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Danescu S, Negrutiu M, Has C. Treatment of Epidermolysis Bullosa and Future Directions: A Review. Dermatol Ther (Heidelb) 2024:10.1007/s13555-024-01227-8. [PMID: 39090514 DOI: 10.1007/s13555-024-01227-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/01/2024] [Indexed: 08/04/2024] Open
Abstract
Epidermolysis bullosa (EB) comprises rare genetic disorders characterized by skin and mucosal membrane blistering induced by mechanical trauma. Molecularly, pathogenic variants affect genes encoding proteins crucial for epidermal-dermal adhesion and stability. Management of severe EB is multidisciplinary, focusing on wound healing support, ensuring that patients thrive, and complication treatment. Despite extensive research over 30 years, novel therapeutic approaches face challenges. Gene therapy and protein therapy struggle with efficacy, while regenerative cell-based therapies show limited effects. Drug repurposing to target various pathogenic mechanisms has gained attention, as has in vivo gene therapy with drugs for dystrophic and junctional EB that were recently approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA). However, their high cost limits global accessibility. This review examines therapeutic advancements made over the past 5 years, exploiting a systematic literature review and clinical trial data.
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Affiliation(s)
- Sorina Danescu
- Department of Dermatology, University of Medicine Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
| | - Mircea Negrutiu
- Department of Dermatology, University of Medicine Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
| | - Cristina Has
- Department of Dermatology, Medical Center University of Freiburg, Freiburg im Breisgau, Germany.
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2
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Brooks SG, Yosipovitch G. Unmet needs in treating itch: reaching beyond eczema. J DERMATOL TREAT 2024; 35:2351487. [PMID: 38945542 DOI: 10.1080/09546634.2024.2351487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/29/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Pruritus is an unpleasant sensation that creates the urge to scratch. In many chronic conditions, relentless pruritus and scratching perpetuates a vicious itch-scratch cycle. Uncontrolled itch can detrimentally affect quality of life and may lead to sleep disturbance, impaired concentration, financial burden, and psychological suffering. Recent strides have been made to develop guidelines and investigate new therapies to treat some of the most common severely pruritic conditions, however, a large group of diseases remains underrecognized and undertreated. The purpose of this article is to provide a comprehensive review of the challenges hindering the treatment of pruritus. METHODS An online search was performed using PubMed, Web of Science, Google Scholar, and ClinicalTrials.gov from 1994 to 2024. Included studies were summarized and assessed for quality and relevance in treating pruritus. RESULTS Several barriers to treating pruritus emerged, including variable presentation, objective measurement of itch, and identifying therapeutic targets. Itch associated with autoimmune conditions, connective tissue diseases, genodermatoses, cutaneous T-cell lymphoma, and pruritus of unknown origin were among the etiologies with the greatest unmet needs. CONCLUSION Treating pruritus poses many challenges and there are many itchy conditions that have no yet been addressed. There is an urgent need for large-scale controlled studies to investigate potential targets for these conditions and novel therapies.
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Affiliation(s)
- Sarah G Brooks
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gil Yosipovitch
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA
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3
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Li P, Rietscher K, Jopp H, Magin TM, Omary MB. Posttranslational modifications of keratins and their associated proteins as therapeutic targets in keratin diseases. Curr Opin Cell Biol 2023; 85:102264. [PMID: 37925932 DOI: 10.1016/j.ceb.2023.102264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/04/2023] [Accepted: 09/24/2023] [Indexed: 11/07/2023]
Abstract
The keratin cytoskeleton protects epithelia against mechanical, nonmechanical, and physical stresses, and participates in multiple signaling pathways that regulate cell integrity and resilience. Keratin gene mutations cause multiple rare monoallelic epithelial diseases termed keratinopathies, including the skin diseases Epidermolysis Bullosa Simplex (EBS) and Pachyonychia Congenita (PC), with limited available therapies. The disease-related keratin mutations trigger posttranslational modifications (PTMs) in keratins and their associated proteins that can aggravate the disease. Recent findings of drug high-throughput screening have led to the identification of compounds that may be repurposed, since they are used for other human diseases, to treat keratinopathies. These drugs target unique PTM pathways and sites, including phosphorylation and acetylation of keratins and their associated proteins, and have shed insights into keratin regulation and interactions. They also offer the prospect of testing the use of drug mixtures, with the long view of possible beneficial human use coupled with increased efficacy and lower side effects.
