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Alotaibi SM, Zahlan A, AlAteeq M, AlMutawa H, Alobaida NW, Aljomah DS, Binnasser A. Supraglottic laryngeal manifestation of epidermolysis bullosa in a pediatric population: A literature review with four case reports. OTOLARYNGOLOGY CASE REPORTS 2023. [DOI: 10.1016/j.xocr.2023.100516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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2
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Fozia F, Nazli R, Bibi N, Khan SA, Muhammad N, Shakeeb N, Khan S, Jelani M, Wasif N. Whole Exome Sequencing Confirms Molecular Diagnostics of Three Pakhtun Families With Autosomal Recessive Epidermolysis Bullosa. Front Pediatr 2021; 9:727288. [PMID: 34414147 PMCID: PMC8369263 DOI: 10.3389/fped.2021.727288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/09/2021] [Indexed: 12/04/2022] Open
Abstract
Epidermolysis bullosa (EB) is a genetic skin disorder that shows heterogeneous clinical fragility. The patients develop skin blisters congenitally or in the early years of life at the dermo-epithelial junctions, including erosions, hyperkeratosis over the palms and soles. The other associated features are hypotrichosis on the scalp, absent or dystrophic nails, and dental anomalies. Molecular diagnosis through whole-exome sequencing (WES) has become one of the successful tool in clinical setups. In this study, three Pakhtun families from the Khyber Pakhtunkhwa province of Pakistan were ascertained. WES analysis of a proband in each family revealed two novel variants (COL17A1: NM_000494.4: c.4041T>G: p.Y1347* and PLEC: NM_201380.3: c.1283_1285delGCT: p.L426del) and one previously known COL17A1: NM_000494.4:c.3067C>T: p.Q1023*) variant in homozygous forms. Sanger sequencing of the identified variants confirmed that the heterozygous genotypes of the obligate carriers. The identified variants have not only increased the mutation spectrum of the COL17A1 and PLEC but also confirms their vital role in the morphogenesis of skin and its associated appendages. WES can be used as a first-line diagnostic tool in genetic testing and counselling families from Khyber Pakhtunkhwa, Pakistan.
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Affiliation(s)
- Fozia Fozia
- Department of Biochemistry, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan.,Department of Biotechnology and Genetic Engineering, Kohat University of Science and Technology, Kohat, Pakistan
| | - Rubina Nazli
- Department of Biochemistry, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Nousheen Bibi
- Department of Bioinformatics, Shaheed Benazir Bhutto Women University, Peshawar, Pakistan
| | - Sher Alam Khan
- Department of Biotechnology and Genetic Engineering, Kohat University of Science and Technology, Kohat, Pakistan
| | - Noor Muhammad
- Department of Biotechnology and Genetic Engineering, Kohat University of Science and Technology, Kohat, Pakistan
| | - Nafila Shakeeb
- Dermatology Department, Services Hospital, Peshawar, Pakistan
| | - Saadullah Khan
- Department of Biotechnology and Genetic Engineering, Kohat University of Science and Technology, Kohat, Pakistan
| | - Musharraf Jelani
- Centre for Omic Sciences, Islamia College Peshawar, Peshawar, Pakistan
| | - Naveed Wasif
- Institute of Human Genetics, University of Ulm, University of Ulm Medical Center, Ulm, Germany.,Institute of Human Genetics, University Hospital Schleswig-Holstein, Kiel, Germany
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Devergne C, Demirtas S, Gauvin Y, Bellon N, Chiaverini C, Misery L, Abasq-Thomas C. Laryngeal stenosis associated with epidermolysis bullosa simplex. JAAD Case Rep 2020; 6:465-467. [PMID: 32395601 PMCID: PMC7203509 DOI: 10.1016/j.jdcr.2020.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Cécile Devergne
- Dermatology, Centre Hospitalier Régional Universitaire Brest, Brest, France
- Correspondence to: Cécile Devergne, MD, 22 rue amiral linois, 29200 Brest, France.
