1
|
Cowan TL, Sundberg JP, Roopenian DC, Sproule TJ, Murrell DF. Phenotypic differences in intermediate generalized junctional epidermolysis bullosa with homozygous LAMC2 mutation and a potential genetic modifier. J Eur Acad Dermatol Venereol 2024; 38:e719-e721. [PMID: 38376117 DOI: 10.1111/jdv.19859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/24/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Timothy L Cowan
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine, UNSW, Sydney, New South Wales, Australia
| | | | | | | | - Dédée F Murrell
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine, UNSW, Sydney, New South Wales, Australia
| |
Collapse
|
2
|
Danescu S, Negrutiu M, Has C. Treatment of Epidermolysis Bullosa and Future Directions: A Review. Dermatol Ther (Heidelb) 2024; 14:2059-2075. [PMID: 39090514 PMCID: PMC11333680 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.
Collapse
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.
| |
Collapse
|
3
|
Sproule TJ, Wilpan RY, Wilson JJ, Low BE, Kabata Y, Ushiki T, Abe R, Wiles MV, Roopenian DC, Sundberg JP. Dystonin modifiers of junctional epidermolysis bullosa and models of epidermolysis bullosa simplex without dystonia musculorum. PLoS One 2023; 18:e0293218. [PMID: 37883475 PMCID: PMC10602294 DOI: 10.1371/journal.pone.0293218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
The Lamc2jeb junctional epidermolysis bullosa (EB) mouse model has been used to demonstrate that significant genetic modification of EB symptoms is possible, identifying as modifiers Col17a1 and six other quantitative trait loci, several with strong candidate genes including dystonin (Dst/Bpag1). Here, CRISPR/Cas9 was used to alter exon 23 in mouse skin specific isoform Dst-e (Ensembl GRCm38 transcript name Dst-213, transcript ID ENSMUST00000183302.5, protein size 2639AA) and validate a proposed arginine/glutamine difference at amino acid p1226 in B6 versus 129 mice as a modifier of EB. Frame shift deletions (FSD) in mouse Dst-e exon 23 (Dst-eFSD/FSD) were also identified that cause mice carrying wild-type Lamc2 to develop a phenotype similar to human EB simplex without dystonia musculorum. When combined, Dst-eFSD/FSD modifies Lamc2jeb/jeb (FSD+jeb) induced disease in unexpected ways implicating an altered balance between DST-e (BPAG1e) and a rarely reported rodless DST-eS (BPAG1eS) in epithelium as a possible mechanism. Further, FSD+jeb mice with pinnae removed are found to provide a test bed for studying internal epithelium EB disease and treatment without severe skin disease as a limiting factor while also revealing and accelerating significant nasopharynx symptoms present but not previously noted in Lamc2jeb/jeb mice.
Collapse
Affiliation(s)
| | - Robert Y. Wilpan
- The Jackson Laboratory, Bar Harbor, ME, United States of America
| | - John J. Wilson
- The Jackson Laboratory, Bar Harbor, ME, United States of America
| | - Benjamin E. Low
- The Jackson Laboratory, Bar Harbor, ME, United States of America
| | - Yudai Kabata
- Division of Dermatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Division of Microscopic Anatomy, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tatsuo Ushiki
- Division of Microscopic Anatomy, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Riichiro Abe
- Division of Dermatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Michael V. Wiles
- The Jackson Laboratory, Bar Harbor, ME, United States of America
| | | | - John P. Sundberg
- The Jackson Laboratory, Bar Harbor, ME, United States of America
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| |
Collapse
|