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Chronic colitis due to an epithelial barrier defect: the role of kindlin-1 isoforms.
[kindler syndrome]
Kindlin-
1
is
an
epithelium-
specific
phosphoprotein
and
focal
adhesion
adaptor
component
.
Mutations
in
the
corresponding
gene
(
KIND
1
)
cause
Kindler
syndrome
(
KS
)
,
which
is
manifested
by
skin
blistering
,
poikiloderma
,
photosensitivity
and
carcinogenesis
.
Some
patients
also
exhibit
gastrointestinal
symptoms
,
but
it
has
remained
unclear
whether
these
represent
a
feature
of
Kindler
syndrome
or
a
coincidence
.
We
examined
kindlin-
1
in
human
gastrointestinal
epithelia
and
showed
that
it
is
involved
in
the
aetiopathology
of
Kindler
syndrome
-associated
colitis
.
Kindlin-
1
expression
was
assessed
by
indirect
immunofluorescence
,
western
blot
and
RT-PCR
.
Kindlin-
1
is
expressed
in
oral
mucosa
,
colon
and
rectum
.
Both
the
full-length
74
kDa
kindlin-
1
protein
and
a
43
kDa
isoform
were
detected
in
CaCo
2
cells
,
the
latter
resulting
from
alternative
splicing
.
In
the
first
months
of
life
,
patients
(
homozygous
for
null
mutations
)
had
severe
intestinal
involvement
with
haemorrhagic
diarrhoea
and
showed
morphological
features
of
severe
ulcerative
colitis
.
Later
in
childhood
,
histopathology
demonstrated
focal
detachment
of
the
epithelium
in
all
segments
of
the
colon
,
chronic
inflammation
and
mucosal
atrophy
.
These
findings
define
an
intestinal
phenotype
for
Kindler
syndrome
as
a
consequence
of
a
primary
epithelial
barrier
defect
.
The
different
clinical
intestinal
manifestations
in
Kindler
syndrome
patients
may
be
explained
by
partial
functional
compensation
of
kindlin-
1
deficiency
by
the
intestinal
isoform
or
by
the
presence
of
truncated
mutant
kindlin-
1
.
Diseases
Validation
Diseases presenting
"poikiloderma"
symptom
erythropoietic protoporphyria
kindler syndrome
This symptom has already been validated