| | - Sirin Demirtas
- Dermatology, Centre Hospitalier Régional Universitaire Brest, Brest, France
| | - Yves Gauvin
- Otorhinolaryngology, Centre Hospitalier Régional Universitaire Brest, Brest, France
| | | | | | - Laurent Misery
- Dermatology, Centre Hospitalier Régional Universitaire Brest, Brest, France
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Bourhis T, Buche S, Fraitag S, Fayoux P. Laryngeal lesion associated with epidermolysis bullosa secondary to congenital plectin deficiency. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:203-205. [PMID: 30880037 DOI: 10.1016/j.anorl.2019.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Epidermolysis bullosa (EB) is a congenital disease characterized by fragility of epithelial structures. The skin is the organ primarily affected, resulting in the formation of skin blisters. Some forms of EB may also present mucosal lesions. CASE REPORT We report the case of a girl with epidermolysis bullosa simplex (EBS) associated with muscular dystrophy secondary to congenital plectin deficiency. She presented severe respiratory tract lesions extending from the oral cavity to the larynx. In particular, we describe our medical and surgical management of the laryngeal lesions, responsible for several episodes of respiratory distress and feeding difficulties. DISCUSSION Epidermolysis bullosa simplex associated with muscular dystrophy is a rare hereditary form of EB, as fewer than 50 cases have been reported in the literature. This form is characterized by mucosal lesions involving the upper aerodigestive tract, with consequences for feeding, phonation and breathing. Special care must be taken when performing diagnostic and therapeutic procedures to avoid worsening the lesions of this very fragile mucosa. Tracheotomy is a harmful procedure in these patients and should only be considered as a last resort.
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Affiliation(s)
- T Bourhis
- ORL et chirurgie cervicofaciale pédiatrique, hôpital Jeanne-de-Flandre, CHRU Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - S Buche
- Service de dermatologie, hôpital Claude-Huriez, CHRU Lille, 59037 Lille, France
| | - S Fraitag
- Service d'anatomie et cytologie pathologiques, hôpital Necker-Enfants malades, AP-HP, 75015 Paris, France
| | - P Fayoux
- ORL et chirurgie cervicofaciale pédiatrique, hôpital Jeanne-de-Flandre, CHRU Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
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Deev RV, Bardakov SN, Mavlikeev MO, Yakovlev IA, Umakhanova ZR, Akhmedova PG, Magomedova RM, Chekmaryeva IA, Dalgatov GD, Isaev AA. Glu20Ter Variant in PLEC 1f Isoform Causes Limb-Girdle Muscle Dystrophy with Lung Injury. Front Neurol 2017; 8:367. [PMID: 28824526 PMCID: PMC5534468 DOI: 10.3389/fneur.2017.00367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/12/2017] [Indexed: 11/13/2022] Open
Abstract
Plectinopathies are orphan diseases caused by PLEC gene mutations. PLEC is encoding the protein plectin, playing a role in linking cytoskeleton components in various tissues. In this study, we describe the clinical case of a 26-year-old patient with an early onset plectinopathy variant “limb-girdle muscle dystrophy type 2Q,” report histopathological and ultrastructural findings in m. vastus lateralis biopsy and a novel homozygous likely pathogenic variant (NM_201378.3:c.58G>T, NP_958780.1:p.Glu20Ter) in isoform 1f of the gene PLEC. The patient had an early childhood onset with retarded physical development, moderate weakness in pelvic girdle muscles, progressive weakening of limb-girdle muscles after the age of 21, pronounced atrophy of axial muscles, and hypertrophy of the gastrocnemius, deltoid, and triceps muscles, intermittent dyspnea, and no skin involvement. Findings included: non-infectious bronchiolitis and atelectasis signs, biopsy revealed myodystrophal pattern without macrophage infiltration, muscle fiber cytoskeleton disorganization resulted from the plectin loss, incomplete reparative rhabdomyogenesis, and moderate endomysial fibrosis. We have determined a novel likely pathogenic variant in PLEC 1f isoform that causes limb-girdle muscle dystrophy type 2Q and described the third case concerning an isolated myodystrophic phenotype of LGMD2Q with the likely pathogenic variant in PLEC 1f isoform. In addition, we have demonstrated the presence of severe lung injury in a patient and his siblings with the same myodystrophic phenotype and discussed the possible role of plectin deficiency in its pathogenesis.
