Abstract
Epidermolysis bullosa (EB) is a group of rare genetic skin fragility disorders, which are hereditary. These disorders are associated with mutations in at least 16 genes that encode components of the epidermal adhesion complex. Currently, there are no effective treatments for this disorder. All current treatment approaches focus on topical treatments to prevent complications and infections. In recent years, significant progress has been achieved in the treatment of the severe genetic skin blistering condition known as EB through preclinical and clinical advancements. Promising developments have emerged in the areas of protein and cell therapies, such as allogeneic stem cell transplantation; in addition, RNA-based therapies and gene therapy approaches have also become a reality. Stem cells obtained from embryonic or adult tissues, including the skin, are undifferentiated cells with the ability to generate, maintain, and replace fully developed cells and tissues. Recent advancements in preclinical and clinical research have significantly enhanced stem cell therapy, presenting a promising treatment option for various diseases that are not effectively addressed by current medical treatments. Different types of stem cells such as primarily hematopoietic and mesenchymal, obtained from the patient or from a donor, have been utilized to treat severe forms of diseases, each with some beneficial effects. In addition, extensive research has shown that gene transfer methods targeting allogeneic and autologous epidermal stem cells to replace or correct the defective gene are promising. These methods can regenerate and restore the adhesion of primary keratinocytes in EB patients. The long-term treatment of skin lesions in a small number of patients has shown promising results through the transplantation of skin grafts produced from gene-corrected autologous epidermal stem cells. This article attempts to summarize the current situation, potential development prospects, and some of the challenges related to the cell therapy approach for EB treatment.
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Abbreviations
- EB:
-
Epidermolysis bullosa
- TEM:
-
Transmission electron microscopy
- ACT:
-
Autologous cell therapy
- DEB:
-
Dystrophic EB
- JEB:
-
Junctional EB
- EBS:
-
EB simplex
- KEB:
-
Kindler EB
- AR:
-
Autosomal recessive
- RDEB:
-
Recessive dystrophic epidermolysis bullosa
- DDEB:
-
Dominant dystrophic epidermolysis bullosa
- NEBR:
-
National Epidermolysis Bullosa Registry
- ECM:
-
Extracellular matrix
- HMGB1:
-
High mobility group box 1
- PDGF:
-
Platelet-derived growth factor
- T4:
-
Thymosin 4
- iPSCs:
-
Induced pluripotent stem cells
- MSCs:
-
Mesenchymal stem/stromal cells
- BMT:
-
Bone marrow transplantation
- BMZ:
-
Basement membrane zone
- BMMSCs:
-
Bone marrow mesenchymal stem cells
- BM:
-
Bone marrow
- LAM5:
-
Laminin 5
- DSB:
-
Double-strand break
- NHEJ:
-
Non-homologous end joining
- HDR:
-
Homology-directed repair
- AAVS1:
-
Adeno-associated virus integration site 1
- ZFN:
-
Zinc-finger nuclease
- EpSCs:
-
Epithelial stem cells
- IDLVs:
-
Integration-defective lentiviral vectors
- TALE:
-
Transcription activator-like effector
- gRNA:
-
Guide RNA
- KRT14:
-
Keratin 14
- TALENs:
-
Transcription activator-like effector nucleases
- COL7A1:
-
Collagen type VII alpha 1 chain
- KLHL24:
-
Kelch-like family member 24
- BPAG:
-
Bullous pemphigoid antigen
- PLEC1:
-
Plectin1
- HSV:
-
Herpes simplex virus
- CRISPR:
-
Clustered regularly interspaced palindromic repeats
- SMaRT:
-
Spliceosome-mediated RNA trans-splicing
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This study is financially supported by the student research committee of Behbahan Faculty of Medical Sciences (Grant Number: 402042).
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Writing and drafting: Fatemeh Gila, Vahab Alamdari-Palangi, Maedeh Rafiee, Arezoo Jokar, and Sajad Ehtiaty. Data curation: Aria Dianatinasab, Seyyed Hossein Khatami, and Mortaza Taheri-Anganeh. Conceptualization: Jafar Fallahi. Supervision: Ahmad Movahedpour.
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Gila, F., Alamdari-Palangi, V., Rafiee, M. et al. Gene-edited cells: novel allogeneic gene/cell therapy for epidermolysis bullosa. J Appl Genetics (2024). https://doi.org/10.1007/s13353-024-00839-2
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DOI: https://doi.org/10.1007/s13353-024-00839-2