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Affiliation(s)
- Pei Li
- Center for Advanced Biotechnology and Medicine, Rutgers University, Piscataway, NJ, USA
| | - Katrin Rietscher
- Division of Cell and Developmental Biology, Institute of Biology, Leipzig University, Leipzig, Germany
| | - Henriette Jopp
- Division of Cell and Developmental Biology, Institute of Biology, Leipzig University, Leipzig, Germany
| | - Thomas M Magin
- Division of Cell and Developmental Biology, Institute of Biology, Leipzig University, Leipzig, Germany.
| | - M Bishr Omary
- Center for Advanced Biotechnology and Medicine, Rutgers University, Piscataway, NJ, USA.
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4
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Zhu Y, Zhang M, Guo S, Xu H, Jie Z, Tao SC. CRISPR-based diagnostics of different biomolecules from nucleic acids, proteins, and small molecules to exosomes. Acta Biochim Biophys Sin (Shanghai) 2023; 55:1539-1550. [PMID: 37528660 PMCID: PMC10577475 DOI: 10.3724/abbs.2023134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/29/2023] [Indexed: 08/03/2023] Open
Abstract
CRISPR-based detection technologies have been widely explored for molecular diagnostics. However, the challenge lies in converting the signal of different biomolecules, such as nucleic acids, proteins, small molecules, exosomes, and ions, into a CRISPR-based nucleic acid detection signal. Understanding the detection of different biomolecules using CRISPR technology can aid in the development of practical and promising detection approaches. Unfortunately, existing reviews rarely provide an overview of CRISPR-based molecular diagnostics from the perspective of different biomolecules. Herein, we first introduce the principles and characteristics of various CRISPR nucleases for molecular diagnostics. Then, we focus on summarizing and evaluating the latest advancements in CRISPR-based detection of different biomolecules. Through a comparison of different methods of amplification and signal readout, we discuss how general detection methods can be integrated with CRISPR. Finally, we conclude by identifying opportunities for the improvement of CRISPR in quantitative, amplification-free, multiplex, all-in-one, and point-of-care testing (POCT) purposes.
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Affiliation(s)
- Yuanshou Zhu
- Shanghai Center for Systems BiomedicineKey Laboratory of Systems Biomedicine (Ministry of Education)Shanghai Jiao Tong UniversityShanghai200240China
- School of Biomedical EngineeringMed-X Research InstituteShanghai Jiao Tong UniversityShanghai200030China
| | - Meng Zhang
- Department of Pulmonary and Critical Care MedicineShanghai Fifth People’s HospitalFudan UniversityShanghai200240China
| | - Shujuan Guo
- Shanghai Center for Systems BiomedicineKey Laboratory of Systems Biomedicine (Ministry of Education)Shanghai Jiao Tong UniversityShanghai200240China
| | - Hong Xu
- School of Biomedical EngineeringMed-X Research InstituteShanghai Jiao Tong UniversityShanghai200030China
| | - Zhijun Jie
- Department of Pulmonary and Critical Care MedicineShanghai Fifth People’s HospitalFudan UniversityShanghai200240China
- Center of Community-Based Health ResearchFudan UniversityShanghai200240China
| | - Sheng-ce Tao
- Shanghai Center for Systems BiomedicineKey Laboratory of Systems Biomedicine (Ministry of Education)Shanghai Jiao Tong UniversityShanghai200240China
- School of Biomedical EngineeringMed-X Research InstituteShanghai Jiao Tong UniversityShanghai200030China
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5
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Niebergall-Roth E, Dieter K, Daniele C, Fluhr S, Khokhrina M, Silva I, Ganss C, Frank MH, Kluth MA. Kinetics of Wound Development and Healing Suggests a Skin-Stabilizing Effect of Allogeneic ABCB5 + Mesenchymal Stromal Cell Treatment in Recessive Dystrophic Epidermolysis Bullosa. Cells 2023; 12:1468. [PMID: 37296590 PMCID: PMC10252830 DOI: 10.3390/cells12111468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Recessive dystrophic epidermolysis (RDEB) is a rare, inherited, and currently incurable skin blistering disorder characterized by cyclically recurring wounds coexisting with chronic non-healing wounds. In a recent clinical trial, three intravenous infusions of skin-derived ABCB5+ mesenchymal stromal cells (MSCs) to 14 patients with RDEB improved the healing of wounds that were present at baseline. Since in RDEB even minor mechanical forces perpetually provoke the development of new or recurrent wounds, a post-hoc analysis of patient photographs was performed to specifically assess the effects of ABCB5+ MSCs on new or recurrent wounds by evaluating 174 wounds that occurred after baseline. During 12 weeks of systemic treatment with ABCB5+ MSCs, the number of newly occurring wounds declined. When compared to the previously reported healing responses of the wounds present at baseline, the newly occurring wounds healed faster, and a greater portion of healed wounds remained stably closed. These data suggest a previously undescribed skin-stabilizing effect of treatment with ABCB5+ MSCs and support repeated dosing of ABCB5+ MSCs in RDEB to continuously slow the wound development and accelerate the healing of new or recurrent wounds before they become infected or progress to a chronic, difficult-to-heal stage.
