1. McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China 2. The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830001, China 3. Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing 100072, China
Epidermolysis bullosa (EB) is a group of clinically and genetically heterogeneous diseases characterized by trauma-induced mucocutaneous fragility and blister formation. Here, we investigated five Chinese families with EB, and eight variants including a novel nonsense variant (c.47G>A, p.W16*) in LAMA3, a known recurrent variant (c.74C>T, p.P25L) in KRT5, 2 novel (c.2531T>A, p.V844E; c.6811_6814del, p.R2271fs) and 4 known (c.6187C>T, p.R2063W; c.7097G>A, p.G2366D; c.8569G>T, p.E2857*; c.3625_3635del, p.S1209fs) variants in COL7A1 were detected. Notably, this study identified a nonsense variant in LAMA3 that causes EB within the Chinese population and revealed that this variant resulted in a reduction in LAMA3 mRNA and protein expression levels by nonsense-mediated mRNA decay. Our study expands the mutation spectra of Chinese patients with EB.
Scars on elbow and orofacial regions, dental enamel defects, nail defects, and hypertrophic scars in the armpit
LAMA3
AR
2
Nail dystrophy and loss with granulation tissue of nail beds and scarring and blistering on hands, neck, back hands, and elbow regions
COL7A1
AR
3
Blistering and excoriated lesions on her neck, abdomen, extremities and healed with hypertrophic scars; severe hemorrhagic blisters in neck; dysphagia; nail dystrophy; and partial nail loss
COL7A1
AR
4
Scarring, erythema, ulceration, crust on his hands, feet, and elbows; blistering on the joint of hands and feet; esophageal strictures
COL7A1
AR AR
5
Blistering from birth especially on friction sites, additional mottled or reticulate macular pigmentation typically of the previous blistering skin
KRT5
AD
Family
Variant type
Exon
cDNA change
Amino acid change
Reference
1
Homozygous
1
c.47G>A
p.W16*
Present study
2
Heterozygous Heterozygous
86 19
c.6811_6814del c.2531T>A
p.R2271fs p.V844E
Present study Present study
3
Heterozygous Heterozygous
74 92
c.6187C>T c.7097G>A
p.R2063W p.G2366D
[18,19] [12]
4
Heterozygous Heterozygous
27 116
c.3625_3635del c. 8569G>T
p.S1209fs p.E2857*
[20] [21,22]
5
Homozygous
1
c.74C>T
p.P25L
[11–17]
Tab.1
1
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2
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3
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4
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5
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6
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pmid: 27463098
9
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pmid: 32973163
T Hamada, N Ishii, Y Kawano, Y Takahashi, M Inoue, S Yasumoto, T Hashimoto. The P25L mutation in the KRT5 gene in a Japanese family with epidermolysis bullosa simplex with mottled pigmentation. Br J Dermatol 2004; 150(3): 609–611 https://doi.org/10.1046/j.1365-2133.2004.05820.x
pmid: 15030360
12
M Pascucci, P Posteraro, C Pedicelli, A Provini, L Auricchio, M Paradisi, D Castiglia. Epidermolysis bullosa simplex with mottled pigmentation due to de novo P25L mutation in keratin 5 in an Italian patient. Eur J Dermatol 2006; 16(6): 620–622
pmid: 17229601
13
X Liu, L Xia, JX Wang, YJ Hao, J Yang, FQ Liu, R Guo. Mutation analysis of keratin 5 and keratin 14 genes in a family with epidermolysis bullosa simplex with mottled pigmentation. Chin J Med Genet (Zhonghua Yi Xue Yi Chuan Xue Za Zhi) 2011; 28(6): 612–615 (in Chinese)
pmid: 22161089
14
A Bergant Suhodolčan, V Dragoš. Epidermolysis bullosa simplex with mottled pigmentation: the first Slovenian case. Acta Dermatovenerol Alp Panonica Adriat 2014; 23(2): 33–34 https://doi.org/10.15570/actaapa.2014.8
pmid: 24964947
15
H Nagai, N Oiso, S Tomida, K Sakai, S Fujiwara, Y Nakamachi, S Kawano, A Kawada, K Nishio, C Nishigori. Epidermolysis bullosa simplex with mottled pigmentation with noncicatricial alopecia: identification of a recurrent p.P25L mutation in KRT5 in four affected family members. Br J Dermatol 2016; 174(3): 633–635 https://doi.org/10.1111/bjd.14083
pmid: 26286811
16
LM Mariath, JT Santin, JA Frantz, MJR Doriqui, AE Kiszewski, L Schuler-Faccini. An overview of the genetic basis of epidermolysis bullosa in Brazil: discovery of novel and recurrent disease-causing variants. Clin Genet 2019; 96(3): 189–198 https://doi.org/10.1111/cge.13555
pmid: 31001817
17
K Okamura, S Fukushima, J Yamashita, Y Abe, M Hayashi, Y Hozumi, H Ihn, T Suzuki. Natural course of epidermolysis bullosa simplex with mottled pigmentation in a Japanese family with the p.P25L mutation in KRT5. J Dermatol 2019; 46(7): e233–e235 https://doi.org/10.1111/1346-8138.14788
pmid: 30690752
18
DT Woodley, Y Hou, S Martin, W Li, M Chen. Characterization of molecular mechanisms underlying mutations in dystrophic epidermolysis bullosa using site-directed mutagenesis. J Biol Chem 2008; 283(26): 17838–17845 https://doi.org/10.1074/jbc.M709452200
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19
R Gardella, N Zoppi, G Zambruno, S Barlati, M Colombi. Different phenotypes in recessive dystrophic epidermolysis bullosa patients sharing the same mutation in compound heterozygosity with two novel mutations in the type VII collagen gene. Br J Dermatol 2002; 147(3): 450–457 https://doi.org/10.1046/j.1365-2133.2002.04914.x
pmid: 12207583
20
W Jiang, Y Sun, S Li, XX Chen, DF Bu, XJ Zhu. Two novel heterozygous mutations in COL7A1 in a Chinese patient with recessive dystrophic epidermolysis bullosa of Hallopeau-Siemens type. Br J Dermatol 2005; 152(6): 1357–1359 https://doi.org/10.1111/j.1365-2133.2005.06638.x
pmid: 15949010
21
Y Shibusawa, I Negishi, O Ishikawa. Compound heterozygosity in sibling patients with recessive dystrophic epidermolysis bullosa associated with a mild phenotype. Int J Dermatol 2006; 45(3): 302–305 https://doi.org/10.1111/j.1365-4632.2006.02774.x
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22
N Yonei, T Ohtani, F Furukawa. Recessive dystrophic epidermolysis bullosa: case of non-Hallopeau-Siemens variant with premature termination codons in both alleles. J Dermatol 2006; 33(11): 802–805 https://doi.org/10.1111/j.1346-8138.2006.00182.x
pmid: 17073998
23
MJ Escámez, M García, N Cuadrado-Corrales, SG Llames, A Charlesworth, N De Luca, N Illera, C Sánchez-Jimeno, A Holguín, B Duarte, MJ Trujillo-Tiebas, JL Vicario, JL Santiago, A Hernández-Martín, A Torrelo, D Castiglia, C Ayuso, F Larcher, JL Jorcano, A Meana, G Meneguzzi, G Zambruno, M Del Rio. The first COL7A1 mutation survey in a large Spanish dystrophic epidermolysis bullosa cohort: c.6527insC disclosed as an unusually recurrent mutation. Br J Dermatol 2010; 163(1): 155–161 https://doi.org/10.1111/j.1365-2133.2010.09713.x
pmid: 20184583