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Epidermolysis bullosa simplex due to KRT5 mutations: mutation-related differences in cellular fragility and the protective effects of trimethylamine N-oxide in cultured primary keratinocytes.
[epidermolysis bullosa simplex]
Epidermolysis
bullosa
simplex
(
EBS
)
is
a
mechanobullous
skin
fragility
disease
characterized
by
cytolysis
of
basal
keratinocytes
and
intraepidermal
blistering
often
caused
by
mutations
in
keratin
genes
(
KRT
5
or
KRT
14
)
.
No
remedies
exist
for
these
disorders
presenting
a
need
for
development
of
novel
therapies
.
To
identify
new
genotype-phenotype
relationships
in
vivo
and
in
cultured
primary
EBS
keratinocytes
in
vitro
,
and
to
study
the
cytoskeletal
stabilizing
effects
of
trimethylamine
N-
oxide
(
TMAO
)
in
heat-stressed
EBS
cells
.
Genomic
DNA
and
cDNA
samples
from
three
Swedish
patients
with
EBS
were
analysed
for
keratin
mutations
.
Primary
EBS
keratinocyte
cultures
were
established
,
heat
stressed
with
and
without
added
TMAO
,
followed
by
evaluation
of
cellular
fragility
.
In
addition
to
the
previously
reported
KRT
5
mutation
(
V
186
L
)
in
one
patient
,
two
patients
were
found
to
have
a
novel
I
18
3
M
and
recurrent
E
475
G
replacements
in
KRT
5
.
Cultured
EBS
keratinocytes
did
not
exhibit
keratin
aggregates
or
cell
loss
,
except
in
the
patient
with
the
p
.
I
18
3
M
mutation
who
showed
3
%
aggregates
and
2
%
cell
loss
.
Upon
transient
heat
stress
the
number
of
aggregate-containing
cells
increased
to
21
%
,
27
%
and
13
%
,
respectively
,
in
the
p
.
I
18
3
M
,
p
.
E
475
G
and
p
.
V
186
L
mutant
cells
.
Interestingly
,
pretreatment
with
TMAO
prior
to
heat
stress
,
dose
dependently
reduced
the
number
of
aggregate-containing
cells
and
cell
loss
.
These
results
revealed
a
genotype-phenotype
correlation
in
EBS
keratinocytes
upon
heat
stress
and
suggest
protein
stabilization
as
a
new
therapeutic
strategy
.
Diseases
Validation
Diseases presenting
"intraepidermal blistering often caused by mutations in keratin genes"
symptom
epidermolysis bullosa simplex
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