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Gene therapy: pursuing restoration of dermal adhesion in recessive dystrophic epidermolysis bullosa.
[dystrophic epidermolysis bullosa]
The
replacement
of
a
defective
gene
with
a
fully
functional
copy
is
the
goal
of
the
most
basic
gene
therapy
.
Recessive
dystrophic
epidermolysis
bullosa
(
RDEB
)
is
characterised
by
a
lack
of
adhesion
of
the
epidermis
to
the
dermis
.
It
is
an
ideal
target
for
gene
therapy
as
all
variants
of
hereditary
RDEB
are
caused
by
mutations
in
a
single
gene
,
COL
7
A
1
,
coding
for
type
VII
collagen
,
a
key
component
of
anchoring
fibrils
that
secure
attachment
of
the
epidermis
to
the
dermis
.
RDEB
is
one
of
the
most
severe
variants
in
the
epidermolysis
bullosa
(
EB
)
group
of
heritable
skin
diseases
.
Epidermolysis
bullosa
is
defined
by
chronic
fragility
and
blistering
of
the
skin
and
mucous
membranes
due
to
mutations
in
the
genes
responsible
for
production
of
the
basement
membrane
proteins
.
This
condition
has
a
high
personal
,
medical
and
socio-economic
impact
.
People
with
RDEB
require
a
broad
spectrum
of
medications
and
specialised
care
.
Due
to
this
being
a
systemic
condition
,
most
research
focus
is
in
the
area
of
gene
therapy
.
Recently
,
preclinical
works
have
begun
to
show
promise
.
They
focus
on
the
virally
mediated
ex
vivo
correction
of
autologous
epithelium
.
These
corrected
cells
are
then
to
be
expanded
and
grafted
onto
the
patient
following
the
lead
of
the
first
successful
gene
therapy
in
dermatology
being
a
grafting
of
corrected
tissue
for
junctional
EB
treatment
.
Current
progress
,
outstanding
challenges
and
future
directions
in
translating
these
approaches
in
clinics
are
reviewed
in
this
article
.
Diseases
Validation
Diseases presenting
"skin diseases"
symptom
cutaneous mastocytosis
dentinogenesis imperfecta
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erythropoietic protoporphyria
fabry disease
harlequin ichthyosis
inclusion body myositis
junctional epidermolysis bullosa
kindler syndrome
lamellar ichthyosis
oculocutaneous albinism
papillon-lefèvre syndrome
sneddon syndrome
systemic capillary leak syndrome
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