PubMed Health⌕ Search

Biomedical subjects

L Bruckner-Tuderman

Publications and source records attributed to L Bruckner-Tuderman.

At least 73 records · Page 4Linked to original sources
PubMed1997

LAD-1 is absent in a subset of junctional epidermolysis bullosa patients.

The anchoring filament protein LAD-1 has been recently identified as the target of autoantibodies in the acquired blistering disorder linear IgA bullous dermatosis. Because this protein appears to be involved in the process of dermal-epidermal cohesion, this study sought to determine the involvement of LAD-1 in the pathology of junctional epidermolysis bullosa (JEB). To this end, 44 patients with a variety of subtypes of JEB were analyzed by indirect immunofluorescence microscopy with antibodies to LAD-1, BP180, and laminin-5. We found that only patients with generalized atrophic benign epidermolysis bullosa (GABEB) contained LAD-1 defects. Of the 16 GABEB patients studied, 13 showed absent or greatly reduced expression of LAD-1 (including 2 patients with a peculiar interrupted staining pattern) and 3 patients showed defects of laminin-5 expression with normal LAD-1 expression. Patients who showed LAD-1 defects also showed abnormal expression of BP180. Keratinocytes were cultured from the skin of two GABEB patients and analyzed by indirect immunofluorescent microscopy. One culture demonstrated defects of BP180 and LAD-1 expression (which was also verified by radioimmunoprecipitation assay), and one culture showed decreased laminin-5 expression but normal BP180 and LAD-1 expression. Thus, these studies demonstrate that: (i) LAD-1 and BP180 are normally expressed in all subtypes of JEB except GABEB, (ii) the majority of GABEB patients show absent or near absent expression of both LAD-1 and BP180 but normal expression of laminin-5, and (iii) a smaller subset of GABEB patients show normal LAD-1 and BP180 expression but express persistent but reduced levels of laminin-5.

Autoantibodies↗
PubMed1997

A combination of a common splice site mutation and a frameshift mutation in the COL7A1 gene: absence of functional collagen VII in keratinocytes and skin.

We describe a patient with severe generalized dystrophic epidermolysis bullosa (EBD) and a novel combination of compound heterozygous mutations in the COL7A1 gene. The maternal mutation was an A-to-G transition (425-A --> G) at position -2 of the donor splice site within exon 3 that causes aberrant splicing of two abnormal transcripts. One includes intron 3, and one excludes both exon 3 and intron 3. Both splice variants contained a premature termination of the translation. The paternal mutation is a 25-bp deletion in exon 20 (2638de125) that leads to a frameshift and a premature termination codon 133 bp downstream from the site of deletion. This combination of mutations allowed expression of collagen VII mRNA. Immunofluorescence staining of the patient's skin and cultured keratinocytes with domain-specific collagen VII antibodies, however, demonstrated markedly reduced levels of alpha1(VII) polypeptides, and no stable collagen VII protein could be extracted from the patient's cells. Electron microscopy showed severely hypoplastic fibrils below the lamina densa, without evidence of normal anchoring fibrils. The clinically unaffected parents were heterozygous for the mutations, suggesting that both COL7A1 gene defects were recessively inherited disease-causing mutations that are "silent" in heterozygous carriers but in combination can severely interfere with the dermal-epidermal adhesion and lead to severe EBD.

Antibody Specificity↗
PubMed1997

Most anchoring fibrils in human skin originate and terminate in the lamina densa.

Anchoring fibrils (AF) at the dermo-epidermal junction are well characterized as ultrastructural entities. They are composed mainly of collagen VII and play a key role in dermo-epidermal adhesion. Previous studies have suggested that AF originate in the lamina densa (LD), extend perpendicularly into the dermis, and insert into amorphous elements, called "anchoring plaques," in the dermal connective tissue. To elucidate the precise structural organization of the AF network in human skin, we analyzed quantitatively the distribution of different domains of collagen VII in the epidermal basement membrane zone, using various techniques of immunoelectron microscopy with a range of domain-specific antibodies that we prepared. Some electron-dense amorphous structures (ie, anchoring plaques) that were positive with aminoterminal end of collagen VII could be recognized only by pre-embedding en bloc labeling, and not by postembedding section labeling of immunoelectron microscopy. Quantitative analysis of surface labeling with postembedding immunoelectron microscopy demonstrated that most (> 90%) gold particles labeling the epitopes in the aminoterminal (NC-1 domain) of collagen VII were precisely localized to the LD, whereas no specific labeling was observed in the dermis. Most (> 90%) of the gold particles labeling the carboxyterminal end of collagen VII localized at a 160- to 360-nm distance from the LD, and most (> 90%) of the labeling epitopes in the central triple-helical collagenous domain were distributed between the LD and up to 360 nm from it; no specific labelings were observed beyond this area. These results suggest that most (> 90%), if not all, of the AF in human skin do not extend perpendicularly into the dermis, but instead originate and terminate in the LD, forming individual semicircular loops that constitute a network of AF.