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Affiliation(s)
| | | | | | - Silvia Fluhr
- RHEACELL GmbH & Co. KG, 69120 Heidelberg, Germany
| | | | - Ines Silva
- RHEACELL GmbH & Co. KG, 69120 Heidelberg, Germany
| | | | - Markus H. Frank
- Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- Harvard Stem Cell Institute, Harvard University, Cambridge, MA 02138, USA
- Transplant Research Program, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
- School of Medical and Health Sciences, Edith Cowan University, Perth 6027, Australia
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6
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Chacón-Solano E, León C, Carretero M, García M, Sánchez-Domínguez R, Quero F, Méndez-Jiménez E, Bonafont J, Ruiz-Mezcua B, Escámez MJ, Larcher F, Del Río M. Mechanistic interrogation of mutation-independent disease modulators of RDEB identifies the small leucine-rich proteoglycan PRELP as a TGF-β antagonist and inhibitor of fibrosis. Matrix Biol 2022; 111:189-206. [PMID: 35779740 DOI: 10.1016/j.matbio.2022.06.007] [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: 09/30/2021] [Revised: 06/17/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is a genetic extracellular matrix disease caused by deficiency in type VII collagen (Col VII). The disease manifests with devastating mucocutaneous fragility leading to progressive fibrosis and metastatic squamous cell carcinomas. Although collagen VII abundance is considered the main predictor of symptom course, previous studies have revealed the existence of mutation-independent mechanisms that control disease progression. Here, to investigate and validate new molecular modifiers of wound healing and fibrosis in a natural human setting, and toward development of disease-modulating treatment of RDEB, we performed gene expression profiling of primary fibroblast from RDEB siblings with marked phenotypic variations, despite having equal COL7A1 genotype. Gene enrichment analysis suggested that severe RDEB was associated with enhanced response to TGF-β stimulus, oxidoreductase activity, and cell contraction. Consistently, we found an increased response to TGF-β, higher levels of basal and induced reactive oxygen species (ROS), and greater contractile ability in collagen lattices in RDEB fibroblasts (RDEBFs) from donors with severe RDEB vs mild RDEB. Treatment with antioxidants allowed a reduction of the pro-fibrotic and contractile phenotype. Importantly, our analyses revealed higher expression and deposition in skin of the relatively uncharacterized small leucine-rich extracellular proteoglycan PRELP/prolargin associated with milder RDEB manifestations. Mechanistic investigations showed that PRELP effectively attenuated fibroblasts' response to TGF-β1 stimulus and cell contractile capacity. Moreover, PRELP overexpression in RDEBFs enhanced RDEB keratinocyte attachment to fibroblast-derived extracellular matrix in the absence of Col VII. Our results highlight the clinical relevance of pro-oxidant status and hyper-responsiveness to TGF-β in RDEB severity and progression. Of note, our study also reveals PRELP as a novel and natural TGF-β antagonist with a likely dermo-epidermal pro-adhesive capacity.
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Affiliation(s)
- E Chacón-Solano
- Departamento de Bioingeniería e Ingería Aeroespacial, Universidad Carlos III de Madrid (UC3M); Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain; División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain.
