology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- Hospital and Clinic for Dermatology and Allergology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Henning Hamm
- Department of Dermatology, Venereology and Allergology, University Würzburg, Würzburg, Germany
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10
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Zhang H, Tang K, Wang Y, Fang R, Sun Q. Botulinum toxin in treating Hailey-Hailey disease: A systematic review. J Cosmet Dermatol 2021; 20:1396-1402. [PMID: 33533135 DOI: 10.1111/jocd.13963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/06/2021] [Accepted: 01/22/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hailey-Hailey disease is a rare disorder characterized by recurrent painful blistering, erosions, maceration in the intertriginous regions. Botulinum toxin has been used in the treatment of Hailey-Hailey disease. AIMS This study aimed to examine all published articles on botulinum toxin in the treatment of Hailey-Hailey disease, and to evaluate its efficacy and safety. METHODS PubMed, Embase, Cochrane Library, and Web of Science were used to identify eligible articles on August 8, 2020. The searching strategy was "(Hailey Hailey or Hailey-Hailey or pemphigus) and botulinum." RESULTS Sixteen articles including 38 patients described the use of botulinum toxin in treating Hailey-Hailey disease. Only one case had no response, while the other patients all had partial or complete remission. No side effects were reported. Nine articles including 10 patients mainly described other treatment options, and the patients were only treated with botulinum toxin previously. Their responses to botulinum toxin were limited: one was mild improvement, one was partial response, and the other eight failed. CONCLUSION Botulinum toxin is not almighty, but a promising alternative option. We recommend botulinum toxin as an adjuvant or supplemental treatment modality for severe and recalcitrant Hailey-Hailey disease. Larger studies are warranted to confirm its efficacy, safety, long-term effects, and cost performance.
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Affiliation(s)
- Hanlin Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Keyun Tang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yuchen Wang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Rouyu Fang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Qiuning Sun
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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11
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Haber RN, Dib NG. Management of Darier disease: A review of the literature and update. Indian J Dermatol Venereol Leprol 2021; 87:14-21. [PMID: 33580925 DOI: 10.25259/ijdvl_963_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/01/2020] [Indexed: 01/26/2023]
Abstract
Darier disease (DD) is a rare type of inherited keratinizing disorder with no definitive therapeutic approach. The objective of this study is to provide a detailed literature review of all the available treatment modalities of Darier disease, including those that are both surgical and non surgical, to compare their efficacies and to propose a novel therapeutic approach. A complete search of the literature for all articles describing the different treatments of Darier disease, with no restrictions on patients' ages, gender or nationalities, was performed with the use of PubMed. A total of 68 articles were included in the study: 3 prospective studies, 44 case reports/case series and 21 letters/correspondences/clinical images. The treatments described were topical, oral or physical. Retinoids (isotretinoin, tazarotene and adapalene) and fluorouracil were the two most effective topical treatments. Oral retinoids were the most effective oral therapy and were prescribed in the cases of generalized Darier disease. For localized and resistant skin lesions, physical therapies including surgical excision, dermabrasion and CO2 laser ablation were the first line choices. Limitations of this article include the inability to verify the accuracy of the published data, the relatively small sample size, the absence of randomized controlled clinical trials and possible unidentified confounding factors in various studies. In every therapeutic approach to Darier disease, consideration of patient comorbidities, disease distribution, severity and treatment accessibility is essential. Large and randomized clinical trials are necessary for the comparison of the efficacy and the safety of all the treatments of Darier disease and settling a consensus for management.
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Affiliation(s)
- Roger N Haber
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Nicole G Dib
- Department of Dermatology, Saint George Hospital University Medical Center, Beirut, Lebanon
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12
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Fourzali K, Yosipovitch G. Genodermatoses with itch as a prominent feature. J Eur Acad Dermatol Venereol 2020; 35:807-814. [PMID: 32977353 DOI: 10.1111/jdv.16963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/14/2020] [Indexed: 12/22/2022]
Abstract
A number of inherited conditions cause chronic itch as a part of the recognized phenotype. Advances in the understanding of the genetic factors that cause these diseases elucidate the molecular underpinning of itch as a symptom. Our knowledge of the causes of chronic itch has also advanced, providing an opportunity to integrate the genetic pathophysiology with the molecular landscape of chronic itch mediators. This article reviews select genodermatoses that have itch as a predominant feature with a focus on the pathophysiology of the disease, how it may lead to itch and potential therapeutic targets.
