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Delgado-Miguel C, Miguel-Ferrero M, De Lucas-Laguna R. Misdiagnosis in Epidermolysis Bullosa: Yet Another Burden on Patients and their Families. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:825-826. [PMID: 36309044 DOI: 10.1016/j.ad.2022.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/18/2022] [Accepted: 03/27/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- C Delgado-Miguel
- Department of Pediatric Surgery, La Paz Children's Hospital, Madrid, Spain.
| | - M Miguel-Ferrero
- Department of Pediatric Surgery, La Paz Children's Hospital, Madrid, Spain
| | - R De Lucas-Laguna
- Department of Pediatric Dermatology, La Paz Children's Hospital, Madrid, Spain
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Delgado-Miguel C, Miguel-Ferrero M, de Lucas-Laguna R. Misdiagnosis in Epidermolysis Bullosa: Yet Another Burden on Patients and their Families. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T825-T826. [PMID: 37506828 DOI: 10.1016/j.ad.2022.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/27/2022] [Indexed: 07/30/2023] Open
Affiliation(s)
- C Delgado-Miguel
- Department of Pediatric Surgery, La Paz Children's Hospital, Madrid, España.
| | - M Miguel-Ferrero
- Department of Pediatric Surgery, La Paz Children's Hospital, Madrid, España
| | - R de Lucas-Laguna
- Department of Pediatric Dermatology, La Paz Children's Hospital, Madrid, España
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Kumar K, Shilpasree AS, Chaudhary M. Oral Manifestations and Molecular Basis of Oral Genodermatoses: A Review. J Clin Diagn Res 2016; 10:ZE08-12. [PMID: 27437377 DOI: 10.7860/jcdr/2016/17647.7751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/11/2016] [Indexed: 12/12/2022]
Abstract
Genodermatoses refers to group of inherited monogenic disorders with skin manifestations. Many of these disorders are rare and also have oral manifestations, called oral genodermatoses. This article provides a focused review of molecular basis of important genodermatoses that affects the oral cavity and also have prominent associated dermatologic features. In several conditions discussed here, the oral findings are distinct and may provide the first clue of an underlying genetic diagnosis. The article also emphasises on the prenatal diagnosis, genetic counselling and the treatment oral genodermatoses.
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Affiliation(s)
- Kiran Kumar
- Reader, Department of Oral Pathology and Microbiology, SDM College of Dental Sciences and Hospital , Sattur, Dharwad, India
| | - A S Shilpasree
- Assistant Professor, Department of Biochemistry, SDM College of Medical Sciences and Hospital , Sattur, Dharwad, India
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A Gene Gun-mediated Nonviral RNA trans-splicing Strategy for Col7a1 Repair. MOLECULAR THERAPY. NUCLEIC ACIDS 2016; 5:e287. [PMID: 26928235 DOI: 10.1038/mtna.2016.3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 01/07/2016] [Indexed: 01/24/2023]
Abstract
RNA trans-splicing represents an auspicious option for the correction of genetic mutations at RNA level. Mutations within COL7A1 causing strong reduction or absence of type VII collagen are associated with the severe skin blistering disease dystrophic epidermolysis bullosa. The human COL7A1 mRNA constitutes a suitable target for this RNA therapy approach, as only a portion of the almost 9 kb transcript has to be delivered into the target cells. Here, we have proven the feasibility of 5' trans-splicing into the Col7a1 mRNA in vitro and in vivo. We designed a 5' RNA trans-splicing molecule, capable of replacing Col7a1 exons 1-15 and verified it in a fluorescence-based trans-splicing model system. Specific and efficient Col7a1 trans-splicing was confirmed in murine keratinocytes. To analyze trans-splicing in vivo, we used gene gun delivery of a minicircle expressing a FLAG-tagged 5' RNA trans-splicing molecule into the skin of wild-type mice. Histological and immunofluorescence analysis of bombarded skin sections revealed vector delivery and expression within dermis and epidermis. Furthermore, we have detected trans-spliced type VII collagen protein using FLAG-tag antibodies. In conclusion, we describe a novel in vivo nonviral RNA therapy approach to restore type VII collagen expression for causative treatment of dystrophic epidermolysis bullosa.
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Jones SM, Smith KA, Jain M, Mellerio JE, Martinez A, Nischal KK. The Frequency of Signs of Meibomian Gland Dysfunction in Children with Epidermolysis Bullosa. Ophthalmology 2016; 123:991-9. [PMID: 26876697 DOI: 10.1016/j.ophtha.2015.12.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 12/09/2015] [Accepted: 12/29/2015] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To determine the frequency of meibomian gland dysfunction (MGD) in children with epidermolysis bullosa (EB). DESIGN Hospital-based cross-sectional study. PARTICIPANTS One hundred five children with different forms of EB. METHODS Prospective ophthalmic examination of children with EB presenting over seventeen months including meibomian gland assessment using a recognized classification. MAIN OUTCOME MEASURES Frequency of MGD. RESULTS One hundred five children were recruited, 8.6% with junctional EB, 34.3% with simplex EB, 34.3% with autosomal recessive dystrophic EB, and 22.9% autosomal dominant dystrophic EB. Mean age was 7.42 years (range, 0.08-17.75 years). Ninety-two children (87.62%) demonstrated 1 or more features of MGD. CONCLUSIONS Most children with EB exhibit signs of MGD. To the best of our knowledge, this is the first prospective ocular surface evaluation in children with EB to include lid margin evaluation using a recognized classification system. Our findings help explain some of the ocular surface anomalies seen in children with EB.
