Journal
FRONTIERS IN GENETICS
Volume 12, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fgene.2021.737272
Keywords
collagen VII; fibrosis; inflammation; transforming growth factor beta; skin
Categories
Funding
- German Research Foundation (DFG) [NY90/5-1, KI1795/2-1, SFB850, SFB1160, SFB1479, 441891347-P13]
- Fritz Thyssen Stiftung [Az. 10.19.1.016MN]
- EB Research Partnership
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This article discusses the pathological mechanisms and modifiers in the monogenetic disease DEB, as well as related methods for alleviating the condition by targeting secondary disease mechanisms or utilizing natural disease modifiers.
The phenotypic presentation of monogenetic diseases is determined not only by the nature of the causative mutations but also is influenced by manifold cellular, microenvironmental, and external factors. Here, heritable extracellular matrix diseases, including dystrophic epidermolysis bullosa (DEB), are no exceptions. Dystrophic epidermolysis bullosa is caused by mutations in the COL7A1 gene encoding collagen VII. Deficiency of collagen VII leads to skin and mucosal fragility, which progresses from skin blistering to severe fibrosis and cancer. Clinical and pre-clinical studies suggest that targeting of secondary disease mechanisms or employment of natural disease modifiers can alleviate DEB severity and progression. However, since many of these mechanisms are needed for tissue homeostasis, informed, selective targeting is essential for safe and efficacious treatment. Here, we discuss a selection of key disease modifiers and modifying processes active in DEB, summarize the still scattered knowledge of them, and reflect on ways forward toward their utilization for symptom-relief or enhancement of curative therapies.
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