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Castiglia D, Fortugno P, Condorelli AG, Barresi S, De Luca N, Pizzi S, Neri I, Graziano C, Trojan D, Ponzin D, Rossi S, Zambruno G, Tartaglia M. A Novel Phenotype of Junctional Epidermolysis Bullosa with Transient Skin Fragility and Predominant Ocular Involvement Responsive to Human Amniotic Membrane Eyedrops. Genes (Basel) 2021; 12:716. [PMID: 34064633 PMCID: PMC8151857 DOI: 10.3390/genes12050716] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
Junctional epidermolysis bullosa (JEB) is a clinically and genetically heterogeneous skin fragility disorder frequently caused by mutations in genes encoding the epithelial laminin isoform, laminin-332. JEB patients also present mucosal involvement, including painful corneal lesions. Recurrent corneal abrasions may lead to corneal opacities and visual impairment. Current treatments are merely supportive. We report a novel JEB phenotype distinguished by the complete resolution of skin fragility in infancy and persistent ocular involvement with unremitting and painful corneal abrasions. Biallelic LAMB3 mutations c.3052-5C>G and c.3492_3493delCG were identified as the molecular basis for this phenotype, with one mutation being a hypomorphic splice variant that allows residual wild-type laminin-332 production. The reduced laminin-332 level was associated with impaired keratinocyte adhesion. Then, we also investigated the therapeutic power of a human amniotic membrane (AM) eyedrop preparation for corneal lesions. AM were isolated from placenta donors, according to a procedure preserving the AM biological characteristics as a tissue, and confirmed to contain laminin-332. We found that AM eyedrop preparation could restore keratinocyte adhesion in an in vitro assay. Of note, AM eyedrop administration to the patient resulted in long-lasting remission of her ocular manifestations. Our findings suggest that AM eyedrops could represent an effective, non-invasive, simple-to-handle treatment for corneal lesions in patients with JEB and possibly other EB forms.
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Affiliation(s)
- Daniele Castiglia
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Paola Fortugno
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Angelo Giuseppe Condorelli
- Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.C.); (G.Z.)
| | - Sabina Barresi
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
| | - Naomi De Luca
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Simone Pizzi
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
| | - Iria Neri
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy;
| | - Claudio Graziano
- Medical Genetics, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy;
| | | | - Diego Ponzin
- The Veneto Eye Bank Foundation, 30174 Venice, Italy;
| | - Sabrina Rossi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Giovanna Zambruno
- Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.C.); (G.Z.)
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
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