Adolescent↗
PubMed1997

Genomic organization of the integrin beta 4 gene (ITGB4): a homozygous splice-site mutation in a patient with junctional epidermolysis bullosa associated with pyloric atresia.

Integrin beta 4 is expressed primarily within the epithelial basement membranes, and it contributes to the stable association of epidermis with the underlying basement membrane. Previous observations have suggested that the expression of this integrin, which is alternatively spliced in various cell types, is deficient in a variant of junctional epidermolysis bullosa associated with pyloric atresia (JEB-PA). To facilitate identification of mutations in the human beta 4 integrin gene, ITGB4, we have now determined its intron-exon organization. The entire gene was shown to consist of 41 exons spanning 36 kb of the genomic DNA on chromosome 17q11-qter. The mutation detection, using PCR-amplification of each exon followed by heteroduplex analysis, revealed a homozygous splicing mutation in a patient with JEB-PA. RT-PCR revealed the presence of two splice variants generated through utilization of cryptic splice sites, and both mRNA transcripts resulted in a frame-shift and premature termination codon of translation. The presence of the mutation resulted in dramatic reduction of the corresponding mRNA transcript level. Because beta 4 integrin is expressed not only in the skin but also in the epithelial lining of the stomach, the absent expression of this integrin in the proband may explain the blistering tendency and development of pyloric atresia.

Amino Acid Sequence↗
PubMed1997

Immunohistochemical, ultrastructural, and molecular features of Kindler syndrome distinguish it from dystrophic epidermolysis bullosa.

BACKGROUND: Kindler syndrome is a rare, inherited skin disease characterized by acral bullae formation, fusion of fingers and toes, and generalized progressive poikiloderma. The purpose of this study was to clarify the nature of the bullous component of Kindler syndrome and to determine whether this inherited skin disorder represents a variant of dystrophic epidermolysis bullosa or a unique independent clinical entity. OBSERVATIONS: Two unrelated patients with Kindler syndrome were studied. Electron microscopy demonstrated marked duplication of the lamina densa, and clefts were observed in areas where the lamina densa was destroyed or obscured. Hemidesmosomes and anchoring fibrils showed normal features. Indirect immunofluorescence revealed normal linear labeling with antibodies against hemidesmosomal components (alpha 6 and beta 4 integrins, BPAG1, and BPAG2) and against anchoring filament components such as uncein, as detected by the 19-DEJ-1 monoclonal antibody. However, antibodies against the 3 respective laminin 5 chains, type IV collagen, and various type VII collagen epitopes (the aminoterminal NC1 domain, the central triple helical collagenous domain, and the carboxyterminal end of the triple helical collagenous domain) revealed a broad reticular staining pattern. Molecular screening of the type VII collagen gene (COL7A1) in the patients and their parents by heteroduplex analysis failed to detect any band shifts indicative of pathologic mutations. CONCLUSIONS: These results suggest that the bullous component of Kindler syndrome is distinct from dystrophic epidermolysis bullosa caused by mutations in the type VII collagen gene. Additionally, the differential distribution patterns of uncein and laminin 5 in the patients' skin samples support the hypothesis that uncein and laminin 5 are different molecules.

Adult↗
PubMed1997

A novel variant of acquired epidermolysis bullosa with autoantibodies against the central triple-helical domain of type VII collagen.