| | - C León
- Departamento de Bioingeniería e Ingería Aeroespacial, Universidad Carlos III de Madrid (UC3M); Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain
| | - M Carretero
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain; División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain
| | - M García
- Departamento de Bioingeniería e Ingería Aeroespacial, Universidad Carlos III de Madrid (UC3M); Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain; División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain
| | - R Sánchez-Domínguez
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain
| | - F Quero
- División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain
| | - E Méndez-Jiménez
- Departamento de Bioingeniería e Ingería Aeroespacial, Universidad Carlos III de Madrid (UC3M); Madrid, Spain; División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain
| | - J Bonafont
- Departamento de Bioingeniería e Ingería Aeroespacial, Universidad Carlos III de Madrid (UC3M); Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain; División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain
| | - B Ruiz-Mezcua
- Departamento de Informática, Universidad Carlos III de Madrid (UC3M); Madrid, Spain
| | - M J Escámez
- Departamento de Bioingeniería e Ingería Aeroespacial, Universidad Carlos III de Madrid (UC3M); Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain; División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain
| | - F Larcher
- Departamento de Bioingeniería e Ingería Aeroespacial, Universidad Carlos III de Madrid (UC3M); Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain; División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain.
| | - M Del Río
- Departamento de Bioingeniería e Ingería Aeroespacial, Universidad Carlos III de Madrid (UC3M); Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), ISCIII; Madrid, Spain; IIS-FJD; Madrid, Spain; División de Biomedicina Epitelial, Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT); Madrid, Spain.
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7
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Kiritsi D, Dieter K, Niebergall-Roth E, Fluhr S, Daniele C, Esterlechner J, Sadeghi S, Ballikaya S, Erdinger L, Schauer F, Gewert S, Laimer M, Bauer JW, Hovnanian A, Zambruno G, El Hachem M, Bourrat E, Papanikolaou M, Petrof G, Kitzmüller S, Ebens CL, Frank MH, Frank NY, Ganss C, Martinez AE, McGrath JA, Tolar J, Kluth MA. Clinical trial of ABCB5+ mesenchymal stem cells for recessive dystrophic epidermolysis bullosa. JCI Insight 2021; 6:151922. [PMID: 34665781 PMCID: PMC8663784 DOI: 10.1172/jci.insight.151922] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/13/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recessive dystrophic epidermolysis bullosa (RDEB) is a rare, devastating, and life-threatening inherited skin fragility disorder that comes about due to a lack of functional type VII collagen, for which no effective therapy exists. ABCB5+ dermal mesenchymal stem cells (ABCB5+ MSCs) possess immunomodulatory, inflammation-dampening, and tissue-healing capacities. In a Col7a1–/– mouse model of RDEB, treatment with ABCB5+ MSCs markedly extended the animals’ lifespans. METHODS In this international, multicentric, single-arm, phase I/IIa clinical trial, 16 patients (aged 4–36 years) enrolled into 4 age cohorts received 3 i.v. infusions of 2 × 106 ABCB5+ MSCs/kg on days 0, 17, and 35. Patients were followed up for 12 weeks regarding efficacy and 12 months regarding safety. RESULTS At 12 weeks, statistically significant median (IQR) reductions in the Epidermolysis Bullosa Disease Activity and Scarring Index activity (EBDASI activity) score of 13.0% (2.9%–30%; P = 0.049) and the Instrument for Scoring Clinical Outcome of Research for Epidermolysis Bullosa clinician (iscorEB‑c) score of 18.2% (1.9%–39.8%; P = 0.037) were observed. Reductions in itch and pain numerical rating scale scores were greatest on day 35, amounting to 37.5% (0.0%–42.9%; P = 0.033) and 25.0% (–8.4% to 46.4%; P = 0.168), respectively. Three adverse events were considered related to the cell product: 1 mild lymphadenopathy and 2 hypersensitivity reactions. The latter 2 were serious but resolved without sequelae shortly after withdrawal of treatment. CONCLUSION This trial demonstrates good tolerability, manageable safety, and potential efficacy of i.v. ABCB5+ MSCs as a readily available disease-modifying therapy for RDEB and provides a rationale for further clinical evaluation. TRIAL REGISTRATION Clinicaltrials.gov NCT03529877; EudraCT 2018-001009-98. FUNDING The trial was sponsored by RHEACELL GmbH & Co. KG. Contributions by NYF and MHF to this work were supported by the NIH/National Eye Institute (NEI) grants RO1EY025794 and R24EY028767.