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Affiliation(s)
- Sophie M Jones
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, United Kingdom; Developmental Biology Unit, Institute of Child Health, University College London, London, United Kingdom
| | - Kate A Smith
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Minakshi Jain
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, United Kingdom
| | - Jemima E Mellerio
- Department of Dermatology, Great Ormond Street Hospital, London, United Kingdom
| | - Anna Martinez
- Department of Dermatology, Great Ormond Street Hospital, London, United Kingdom
| | - Ken K Nischal
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, United Kingdom; Developmental Biology Unit, Institute of Child Health, University College London, London, United Kingdom; UPMC Childrens Eye Center, Childrens Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
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Kubanov AA, Albanova VI, Chikin VV, Yepishev RV. Modern methods of the treatment of hereditary epidermolysis bullosa. VESTNIK DERMATOLOGII I VENEROLOGII 2014. [DOI: 10.25208/0042-4609-2014-90-6-47-56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Today there are no ethiopathogenetic treatment methods for treating hereditary epidermolysis bullosa. All available treatment methods are symptomatic and are mainly aimed at patient care. Since severe forms of hereditary epidermolysis bullosa affect multiple organs, patients need assistance of both dermatologists and skilled experts such as general practitioners (pediatricians), gastroenterologists and dentists or ophthalmologists, surgeons, hematologists, oncologists, etc. when needed. To take efficient therapeutic and preventive measures, clinical recommendations and treatment standards are needed. Promising therapeutic methods (protein replacement, cell and gene techniques) are currently at different development and implementation stages but they can solve problems related to the treatment of hereditary epidermolysis bullosa in the future.
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Badran EF, Battah HA, Akl KF, Khalil RW, Al Amori I. Detection of novel LAMA3 mutation in Herlitz junctional epidermolysis bullosa in a Jordanian family. Australas J Dermatol 2013; 54:218-21. [PMID: 22963541 DOI: 10.1111/j.1440-0960.2012.00945.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 06/18/2012] [Indexed: 11/29/2022]
Abstract
The Herlitz junctional epidermolysis bullosa (H-JEB) subtype usually presents as a severe lethal inherited variant of epidermolysis bullosa (EB) caused by a homozygous mutation in the genes LAMA3, LMAB3, or LAMAC3. Each gene encodes one of the three chains of heterotrimer laminin-332 proteins (including the alpha-3 chain, beta-3 chain and gamma-2-chain) responsible for the adherence of the epidermis to the underlying dermis. The aim of this report is to add to the existing knowledge about EB by describing a novel mutation in a gene responsible for genodermatosis. A case of a Jordanian male neonate, born to healthy, first cousin consanguineous parents, who developed nonhealing blistering skin and mucous membrane lesions, crusted erosions with significant granulation tissue and dystrophic nails immediately after birth is described. The patient was diagnosed as having a novel LAMA3 mutation causing (H-JEB) by immunofluorescence mapping and molecular analysis. Both parents and this baby's sibling were shown to be heterozygous carriers of the same mutation. Pre-implantation diagnosis using molecular analysis for subsequent pregnancies in this family is crucial for managing any new pregnancy.
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Affiliation(s)
- Eman F Badran
- Department of Pediatrics, Neonatal Division, University of Jordan, Amman, Jordan.
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Clements SE, Techanukul T, Lai-Cheong JE, Mee JB, South AP, Pourreyron C, Burrows NP, Mellerio JE, McGrath JA. Mutations in AEC syndrome skin reveal a role for p63 in basement membrane adhesion, skin barrier integrity and hair follicle biology. Br J Dermatol 2012; 167:134-44. [PMID: 22329826 DOI: 10.1111/j.1365-2133.2012.10888.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AEC (ankyloblepharon-ectodermal defects-clefting) syndrome is an autosomal dominant ectodermal dysplasia disorder caused by mutations in the transcription factor p63. Clinically, the skin is dry and often fragile; other features can include partial eyelid fusion (ankyloblepharon), hypodontia, orofacial clefting, sparse hair or alopecia, and nail dystrophy. OBJECTIVES To investigate how p63 gene mutations affect gene and protein expression in AEC syndrome skin. METHODS We performed microarray analysis on samples of intact and eroded AEC syndrome skin compared with control skin. Changes were verified by quantitative real-time reverse transcription-polymerase chain reaction and, for basal keratinocyte-associated genes, by immunohistochemistry and analysis of microdissected skin. RESULTS We identified significant upregulation of six genes and downregulation of 69 genes in AEC syndrome skin, with the main changes in genes implicated in epidermal adhesion, skin barrier formation and hair follicle biology. There was reduced expression of genes encoding the basement membrane proteins FRAS1 and collagen VII, as well as the skin barrier-associated small proline-rich proteins 1A and 4, late cornified envelope protein 5A, hornerin, and lipid transporters including ALOX15B. Reduced expression of the hair-associated keratins 25, 27, 31, 33B, 34, 35, 81 and 85 was also noted. We also confirmed similar alterations in gene expression for 26 of the 75 genes in eroded AEC scalp skin. CONCLUSIONS This study identifies specific changes in skin structural biology and signalling pathways that result from mutant p63 and provides new molecular insight into the AEC syndrome phenotype.