Epidermolysis bullosa acquisita and bullous systemic lupus erythematosus are autoimmune bullous disorders, with tissue-bound and circulating autoantibodies reactive with the noncollagenous NC1 domain of type VII collagen (C-VII). Here, we describe a novel acquired bullous dermatosis with autoantibodies against the triple-helical domain of C-VII. Three patients, all Japanese children, presented with widespread inflammatory tense blisters. Histologically, subepidermal tissue separation was noted with inflammatory infiltrate in the superficial dermis. Direct immunofluorescence staining revealed linear IgG/C3 deposits along the dermal-epidermal junction. Circulating IgG anti-basement membrane zone autoantibodies stained the dermal side of normal skin separated with 1 M NaCl. Direct and indirect immunoelectron microscopy using colloidal gold labeling showed that patient sera reacted with anchoring fibrils. The gold particles were localized both near the lamina densa and on the central banded portion of the fibrils. The sera reacted with C-VII in immunoblots. Epitope analyses with natural and recombinant fragments of C-VII disclosed that the sera did not recognize the NC1 domain of C-VII, but the central triple-helical domain of this anchoring fibril protein. Thus, the present probands show a hitherto unrecognized variant of epidermolysis bullosa acquisita, with autoantibodies against epitopes in the collagenous domain of C-VII.

Autoantibodies↗
PubMed1996

Cross-linking of the dermo-epidermal junction of skin regenerating from keratinocyte autografts. Anchoring fibrils are a target for tissue transglutaminase.

Since transglutaminases create covalent gamma-glutamyl-epsilon-lysine cross-links between extracellular matrix proteins they are prime candidates for stabilizing tissue during wound healing. Therefore, we studied the temporo-spatial expression of transglutaminase activity in skin regenerating from cultured epithelial autografts in severely burned children by the specific incorporation of monodansylcadaverine into cryostat sections from skin biopsies obtained between 5 d to 17 mo after grafting. The dansyl label was subsequently immunolocalized in the epidermis, dermal connective tissue, and along the basement membrane. Incubation of cryosections of normal and regenerating skin with purified tissue transglutaminase confirmed the dermo-epidermal junction and the papillary dermis as targets for this enzyme and revealed that in regenerating skin transamidation of the basement membrane zone was completed only 4-5 mo after grafting. Immunoelectron microscopy revealed that three distinct regions on the central portion of anchoring fibrils were positive for monodansylcadaverine in normal skin which were negative during the initial phase of de novo formation of anchoring fibrils in regenerating skin. Biochemically, we identified collagen VII as potential substrate for tissue transglutaminase. Thus, tissue transglutaminase appears to play an important role not only in cross-linking of the papillary dermis but also of the dermo-epidermal junction in particular.

Adolescent↗
PubMed1996

Generalized atrophic benign epidermolysis bullosa. Either 180-kd bullous pemphigoid antigen or laminin-5 deficiency.

BACKGROUND: Generalized atrophic benign epidermolysis bullosa (GABEB) is a form of nonlethal junctional epidermolysis bullosa, clinically characterized by generalized blistering after birth, atrophic healing, and incomplete universal atrophic alopecia with onset in childhood. Recently, we discovered a deficiency of the 180-kd bullous pemphigoid antigen (BP180) and a reduced amount of BP180 messenger RNA in three patients with GABEB. It is not yet clear, however, whether GABEB is invariably caused by BP180 deficiency. RESULTS: We examined 18 patients with nonlethal junctional epidermolysis bullosa from unrelated families; nine of these individuals presented with the clinical characteristics of GABEB. Specimens of clinically normal skin obtained from the patients were stained by immunofluorescence with monoclonal antibodies to BP180 and laminin-5. The BP180 epitopes were not expressed in eight patients, all of whom were sharing the typical clinical features of GABEB. In one of the nine patients with GABEB, the BP180 level was sufficient, but the laminin-5 level was reduced. Among the nine patients with junctional epidermolysis bullosa without atrophic alopecia, laminin-5 level was not expressed in one patient, while in the other patients both antigens were normally expressed. CONCLUSIONS: Not all patients with GABEB are deficient in BP180, since some individuals with GABEB only exhibit reduction of the laminin-5 expression. The BP180 deficiency in the skin invariably seems to result in GABEB. Immunofluorescence analysis using monoclonal antibodies against BP180 (and laminin-5) may allow early subtyping, which is of prognostic significance, in children born with junctional epidermolysis bullosa.

Adolescent↗
PubMed1996

[PUVA-induced acro-bullous dermatosis].

PUVA-induced acrobullous dermatosis is characterized by the occurrence of blisters on the acral extremities during PUVA therapy. The tense blisters apparently arise as a result of PUVA damage to the epidermodermal cohesion coupled with friction or trauma. They must be distinguished from phototoxic reactions induced either by UVA over-dosage or excessive psoralen uptake. We report on, two cases of acrobullous PUVA-induced dermatosis, discussing clinical features, pathophysiological aspects and differential diagnosis.

