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Molecular mechanisms of phenotypic variability in junctional epidermolysis bullosa.
[junctional epidermolysis bullosa]
Junctional
epidermolysis
bullosa
(
JEB
)
,
a
group
of
hereditary
skin
fragility
disorders
,
is
associated
with
a
wide
variety
of
phenotypes
,
although
all
forms
are
characterised
by
trauma
induced
skin
blistering
and
tissue
separation
at
the
dermal-epidermal
junction
zone
.
A
subgroup
,
coined
JEB
-other
,
is
associated
with
mutations
in
the
COL
17
A
1
gene
encoding
collagen
XVII
or
,
more
rarely
,
with
mutations
in
the
laminin
332
genes
LAMA
3
,
LAMB
3
,
or
LAMC
2
.
The
objective
of
this
study
is
comprehensive
genotype-phenotype
analysis
in
JEB
-other
patients
with
COL
17
A
1
mutations
and
elucidation
of
disease
mechanisms
underlying
different
skin
phenotypes
.
COL
17
A
1
mutations
and
their
clinical
and
cellular
consequences
were
systematically
analysed
in
43
patients
with
JEB
-other
.
Cell
culture
,
RT-PCR
,
and
protein
biochemistry
were
applied
to
assess
the
effects
of
splice
site
mutations
-that
is
,
the
nature
and
amounts
of
transcripts
and
polypeptides
synthesised
and
their
association
with
the
phenotypic
outcome
.
34
distinct
COL
17
A
1
mutations
were
disclosed
,
12
of
them
novel
.
mRNA
and
protein
analyses
demonstrated
that
patients
with
only
about
12
-
14
%
of
the
physiological
collagen
XVII
levels
had
mild
cutaneous
involvement
and
a
long
life
span
.
In
contrast
to
complete
null
phenotypes
,
presence
of
minor
amounts
of
collagen
XVII
protein
in
JEB
skin
is
associated
with
mild
phenotypic
manifestations
.
The
data
have
significant
implications
for
design
of
molecular
therapies
for
JEB
,
since
they
suggest
that
already
a
low
extent
of
collagen
XVII
restoration
will
improve
skin
stability
and
alleviate
symptoms
.
Diseases
Validation
Diseases presenting
"presence of minor amounts of collagen xvii protein in jeb skin is associated with mild phenotypic manifestations"
symptom
junctional epidermolysis bullosa
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