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Affiliation(s)
- S E Clements
- St John's Institute of Dermatology, King's College London (Guy's Campus), London SE1 9RT, UK
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Abstract
The dermal-epidermal basement membrane is a complex assembly of proteins that provide adhesion and regulate many important processes such as development, wound healing, and cancer progression. This contribution focuses on the structure and function of individual components of the basement membrane, how they assemble together, and how they participate in human tissues and diseases, with an emphasis on skin involvement. Understanding the composition and structure of the basement membrane provides insight into the pathophysiology of inherited blistering disorders, such as epidermolysis bullosa, and acquired bullous diseases, such as the pemphigoid group of autoimmune diseases and epidermolysis bullosa acquisita.
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Affiliation(s)
- Sana Hashmi
- Stanford University School of Medicine, Li Ka Shing Building, 291 Campus Drive, Stanford, CA 94305, USA
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Prasad AN. Epidermolysis bullosae. Med J Armed Forces India 2011; 67:165-6. [DOI: 10.1016/s0377-1237(11)60024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Accepted: 09/09/2010] [Indexed: 10/18/2022] Open
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KUBANOVA AA, MURASHKIN NN. Peculiarities of up-to-day running and epidemiology of the epidermolysis bullosa in the Krasnodar Territory. VESTNIK DERMATOLOGII I VENEROLOGII 2011. [DOI: 10.25208/vdv952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Analysis of the incidence and clinical peculiarities of the bullous epidermolysis in children at Krasnodar Territory circumstances is represented. The authors conclude that there is a growth of the incidence of the various forms of bullous epidermolysis in pediatric patients. They describe the results of analysis concerning the present clinical polymorphism of the disease.
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Minicucci EM, Barraviera SRCS, Miot H, Almeida-Lopes L. Low-level laser therapy for the treatment of epidermolysis bullosa: A case report. J COSMET LASER THER 2010; 12:203-5. [DOI: 10.3109/14764172.2010.502460] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Munro CS. Molecular genetics of the skin: the implications of understanding. Clin Med (Lond) 2009; 9:591-2. [PMID: 20095307 PMCID: PMC4952303 DOI: 10.7861/clinmedicine.9-6-591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
During recent decades, discoveries in genetic skin disease have produced insights into the biology of the skin, and in some cases permitted preventive prenatal diagnosis, but application of this knowledge in palliation or cure remains a tantalising prospect.
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Affiliation(s)
- Colin S Munro
- Alan Lyell Centre for Dermatology, Southern General Hospital, Glasgow.
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Sethuraman G, Mancini AJ. Neonatal Skin Disorders and the Emergency Medicine Physician. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2008. [DOI: 10.1016/j.cpem.2008.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Potential of fibroblast cell therapy for recessive dystrophic epidermolysis bullosa. J Invest Dermatol 2008; 128:2179-89. [PMID: 18385758 DOI: 10.1038/jid.2008.78] [Citation(s) in RCA: 173] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is a severe inherited skin-blistering disorder caused by mutations in the COL7A1 gene that lead to reduced type-VII collagen and defective anchoring fibrils at the dermal-epidermal junction (DEJ). Presently there are no effective treatments for this disorder. Recent mouse studies have shown that intradermal injections of normal human fibroblasts can generate new human type-VII collagen and anchoring fibrils at the DEJ. To assess potential clinical benefits in humans, we gave single intradermal injections of allogeneic fibroblasts to five subjects with RDEB. We noted increased type-VII collagen at the DEJ at 2 weeks and at 3 months following injection and increased anchoring fibrils, although none of these had normal morphology. No adverse effects, clinical or immunopathologic, were noted. We believe the major effect of allogeneic fibroblasts is to increase the recipients' own COL7A1 mRNA levels with greater deposition of mutant type-VII collagen at the DEJ and formation of additional rudimentary anchoring fibrils. Nevertheless, this mutant protein may be partially functional and capable of increasing adhesion at the DEJ. This is the first study demonstrating that intradermal injections of allogeneic fibroblasts have therapeutic potential in human subjects with RDEB.
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Stavropoulos F, Abramowicz S. Management of the oral surgery patient diagnosed with epidermolysis bullosa: report of 3 cases and review of the literature. J Oral Maxillofac Surg 2008; 66:554-9. [PMID: 18280394 DOI: 10.1016/j.joms.2007.06.672] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Revised: 04/16/2007] [Accepted: 06/07/2007] [Indexed: 11/26/2022]
Affiliation(s)
- Franci Stavropoulos
- Department of Oral and Maxillofacial Surgery, University of Florida College of Dentistry, Gainesville, FL 32610-0416, USA.
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