Adult↗
PubMed1996

The immunology of bullous oculo-muco-cutaneous disorders.

In skin-blistering diseases, alteration of cellular adhesion results in a loss of cohesion of the epithelium of the skin and the mucous membranes. These disorders are often genetically determined and involve highly specific autoantibodies. A recent workshop discussed the immunology of these diseases.

Eye Diseases↗
PubMed1996

Fibrillin and elastin expression in skin regenerating from cultured keratinocyte autografts: morphogenesis of microfibrils begins at the dermo-epidermal junction and precedes elastic fiber formation.

The temporo-spatial expression of fibrillin and elastin in skin regenerating from autologous keratinocyte grafts was studied in three burned children. Skin biopsies taken between 5 days and 17 months after grafting were investigated by conventional immunofluorescence, confocal laser scanning, and electron microscopy. Fibrillin, the major component of 10-12nm microfibrils, appeared 5 days after grafting in a band-like fashion similar to collagen VII at the prospective basement membrane, and the formed the characteristic microfibrillar candelabra at the dermo-epidermal junction by fusion of several fine microfibrils to communicating microfibrils projecting downward into the reticular layer of the neodermis. Four to five months after grafting, several communicating microfibrils were connected to a web of horizontally undulating microfibrils of the neodermis which had developed independently. Elastin was first identified in the deeper neodermis 1 month after grafting as granular aggregates and 4 months after grafting on fibrillar structures and surrounding capillaries of the upper neodermis. Association of elastin with microfibrils in the papillary dermis was not detectable before month 17. Our findings suggest that the cutaneous microfibrillar apparatus develops simultaneously at both the dermo-epidermal junction and the reticular dermis and is a prerequisite for elastic fiber formation. In addition, it might be a driving force for the formation of the papilla-rete ridge pattern.

Adolescent↗
PubMed1996

Blistering skin diseases: models for studies on epidermal-dermal adhesion.

Blistering skin diseases represent a genetically and biologically heterogeneous group of pathologic conditions with attenuated epithelial adhesion in the skin or in mucosal surfaces. Investigations on genetic blistering disorders with ultrastructural analysis, determination of candidate genes, and isolation and characterization of the target proteins have had a major impact on our understanding of normal epithelial-mesenchymal interactions and epithelial cell adhesion in general. A higf1p4gree of molecular heterogeneity underlies the different pathological phenotypes, and certain genotype-phenotype correlations are starting to emerge. Accumulating data on the molecular basis of different blistering diseases have already disclosed ample new information on the physiological functions of many of the molecular components of the dermal-epidermal junction, and we expect a rapid expansion of knowledge on the field when genotype-phenotype correlations of more patients are discerned.

Blister↗
PubMed1995

Expression of type VII collagen, the major anchoring fibril component, in normal and neoplastic human nervous system.

The distribution of type VII collagen was examined in the normal human nervous system, in brain tumour biopsies and in glioma cell lines by immunohistochemistry and western blotting. In normal tissue, positivity was observed beneath choroid plexus epithelial cells and around pineal gland and pituitary gland cell nests, while other brain regions and peripheral nerves were negative. Expression was preserved in most related tumours (choroid plexus papilloma, pineoblastoma, pituitary adenoma). Scattered abnormal vessels showed neo-expression of type VII collagen in about half of the astrocytic and ependymal tumours. Glioma cells in situ were consistently negative for type VII collagen, whereas the glioblastoma cell lines were positive. Our results suggest that anchoring fibrils or at least epitopes of their major structural component are present in normal and pathological cerebral structures, indicating a unique distribution of type VII collagen in the nervous system.

Adult↗
PubMed1995

Immunohistochemical and mutation analyses demonstrate that procollagen VII is processed to collagen VII through removal of the NC-2 domain.

