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Malovitski K, Sarig O, Assaf S, Mohamad J, Malki L, Bergson S, Peled A, Eskin-Schwartz M, Gat A, Pavlovsky M, Sprecher E. Loss-of-function variants in KLF4 underlie autosomal dominant palmoplantar keratoderma. Genet Med 2022; 24:1085-1095. [PMID: 35168889 DOI: 10.1016/j.gim.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/09/2022] [Accepted: 01/14/2022] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Palmoplantar keratodermas (PPKs) form a group of disorders characterized by thickening of palm and sole skin. Over the past 2 decades, many types of inherited PPKs have been found to result from abnormal expression, processing, or function of adhesion proteins. METHODS We used exome and direct sequencing to detect causative pathogenic variants. Functional analysis of these variants was conducted using reverse transcription quantitative polymerase chain reaction, immunofluorescence confocal microscopy, immunoblotting, a promoter reporter assay, and chromatin immunoprecipitation. RESULTS We identified 2 heterozygous variants (c.1226A>G and c.633_634dupGT) in KLF4 in 3 individuals from 2 different unrelated families affected by a dominant form of PPK. Immunofluorescence staining for a number of functional markers revealed reduced epidermal DSG1 expression in patients harboring heterozygous KLF4 variants. Accordingly, human keratinocytes either transfected with constructs expressing these variants or downregulated for KLF4 displayed reduced DSG1 expression, which in turn has previously been found to be associated with PPK. A chromatin immunoprecipitation assay confirmed direct binding of KLF4 to the DSG1 promoter region. The ability of mutant KLF4 to transactivate the DSG1 promoter was significantly decreased when compared with wild-type KLF4. CONCLUSION Loss-of-function variants in KLF4 cause a novel form of dominant PPK and show its importance in the regulation of epidermal differentiation.
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Affiliation(s)
- Kiril Malovitski
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Sarig
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sari Assaf
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Janan Mohamad
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liron Malki
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shir Bergson
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Peled
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Marina Eskin-Schwartz
- Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel; Genetic Institute, Soroka University Medical Center, Be'er Sheva, Israel
| | - Andrea Gat
- Institute of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Mor Pavlovsky
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eli Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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2
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Wu AG, Lipner SR. Distinctions in the Management, Patient Impact, and Clinical Profiles of Pachyonychia Congenita Subtypes. Skin Appendage Disord 2021; 7:194-202. [PMID: 34055907 DOI: 10.1159/000513340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/19/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Pachyonychia congenita (PC) is a rare dermatosis that confers lifelong physical and emotional morbidities in affected patients. However, the clinical findings, treatments, and psychosocial impact of this disease have not been adequately described. The International PC Research Registry (IPCRR), a multinational initiative to collect data on PC patients, has allowed an opportunity to distinguish the salient features of this disease. We aimed to characterize the breadth and extent of nail disease, treatments, and quality of life in PC patients, and to describe any significant differences in clinical presentation or treatment of PC subtypes. Methods The most recent IPCRR patient survey data consisting of an 857-response questionnaire and a 102-response addendum were analyzed in a retrospective analysis. The survey data were collected as part of a multinational, multicenter initiative and comprise the largest representative population of PC to date. Participants (survey respondents) were included in the study based on questionnaire responses and a genetic confirmation of having a PC subtype. Results A total of 857 survey responses were collected. Genetic variations among PC subtypes influence nail disease onset and severity of symptoms. Nail disease negatively impacts patients' emotional health, especially during the adolescent and young adult years. Nail treatment tools vary little in terms of effectiveness and acquired infection rates. Conclusion and Discussion Patients with different PC subtypes have distinct clinical nail presentations and psychosocial impact. Genetic testing should be used to confirm PC diagnoses. Further characterization of PC, especially the rarer subtypes, may allow for more individualized patient education.