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Affiliation(s)
- K Fourzali
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - G Yosipovitch
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
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13
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Jfri A, Litvinov IV, Netchiporouk E. Naltrexone for the Treatment of Darier and Hailey-Hailey Diseases. J Cutan Med Surg 2020; 23:453-454. [PMID: 31337235 DOI: 10.1177/1203475419843122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Abdulhadi Jfri
- 1 Division of Dermatology, McGill University Health Centre, Montreal General Hospital, QC, Canada
| | - Ivan V Litvinov
- 1 Division of Dermatology, McGill University Health Centre, Montreal General Hospital, QC, Canada
| | - Elena Netchiporouk
- 1 Division of Dermatology, McGill University Health Centre, Montreal General Hospital, QC, Canada
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14
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Kovalev N, Pogany J, Nagy PD. Interviral Recombination between Plant, Insect, and Fungal RNA Viruses: Role of the Intracellular Ca 2+/Mn 2+ Pump. J Virol 2019; 94:e01015-19. [PMID: 31597780 PMCID: PMC6912095 DOI: 10.1128/jvi.01015-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/07/2019] [Indexed: 01/18/2023] Open
Abstract
Recombination is one of the driving forces of viral evolution. RNA recombination events among similar RNA viruses are frequent, although RNA recombination could also take place among unrelated viruses. In this paper, we have established efficient interviral recombination systems based on yeast and plants. We show that diverse RNA viruses, including the plant viruses tomato bushy stunt virus, carnation Italian ringspot virus, and turnip crinkle virus-associated RNA; the insect plus-strand RNA [(+)RNA] viruses Flock House virus and Nodamura virus; and the double-stranded L-A virus of yeast, are involved in interviral recombination events. Most interviral recombinants are minus-strand recombinant RNAs, and the junction sites are not randomly distributed, but there are certain hot spot regions. Formation of interviral recombinants in yeast and plants is accelerated by depletion of the cellular SERCA-like Pmr1 ATPase-driven Ca2+/Mn2+ pump, regulating intracellular Ca2+ and Mn2+ influx into the Golgi apparatus from the cytosol. The interviral recombinants are generated by a template-switching mechanism during RNA replication by the viral replicase. Replication studies revealed that a group of interviral recombinants is replication competent in cell-free extracts, in yeast, and in the plant Nicotiana benthamiana We propose that there are major differences among the viral replicases to generate and maintain interviral recombinants. Altogether, the obtained data promote the model that host factors greatly contribute to the formation of recombinants among related and unrelated viruses. This is the first time that a host factor's role in affecting interviral recombination is established.IMPORTANCE Viruses with RNA genomes are abundant, and their genomic sequences show astonishing variation. Genetic recombination in RNA viruses is a major force behind their rapid evolution, enhanced pathogenesis, and adaptation to their hosts. We utilized a previously identified intracellular Ca2+/Mn2+ pump-deficient yeast to search for interviral recombinants. Noninfectious viral replication systems were used to avoid generating unwanted infectious interviral recombinants. Altogether, interviral RNA recombinants were observed between plant and insect viruses, and between a fungal double-stranded RNA (dsRNA) virus and an insect virus, in the yeast host. In addition, interviral recombinants between two plant virus replicon RNAs were identified in N. benthamiana plants, in which the intracellular Ca2+/Mn2+ pump was depleted. These findings underline the crucial role of the host in promoting RNA recombination among unrelated viruses.
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Affiliation(s)
- Nikolay Kovalev
- Department of Plant Pathology, University of Kentucky, Lexington, Kentucky, USA
| | - Judit Pogany
- Department of Plant Pathology, University of Kentucky, Lexington, Kentucky, USA
| | - Peter D Nagy
- Department of Plant Pathology, University of Kentucky, Lexington, Kentucky, USA
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15
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Alajmi A, Jfri A, Lovett A. Hailey-Hailey disease treated successfully with naltrexone and magnesium. JAAD Case Rep 2019; 5:760-762. [PMID: 31516990 PMCID: PMC6728728 DOI: 10.1016/j.jdcr.2019.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Ali Alajmi
- Division of Dermatology, McGill University Health Centre, Montreal General Hospital, Montreal, Canada
| | - Abdulhadi Jfri
- Division of Dermatology, McGill University Health Centre, Montreal General Hospital, Montreal, Canada
| | - Audrey Lovett
- Division of Dermatology, McGill University Health Centre, Montreal General Hospital, Montreal, Canada
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