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Type VII collagen deficiency causes defective tooth enamel formation due to poor differentiation of ameloblasts.
[dystrophic epidermolysis bullosa]
Recessive
dystrophic
epidermolysis
bullosa
(
RDEB
)
is
caused
by
mutations
in
the
gene
encoding
type
VII
collagen
(
COL
7
)
,
a
major
component
of
anchoring
fibrils
in
the
epidermal
basement
membrane
zone
.
Patients
with
RDEB
present
a
low
oral
hygiene
index
and
prevalent
tooth
abnormalities
with
caries
.
We
examined
the
tooth
enamel
structure
of
an
RDEB
patient
by
scanning
electron
microscopy
.
It
showed
irregular
enamel
prisms
,
indicating
structural
enamel
defects
.
To
elucidate
the
pathomechanisms
of
enamel
defects
due
to
COL
7
deficiency
,
we
investigated
tooth
formation
in
Col
7
a
1
(
-
/
-
)
and
COL
7
-
rescued
humanized
mice
that
we
have
established
.
The
enamel
from
Col
7
a
1
(
-
/
-
)
mice
had
normal
surface
structure
.
The
enamel
calcification
and
chemical
composition
of
Col
7
a
1
(
-
/
-
)
mice
were
similar
to
those
of
the
wild
type
.
However
,
transverse
sections
of
teeth
from
the
Col
7
a
1
(
-
/
-
)
mice
showed
irregular
enamel
prisms
,
which
were
also
observed
in
the
RDEB
patient
.
Furthermore
,
the
Col
7
a
1
(
-
/
-
)
mice
teeth
had
poorly
differentiated
ameloblasts
,
lacking
normal
enamel
protein-secreting
Tomes
'
processes
,
and
showed
reduced
mRNA
expression
of
amelogenin
and
other
enamel
-related
molecules
.
These
enamel
abnormalities
were
corrected
in
the
COL
7
-
rescued
humanized
mice
expressing
a
human
COL
7
A
1
transgene
.
These
findings
suggest
that
COL
7
regulates
ameloblast
differentiation
and
is
essential
for
the
formation
of
Tomes
'
processes
.
Collectively
,
COL
7
deficiency
is
thought
to
disrupt
epithelial-mesenchymal
interactions
,
leading
to
defective
ameloblast
differentiation
and
enamel
malformation
in
RDEB
patients
.
Diseases
Validation
Diseases presenting
"enamel malformation in rdeb patients"
symptom
dystrophic epidermolysis bullosa
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