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Affiliation(s)
- Roman V Deev
- Human Stem Cells Institute, Moscow, Russia.,Ryazan State Medical University, Ryazan, Russia
| | - Sergei N Bardakov
- Department of Neurology, S.M. Kirov Military Medical Academy, St. Petersburg, Russia
| | - Mikhail O Mavlikeev
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Ivan A Yakovlev
- Human Stem Cells Institute, Moscow, Russia.,Ryazan State Medical University, Ryazan, Russia.,Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan, Russia
| | - Zoya R Umakhanova
- Department of Neurology, Dagestan State Medical Academy, Makhachkala, Russia
| | - Patimat G Akhmedova
- Department of Neurology, Dagestan State Medical Academy, Makhachkala, Russia
| | - Raisat M Magomedova
- Department of Neurology, Dagestan State Medical Academy, Makhachkala, Russia
| | - Irina A Chekmaryeva
- Laboratory of Electron Microscopy, A.A. Vishnevsky Institute of Surgery, Moscow, Russia
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Palinko D, Matievics V, Szegesdi I, Sztano B, Rovo L. Minimally invasive endoscopic treatment for pediatric combined high grade stenosis as a laryngeal manifestation of epidermolysis bullosa. Int J Pediatr Otorhinolaryngol 2017; 92:126-129. [PMID: 28012513 DOI: 10.1016/j.ijporl.2016.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/16/2016] [Accepted: 11/19/2016] [Indexed: 10/20/2022]
Abstract
Epidermolysis bullosa refers to a clinically and genetically heterogeneous group of inherited mucocutaneous diseases. Laryngotracheal lesions are momentous regarding the risk of sudden airway obstruction. The traditional treatment is tracheostomy. This case report highlights the advantages of minimally invasive interventions. A successful combined endoscopic management of a life-threatening respiratory crisis is presented in a 4-year-old child. Combined commissure stenosis with supraglottic spread was treated by CO2 laser dissection and bilateral endoscopic arytenoid abduction lateropexy, supplemented with mitomycin C application. Due to expectable less scarring, the combination of these modern methods may be an efficient solution in these vulnerable respiratory tracts.
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Affiliation(s)
- Dora Palinko
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary.
| | - Vera Matievics
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary
| | - Ilona Szegesdi
- Department of Anaesthesiology and Intensive Therapy, University of Szeged, Hungary
| | - Balazs Sztano
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary
| | - Laszlo Rovo
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary
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Kyrova J, Kopeckova L, Buckova H, Mrazova L, Vesely K, Hermanova M, Oslejskova H, Fajkusova L. Epidermolysis bullosa simplex with muscular dystrophy. Review of the literature and a case report. J Dermatol Case Rep 2016; 10:39-48. [PMID: 28400893 DOI: 10.3315/jdcr.2016.1231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/06/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Epidermolysis bullosa simplex associated with muscular dystrophy is a genetic skin disease caused by plectin deficiency. A case of a 19-year-old Czech patient affected with this disease and a review all previously published clinical cases are presented. MAIN OBSERVATIONS In our patient, skin signs of the disease developed after birth. Bilateral ptosis at the age of 8 years was considered as the first specific symptom of muscular dystrophy. Since then, severe scoliosis, urological and psychiatric complication have quickly developed. The signs of plectin deficiency were found by histopathological studies, electron microscopy and antigen mapping of the skin and muscular samples. Two autosomal recessive mutations in the plectin gene leading to premature termination codon were disclosed by mutation analysis. By review of all published clinical cases, 49 patients with this disease were found. 54 different mutations in the plectin gene were published, p.(Arg2319*) in exon 31 being the most frequently found. Median age of muscular dystrophy development was 9.5 years. Hoarseness and respiratory complications were the most often complications beside skin involvement. CONCLUSION Epidermolysis bullosa simplex with muscular dystrophy was diagnosed based on clinical, histopathological (skin and muscle biopsy) and mutation analysis of the plectin gene. Overview of the genetic and clinical characteristic of this disease could be presented by review of all previously published clinical cases.
