Journal
HUMAN MUTATION
Volume 32, Issue 4, Pages 397-406Publisher
WILEY
DOI: 10.1002/humu.21449
Keywords
Kindler syndrome; kindlin; fermitin; epidermolysis bullosa; fibrosis; TGF-beta; cytokine
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Funding
- DFG [HA 5663/1-1]
- ERANET [01GM0812]
- Federal Ministry for Education and Research (BMBF)
- The Excellence Initiative of the German Federal Governments
- The Freiburg Institute for Advanced Studies FRIAS
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Kindler syndrome (KS) is a progressive skin disorder caused by FERMT1 mutations. Early in life, KS manifests as a mechanobullous disease reflecting diminished cell adhesion, but the mechanisms of its later phenotypic features, progressive poikiloderma, and mucocutaneous fibrosis, remain elusive. The FERMT1 gene product and KS protein, kindlin-1, is an epithelial-specific phosphoprotein involved in integrin beta-1 activation, without an obvious link to dermal connective tissue. Here we show how lack of intracellular kindlin-1 in epidermal keratinocytes leads to profound changes in another skin compartment, the dermis. Kindlin-1-deficient keratinocytes respond to cell stress by upregulating the expression of cytokines such as IL-20, IL-24, TGF-beta 2, IL1F5, PDGFB, and CTGF. These launch-via paracrine communication-an inflammatory response in the dermis, accompanied by the presence of TGF-beta, IL-6, and CTGF, activation of fibroblasts and their differentiation to myofibroblasts, which secrete and deposit increased amounts of extracellular matrix proteins. These data are concordant with a model wherein repeated cycles of epidermal cell stress, cytokine secretion, dermal inflammation, and profibrotic processes underlie mucocutaneous fibrosis in KS. Hum Mutat 32: 397-406, 2011. (C) 2011 Wiley-Liss, Inc.
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