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Cell- and protein-based therapy approaches for epidermolysis bullosa.
[dystrophic epidermolysis bullosa]
Dystrophic
epidermolysis
bullosa
(
DEB
)
is
a
clinically
heterogeneous
heritable
skin
fragility
disorder
characterized
by
mechanically
induced
mucocutaneous
blistering
.
On
the
molecular
level
DEB
is
caused
by
mutations
leading
to
deficiency
in
collagen
VII
(
CVII
)
,
a
large
extracellular
protein
building
anchoring
fibrils
that
attach
the
epidermis
to
the
dermis
.
Severely
affected
patients
suffer
from
wounds
,
which
heal
with
excessive
scarring
causing
mutilating
deformities
of
hands
and
feet
.
The
patients
are
also
predisposed
to
development
of
aggressive
squamous
cell
carcinomas
at
sites
of
chronic
wounds
.
Currently
no
available
therapies
exist
for
this
extremely
disabling
and
stigmatizing
disorder
.
We
are
developing
and
evaluating
cell-
and
protein-based
therapies
for
the
management
of
DEB
.
Dermal
fibroblasts
are
easy
to
propagate
in
vitro
,
they
produce
CVII
,
and
they
have
immunomodulating
capacities
,
which
makes
it
possible
to
use
allogeneic
fibroblasts
for
therapy
without
risking
major
adverse
effects
from
the
host
's
immune
system
.
Hence
,
fibroblasts
,
and
fibroblast-like
cells
such
as
mesenchymal
stromal
cells
,
are
prime
candidates
for
cell-based
DEB
therapies
.
An
alternative
for
management
of
disorders
caused
by
defects
in
proteins
with
relatively
low
turnover
rate
is
to
introduce
the
protein
de
novo
to
the
tissue
by
direct
application
of
the
protein
.
CVII
is
long
-lived
and
expressed
in
moderate
amounts
in
the
skin
;
this
makes
injection
of
collagen
VII
protein
a
realistic
approach
for
the
treatment
of
DEB
.
Here
we
present
methods
and
protocols
that
we
are
using
for
fibroblast-
and
recombinant
CVII-based
therapies
of
DEB
in
our
model
of
this
disease
,
the
CVII
hypomorphic
mouse
.
These
protocols
are
directed
towards
management
of
DEB
but
they
can
be
easily
adapted
for
the
treatment
of
other
skin
fragility
disorders
.
Diseases
Validation
Diseases presenting
"clinically heterogeneous heritable skin fragility disorder"
symptom
dystrophic epidermolysis bullosa
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