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Affiliation(s)
- Jana Kyrova
- Department of Pediatric Dermatology, Pediatric Clinic, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic; ; EB Centre Czech Republic, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic
| | - Lenka Kopeckova
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic
| | - Hana Buckova
- Department of Pediatric Dermatology, Pediatric Clinic, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic; ; EB Centre Czech Republic, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic
| | - Lenka Mrazova
- Clinic of Pediatric Neurology, University Hospital and Masaryk University Brno, Brno, Czech Republic
| | - Karel Vesely
- 1st Department of Pathological Anatomy, St. Anne´s University Hospital Brno and Masaryk University Brno, Brno, Czech Republic
| | - Marketa Hermanova
- 1st Department of Pathological Anatomy, St. Anne´s University Hospital Brno and Masaryk University Brno, Brno, Czech Republic
| | - Hana Oslejskova
- Clinic of Pediatric Neurology, University Hospital and Masaryk University Brno, Brno, Czech Republic
| | - Lenka Fajkusova
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic
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Osmanagic-Myers S, Rus S, Wolfram M, Brunner D, Goldmann WH, Bonakdar N, Fischer I, Reipert S, Zuzuarregui A, Walko G, Wiche G. Plectin reinforces vascular integrity by mediating crosstalk between the vimentin and the actin networks. J Cell Sci 2015; 128:4138-50. [PMID: 26519478 PMCID: PMC4712781 DOI: 10.1242/jcs.172056] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/01/2015] [Indexed: 12/13/2022] Open
Abstract
Mutations in the cytoskeletal linker protein plectin result in multisystemic diseases affecting skin and muscle with indications of additional vascular system involvement. To study the mechanisms underlying vascular disorders, we established plectin-deficient endothelial cell and mouse models. We show that apart from perturbing the vimentin cytoskeleton of endothelial cells, plectin deficiency leads to severe distortions of adherens junctions (AJs), as well as tight junctions, accompanied by an upregulation of actin stress fibres and increased cellular contractility. Plectin-deficient endothelial cell layers were more leaky and showed reduced mechanical resilience in fluid-shear stress and mechanical stretch experiments. We suggest that the distorted AJs and upregulated actin stress fibres in plectin-deficient cells are rooted in perturbations of the vimentin cytoskeleton, as similar phenotypes could be mimicked in wild-type cells by disruption of vimentin filaments. In vivo studies in endothelium-restricted conditional plectin-knockout mice revealed significant distortions of AJs in stress-prone aortic arch regions and increased pulmonary vascular leakage. Our study opens a new perspective on cytoskeleton-controlled vascular permeability, where a plectin-organized vimentin scaffold keeps actomyosin contractility ‘in-check’ and maintains AJ homeostasis. Summary: Plectin-arranged vimentin scaffolds keep actomyosin contractility ‘in-check’ and maintain cell–cell junction homeostasis, providing a new perspective on cytoskeleton-controlled vascular permeability.