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Affiliation(s)
- Dimitra Kiritsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | | | | | | | | | | | | | | | | | - Franziska Schauer
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Stella Gewert
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Martin Laimer
- EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Johann W Bauer
- EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Alain Hovnanian
- Department of Genetics at Necker Hospital and.,Department of Dermatology at Saint-Louis Hospital, INSERM UMR
| | | | - May El Hachem
- Dermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCSS, Rome, Italy
| | - Emmanuelle Bourrat
- Department of Dermatology, Reference Center for Rare Skin Diseases MAGEC, St. Louis Hospital, Paris, France
| | - Maria Papanikolaou
- St. John's Institute of Dermatology, Guy's Hospital, King's College London, London, United Kingdom
| | - Gabriela Petrof
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Sophie Kitzmüller
- EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Christen L Ebens
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Pediatrics, University of Minnesota M Health Fairview Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Markus H Frank
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Transplant Research Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Harvard Stem Cell Institute, Harvard University, Cambridge, Massachusetts, USA.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Natasha Y Frank
- Transplant Research Program, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Harvard Stem Cell Institute, Harvard University, Cambridge, Massachusetts, USA.,Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts, USA.,Division of Genetics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Christoph Ganss
- RHEACELL GmbH & Co. KG, Heidelberg, Germany.,TICEBA GmbH, Heidelberg, Germany
| | - Anna E Martinez
- Department of Dermatology, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - John A McGrath
- St. John's Institute of Dermatology, Guy's Hospital, King's College London, London, United Kingdom
| | - Jakub Tolar
- Division of Blood and Marrow Transplantation and Cellular Therapy, Department of Pediatrics, University of Minnesota M Health Fairview Masonic Children's Hospital, Minneapolis, Minnesota, USA
| | - Mark A Kluth
- RHEACELL GmbH & Co. KG, Heidelberg, Germany.,TICEBA GmbH, Heidelberg, Germany
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8
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Ablinger M, Lettner T, Friedl N, Potocki H, Palmetzhofer T, Koller U, Illmer J, Liemberger B, Hainzl S, Klausegger A, Reisenberger M, Lambert J, Van Gele M, Desmet E, Van Maelsaeke E, Wimmer M, Zauner R, Bauer JW, Wally V. Personalized Development of Antisense Oligonucleotides for Exon Skipping Restores Type XVII Collagen Expression in Junctional Epidermolysis Bullosa. Int J Mol Sci 2021; 22:3326. [PMID: 33805154 PMCID: PMC8036626 DOI: 10.3390/ijms22073326] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/17/2021] [Accepted: 03/20/2021] [Indexed: 02/06/2023] Open
Abstract
Intermediate junctional epidermolysis bullosa caused by mutations in the COL17A1 gene is characterized by the frequent development of blisters and erosions on the skin and mucous membranes. The rarity of the disease and the heterogeneity of the underlying mutations renders therapy developments challenging. However, the high number of short in-frame exons facilitates the use of antisense oligonucleotides (AON) to restore collagen 17 (C17) expression by inducing exon skipping. In a personalized approach, we designed and tested three AONs in combination with a cationic liposomal carrier for their ability to induce skipping of COL17A1 exon 7 in 2D culture and in 3D skin equivalents. We show that AON-induced exon skipping excludes the targeted exon from pre-mRNA processing, which restores the reading frame, leading to the expression of a slightly truncated protein. Furthermore, the expression and correct deposition of C17 at the dermal-epidermal junction indicates its functionality. Thus, we assume AON-mediated exon skipping to be a promising tool for the treatment of junctional epidermolysis bullosa, particularly applicable in a personalized manner for rare genotypes.
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Affiliation(s)
- Michael Ablinger
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Thomas Lettner
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Nicole Friedl
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Hannah Potocki
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Theresa Palmetzhofer
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Ulrich Koller
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Julia Illmer
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Bernadette Liemberger
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Stefan Hainzl
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Alfred Klausegger
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Manuela Reisenberger
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
- Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (J.L.); (M.V.G.); (E.D.); (E.V.M.)
| | - Mireille Van Gele
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (J.L.); (M.V.G.); (E.D.); (E.V.M.)
| | - Eline Desmet
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (J.L.); (M.V.G.); (E.D.); (E.V.M.)
| | - Els Van Maelsaeke
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (J.L.); (M.V.G.); (E.D.); (E.V.M.)
| | - Monika Wimmer
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Roland Zauner
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
| | - Johann W. Bauer
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
- Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria
| | - Verena Wally
- Research Program for Molecular Therapy of Genodermatoses, EB House Austria, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020 Salzburg, Austria; (M.A.); (T.L.); (N.F.); (H.P.); (T.P.); (U.K.); (J.I.); (B.L.); (S.H.); (A.K.); (M.R.); (M.W.); (R.Z.); (J.W.B.)
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