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Affiliation(s)
- Albert G Wu
- New York Medical College, New York, New York, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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3
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Lee JYW, McGrath JA. Mutations in genes encoding desmosomal proteins: spectrum of cutaneous and extracutaneous abnormalities. Br J Dermatol 2020; 184:596-605. [PMID: 32593191 DOI: 10.1111/bjd.19342] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2020] [Indexed: 12/27/2022]
Abstract
The desmosome is a type of intercellular junction found in epithelial cells, cardiomyocytes and other specialized cell types. Composed of a network of transmembranous cadherins and intracellular armadillo, plakin and other proteins, desmosomes contribute to cell-cell adhesion, signalling, development and differentiation. Mutations in genes encoding desmosomal proteins result in a spectrum of erosive skin and mucosal phenotypes that also may affect hair or heart. This review summarizes the molecular pathology and phenotypes associated with desmosomal dysfunction with a focus on inherited disorders that involve the skin/hair, as well as associated extracutaneous pathologies. We reviewed the relevant literature to collate studies of pathogenic human mutations in desmosomes that have been reported over the last 25 years. Mutations in 12 different desmosome genes have been documented, with mutations in nine genes affecting the skin/mucous membranes (DSG1, DSG3, DSC2, DSC3, JUP, PKP1, DSP, CDSN, PERP) and eight resulting in hair abnormalities (DSG4, DSC2, DSC3, JUP, PKP1, DSP, CDSN, PERP). Mutations in three genes can result in cardiocutaneous syndromes (DSC2, JUP, DSP), although mutations have been described in five genes in inherited heart disorders that may lack any dermatological manifestations (DSG2, DSC2, JUP, PKP2, DSP). Understanding the diverse nature of these clinical phenotypes, as well as the desmosome gene mutation(s), has clinical value in managing and counselling patients, as well as demonstrating the biological role and activity of specific components of desmosomes in skin and other tissues.
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Affiliation(s)
- J Y W Lee
- St John's Institute of Dermatology, King's College London, Guy's Hospital, London, UK
| | - J A McGrath
- St John's Institute of Dermatology, King's College London, Guy's Hospital, London, UK
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4
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Rodríguez Tejero A, Tercedor Sánchez J, Montero Vilchez T, López Delgado D, Arias Santiago S, Molina Leyva A. A case report of severe dermatitis, allergies, and metabolic wasting (SAM syndrome). Pediatr Dermatol 2020; 37:576-578. [PMID: 32126589 DOI: 10.1111/pde.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 01/19/2020] [Accepted: 01/30/2020] [Indexed: 11/30/2022]
Abstract
The presence of eczema and elevated IgE in pediatric patients does not always indicate atopic dermatitis. Rare genodermatoses may share this clinical presentation and should be considered in the differential diagnosis for patients with congenital immunodeficiency and severe refractory dermatitis. We describe a case of severe dermatitis, allergies, and metabolic wasting syndrome, due to a novel mutation in DSG1 gene, an additional example of this uncommon genetic disorder of desmosome function.