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Affiliation(s)
- Selma Osmanagic-Myers
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
| | - Stefanie Rus
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
| | - Michael Wolfram
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
| | - Daniela Brunner
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
| | - Wolfgang H Goldmann
- Department of Physics, Friedrich-Alexander-University of Erlangen-Nuremberg, 91052 Erlangen, Germany
| | - Navid Bonakdar
- Department of Physics, Friedrich-Alexander-University of Erlangen-Nuremberg, 91052 Erlangen, Germany
| | - Irmgard Fischer
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
| | - Siegfried Reipert
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
| | - Aurora Zuzuarregui
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
| | - Gernot Walko
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
| | - Gerhard Wiche
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, 1030 Vienna, Austria
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Arya R, Boujaoude Z, Gratz I, Akers S, Abouzgheib W. Bronchial stenosis secondary to epidermolysis bullosa successfully treated with bronchoscopic balloon dilatation. Respirol Case Rep 2015; 3:33-5. [PMID: 25802748 PMCID: PMC4364797 DOI: 10.1002/rcr2.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 12/15/2014] [Accepted: 12/24/2014] [Indexed: 11/11/2022] Open
Abstract
Epidermolysis bullosa rarely affects lower airways. We present a case of lower airway involvement and stenosis successfully managed with flexible bronchoscopy and balloon dilation.
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Affiliation(s)
- Rohan Arya
- Pulmonary and Critical Care Medicine, Cooper University Hospital, Cooper Medical School of Rowan University Camden, New Jersey
| | - Ziad Boujaoude
- Pulmonary and Critical Care Medicine, Cooper University Hospital, Cooper Medical School of Rowan University Camden, New Jersey
| | - Irwin Gratz
- Department of Anesthesiology, Cooper University Hospital, Cooper Medical School of Rowan University Camden, New Jersey
| | - Stephen Akers
- Pulmonary and Critical Care Medicine, Cooper University Hospital, Cooper Medical School of Rowan University Camden, New Jersey
| | - Wissam Abouzgheib
- Pulmonary and Critical Care Medicine, Cooper University Hospital, Cooper Medical School of Rowan University Camden, New Jersey
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Castañón MJ, Walko G, Winter L, Wiche G. Plectin-intermediate filament partnership in skin, skeletal muscle, and peripheral nerve. Histochem Cell Biol 2013; 140:33-53. [PMID: 23748243 PMCID: PMC3695321 DOI: 10.1007/s00418-013-1102-0] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2013] [Indexed: 01/13/2023]
Abstract
Plectin is a large, 500-kDa, intermediate filament (IF)-associated protein. It acts as a cytoskeletal crosslinker and signaling scaffold, affecting mechanical as well as dynamic properties of the cytoskeleton. As a member of the plakin family of cytolinker proteins, plectin has a multidomain structure that is responsible for its vast binding portfolio. It not only binds to all types of IFs, actin filaments and microtubules, but also to transmembrane receptors, proteins of the subplasma membrane protein skeleton, components of the nuclear envelope, and several kinases with known roles in migration, proliferation, and energy metabolism of cells. Due to alternative splicing, plectin is expressed as various isoforms with differing N-terminal heads that dictate their differential subcellular targeting. Through specific interactions with other proteins at their target sites and their ability to bind to all types of IFs, plectin molecules provide strategically located IF anchorage sites within the cytoplasm of cells. In this review, we will present an overview of the structural features and functional properties of plectin and discuss recent progress in defining the role of its isoforms in stress-prone tissues and the implicated diseases, with focus on skin, skeletal muscle, and Schwann cells of peripheral nerve.
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Affiliation(s)
- Maria J. Castañón
- Max F. Perutz Laboratories, Department of Biochemistry and Cell Biology, University of Vienna, 1030 Vienna, Austria
| | - Gernot Walko
- Max F. Perutz Laboratories, Department of Biochemistry and Cell Biology, University of Vienna, 1030 Vienna, Austria
- Present Address: Centre for Stem Cells and Regenerative Medicine, King’s College London School of Medicine, 28th Floor, Tower Wing, Guy’s Hospital, Great Maze Pond, London, SE1 9RT UK
| | - Lilli Winter
- Max F. Perutz Laboratories, Department of Biochemistry and Cell Biology, University of Vienna, 1030 Vienna, Austria
- Present Address: Institute of Neuropathology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Gerhard Wiche
- Max F. Perutz Laboratories, Department of Biochemistry and Cell Biology, University of Vienna, 1030 Vienna, Austria
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