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Natural gene therapy may occur in all patients with generalized non-Herlitz junctional epidermolysis bullosa with COL17A1 mutations.
[junctional epidermolysis bullosa]
Mutations
in
the
type
XVII
collagen
gene
(
COL
17
A
1
)
result
in
the
blistering
disorder
non-
Herlitz
junctional
epidermolysis
bullosa
(
JEB
-nH
)
.
The
incidence
of
revertant
mosaicism
,
also
called
"
natural
gene
therapy
"
,
was
identified
in
a
cohort
of
14
patients
with
JEB
-nH
caused
by
COL
17
A
1
mutations
in
the
Netherlands
.
Five
different
in
vivo
reversions
,
all
correcting
the
germ-line
COL
17
A
1
mutation
c
.
2237
delG
in
exon
30
,
were
found
in
four
mosaic
JEB
-nH
patients
.
The
correcting
DNA
changes
involved
a
wide
variety
of
somatic
mutations
,
from
which
an
indel
mutation
(
c
.
2228
-
101
_
2263
+
70
delins
15
)
and
a
large
deletion
of
2
,
165
base
pairs
(
c
.
2227
+
153
_
2336
-
318
del
)
have
not
been
previously
observed
in
patients
with
revertant
mosaicism
.
Our
results
show
that
there
is
no
preference
for
a
repair
mechanism
.
Moreover
,
revertant
mosaicism
was
confirmed
on
a
DNA
level
in
6
out
of
10
generalized
JEB
-nH
patients
.
Further
,
photo-material
and
clinical
history
of
the
other
four
generalized
JEB
-nH
patients
demonstrated
that
each
patient
has
revertant
skin
patches
.
In
contrast
,
revertant
mosaicism
was
not
detected
in
the
four
localized
JEB
-nH
patients
.
The
fact
that
so
many
,
if
not
all
,
generalized
JEB
-nH
COL
17
A
1
patients
have
revertant
patches
offers
opportunities
for
cell
therapies
in
which
the
patient
's
own
naturally
corrected
cells
are
used
as
a
source
.
Diseases
Validation
Diseases presenting
"large deletion"
symptom
aniridia
canavan disease
junctional epidermolysis bullosa
kallmann syndrome
kindler syndrome
primary effusion lymphoma
von hippel-lindau disease
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
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