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Affiliation(s)
- Andrea Rodríguez Tejero
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Jesús Tercedor Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Unidad de Dermatología Pediátrica y Anomalías Vasculares, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Trinidad Montero Vilchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - David López Delgado
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Salvador Arias Santiago
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Dermatology Department, Granada School of Medicine, Granada University, Granada, Spain
| | - Alejandro Molina Leyva
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
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5
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Akbar A, Prince C, Payne C, Fasham J, Ahmad W, Baple EL, Crosby AH, Harlalka GV, Gul A. Novel nonsense variants in SLURP1 and DSG1 cause palmoplantar keratoderma in Pakistani families. BMC MEDICAL GENETICS 2019; 20:145. [PMID: 31443639 PMCID: PMC6708247 DOI: 10.1186/s12881-019-0872-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/02/2019] [Indexed: 12/31/2022]
Abstract
Background Inherited palmoplantar keratodermas (PPKs) are clinically and genetically heterogeneous and phenotypically diverse group of genodermatoses characterized by hyperkeratosis of the palms and soles. More than 20 genes have been reported to be associated with PPKs including desmoglein 1 (DSG1) a key molecular component for epidermal adhesion and differentiation. Mal de Meleda (MDM) is a rare inherited autosomal recessive genodermatosis characterized by transgrediens PPK, associated with mutations in the secreted LY6/PLAUR domain containing 1 (SLURP1) gene. Methods This study describes clinical as well as genetic whole exome sequencing (WES) and di-deoxy sequencing investigations in two Pakistani families with a total of 12 individuals affected by PPK. Results WES identified a novel homozygous nonsense variant in SLURP1, and a novel heterozygous nonsense variant in DSG1, as likely causes of the conditions in each family. Conclusions This study expands knowledge regarding the molecular basis of PPK, providing important information to aid clinical management in families with PPK from Pakistan. Electronic supplementary material The online version of this article (10.1186/s12881-019-0872-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abida Akbar
- Department of Biological Sciences, International Islamic University, H-10, Islamabad, 44000, Pakistan.,College of Medicine and Health, RILD Wellcome Wolfson Centre, University of Exeter, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Claire Prince
- College of Medicine and Health, RILD Wellcome Wolfson Centre, University of Exeter, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Chloe Payne
- College of Medicine and Health, RILD Wellcome Wolfson Centre, University of Exeter, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - James Fasham
- College of Medicine and Health, RILD Wellcome Wolfson Centre, University of Exeter, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Wasim Ahmad
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-e-Azam University (QAU), Islamabad, Pakistan
| | - Emma L Baple
- College of Medicine and Health, RILD Wellcome Wolfson Centre, University of Exeter, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Andrew H Crosby
- College of Medicine and Health, RILD Wellcome Wolfson Centre, University of Exeter, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Gaurav V Harlalka
- College of Medicine and Health, RILD Wellcome Wolfson Centre, University of Exeter, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.,Rajarshi Shahu College of Pharmacy, Malvihir Buldana, Maharashtra, Post code 443001, India
| | - Asma Gul
- Department of Biological Sciences, International Islamic University, H-10, Islamabad, 44000, Pakistan.
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6
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Abi Zamer B, Mahfood M, Saleh B, Al Mutery AF, Tlili A. Novel mutation in the
DSG1
gene causes autosomal‐dominant striate palmoplantar keratoderma in a large Syrian family. Ann Hum Genet 2019; 83:472-476. [DOI: 10.1111/ahg.12335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 04/15/2019] [Accepted: 05/16/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Batoul Abi Zamer
- Department of Applied Biology, College of Sciences University of Sharjah Sharjah United Arab Emirates
| | - Mona Mahfood
- Department of Applied Biology, College of Sciences University of Sharjah Sharjah United Arab Emirates
| | - Batoul Saleh
- Department of Applied Biology, College of Sciences University of Sharjah Sharjah United Arab Emirates
| | - Abdullah Fahd Al Mutery
- Department of Applied Biology, College of Sciences University of Sharjah Sharjah United Arab Emirates
- Molecular Genetics Research Laboratory University of Sharjah Sharjah United Arab Emirates
| | - Abdelaziz Tlili
- Department of Applied Biology, College of Sciences University of Sharjah Sharjah United Arab Emirates
- Molecular Genetics Research Laboratory University of Sharjah Sharjah United Arab Emirates
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7
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Zamiri M, Wilson NJ, O'Toole EA, Smith FJD. Novel mutations in desmoglein 1: focal palmoplantar keratoderma in milder phenotypes. Br J Dermatol 2019; 181:618-620. [PMID: 30822367 DOI: 10.1111/bjd.17839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Zamiri
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, U.K
| | - N J Wilson
- Dermatology and Genetic Medicine, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, Dundee, U.K
| | - E A O'Toole
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - F J D Smith
- Dermatology and Genetic Medicine, Division of Biological Chemistry and Drug Discovery, School of Life Sciences, University of Dundee, Dundee, U.K.,Pachyonychia Congenita Project, Holladay, Utah, U.S.A
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