Collagen VII is the major structural constituent of anchoring fibrils in the skin. It is synthesized as a procollagen that is larger than the collagen deposited in the tissue. In this study, we investigated the conversion of procollagen VII to collagen VII in human skin and in cutaneous cells in vitro and identified the propeptide using domain-specific antibodies. For this purpose, two bacterial fusion proteins containing unique sequences of the carboxy-terminal globular NC-2 domain of procollagen VII were prepared, and polyclonal antibodies raised against them. Immunoblotting showed that the anti-NC2 antibodies reacted with procollagen VII isolated from cultured keratinocytes, but not with collagen VII extracted from the skin. Immunohistochemical experiments with the NC-2 antibodies revealed a strong reaction in cultured keratinocytes, but the basement membrane zone of normal skin remained negative. The staining could not be rendered positive by chemical or enzymatic unmasking of potential hidden epitopes in the skin, indicating that most of the NC-2 domain is absent from normal skin. In contrast, a positive staining with NC-2 antibodies was observed in the skin of a patient with NC-2 antibodies was observed in the skin of a patient with dystrophic epidermolysis bullosa, who carried a 14-bp deletion at one of the intro-exon junctions of the collagen VII gene. This aberration led to an in-frame skipping of exon 115 from the mRNA and eliminated 29 amino acids from the NC-2 domain which include the putative cleavage site for the physiological processing enzyme, procollagen C-proteinase. The results indicate that in normal human skin, the removal of the NC-2 domain from procollagen VII precedes its deposition at the dermal-epidermal junction. Furthermore, they suggest that an aberration in the procollagen VII cleavage interferes with the normal fibrillogenesis of the anchoring fibrils.

Amino Acid Sequence↗
PubMed1995

Dermo-epidermal separation is associated with induced tenascin expression in human skin.

Tenascin, a large glycoprotein of the extracellular matrix, shows a site-restricted distribution during embryogenesis, and can be found in adults in a variety of pathological conditions. In normal skin, tenascin is expressed at low levels, but it is upregulated in skin tumours, in a number of skin diseases with epidermal hyperproliferation and during wound healing. Several tenascin variants have been described, and these arise by alternative splicing. Using a monoclonal antibody recognizing all tenascin variants, and polyclonal antibodies specific for the large tenascin variants, we have investigated tenascin expression in bullous diseases such as epidermolysis bullosa, pemphigus, bullous pemphigoid and pemphigoid gestationis. By immunohistochemistry, we have found increased tenascin staining in all patient skin samples, with a more pronounced tenascin expression in samples of autoimmune bullous diseases. The large tenascin variants seem to be major forms of tenascin occurring in healthy skin. In patients with blistering diseases, however, these large variants appear to represent a subpopulation of the induced tenascin accumulation. These findings suggest different functions for the tenascin variants in normal and diseased skin.

Animals↗
PubMed1995

Nail changes in epidermolysis bullosa: clinical and pathogenetic considerations.

Nail changes in epidermolysis bullosa (EB) are common, but although they are highly suggestive of the disease, they are not pathognomonic. They are the result of abnormalities of the nail matrix and nail bed, associated with the pathogenetic alterations of the dermo-epidermal junction which occur in EB. In addition, secondary trauma in the areas of epidermal-dermal separation, and chronic inflammation of the nail matrix, are probable contributory factors, even in non-scarring forms of EB. Recent developments in the molecular and cell biology of the cutaneous basement membrane zone have greatly advanced our understanding of the pathomechanisms underlying different subtypes of EB. Defects in genes coding for the structural proteins of the basement membrane zone have been defined in some EB subtypes, and abnormal expression of structural proteins in others. The data accumulated from study of these genetic disorders will contribute to knowledge of the role of the dermo-epidermal junction in the normal physiology and differentiation of the nails, and be of value in discerning the aetiopathogenesis of acquired nail diseases.

Basement Membrane↗
PubMed1995

Scalp dermatitis, distinctive hair abnormalities and atopic disease in the ectrodactyly-ectodermal dysplasia-clefting syndrome.

We report a 2-year-old girl with a combination of the ectodermal dysplasia, ectrodactyly, cleft lip/palate (EEC) syndrome, distinctive hair abnormalities, scalp dermatitis and atopic disease. To our knowledge, this is the first report of scalp dermatitis in the EEC syndrome. Distinctive structural hair abnormalities shared by the syndromes of ectodermal dysplasia and clefting are helicotrichia, pili torti et canaliculi, and cuticle defects, all of which were observed in the present case. A high incidence of atopic disease in certain subsets of ectodermal dysplasia has been reported. In our patient this manifested as food-induced exacerbation of atopic dermatitis, associated with positive prick tests and significant levels of circulating specific IgE.

Abnormalities, Multiple↗