Abstract
BACKGROUND: Epidermolysis bullosa (EB) is a group of heritable diseases that manifest as blistering and erosions of the skin and mucous membranes. In the dystrophic forms of EB (DEB), the diagnostic hallmark is abnormalities in the anchoring fibrils, attachment structures beneath the cutaneous basement membrane zone. The major component of anchoring fibrils is type VII collagen, and DEB has been linked to the type VII collagen gene (COL7A1) at 3p21, with no evidence for locus heterogeneity. Due to life-threatening complications and significant long-term morbidity associated with the severe, mutilating form of recessive dystrophic EB (RDEB), there has been a demand for prenatal diagnosis from families with affected offspring. MATERIALS AND METHODS: Intragenic polymorphisms in COL7A1 and flanking microsatellite markers on chromosome 3p21, as well as detection of pathogenetic mutations in families, were used to perform PCR-based prenatal diagnosis from DNA obtained by chorionic villus sampling at 10-15 weeks or amniocentesis at 12-15 weeks gestation in 10 families at risk for recurrence of RDEB. RESULTS: In nine cases, the fetus was predicted to be normal or a clinically unaffected carrier of a mutation in one allele. These predictions have been validated in nine cases by the birth of a healthy child. In one case, an affected fetus was predicted, and the diagnosis was confirmed by fetal skin biopsy. CONCLUSIONS: DNA-based prenatal diagnosis of RDEB offers an early, expedient method of testing which will largely replace the previously available invasive fetal skin biopsy at 18-20 weeks gestation.
Full text
PDF

















Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aberdam D., Galliano M. F., Vailly J., Pulkkinen L., Bonifas J., Christiano A. M., Tryggvason K., Uitto J., Epstein E. H., Jr, Ortonne J. P. Herlitz's junctional epidermolysis bullosa is linked to mutations in the gene (LAMC2) for the gamma 2 subunit of nicein/kalinin (LAMININ-5). Nat Genet. 1994 Mar;6(3):299–304. doi: 10.1038/ng0394-299. [DOI] [PubMed] [Google Scholar]
- Burgeson R. E., Chiquet M., Deutzmann R., Ekblom P., Engel J., Kleinman H., Martin G. R., Meneguzzi G., Paulsson M., Sanes J. A new nomenclature for the laminins. Matrix Biol. 1994 Apr;14(3):209–211. doi: 10.1016/0945-053x(94)90184-8. [DOI] [PubMed] [Google Scholar]
- Christiano A. M., Anhalt G., Gibbons S., Bauer E. A., Uitto J. Premature termination codons in the type VII collagen gene (COL7A1) underlie severe, mutilating recessive dystrophic epidermolysis bullosa. Genomics. 1994 May 1;21(1):160–168. doi: 10.1006/geno.1994.1238. [DOI] [PubMed] [Google Scholar]
- Christiano A. M., Chung-Honet L. C., Hovnanian A., Uitto J. PCR-based detection of two exonic polymorphisms in the human type VII collagen gene (COL7A1) at 3p21.1. Genomics. 1992 Nov;14(3):827–828. doi: 10.1016/s0888-7543(05)80204-6. [DOI] [PubMed] [Google Scholar]
- Christiano A. M., Greenspan D. S., Hoffman G. G., Zhang X., Tamai Y., Lin A. N., Dietz H. C., Hovnanian A., Uitto J. A missense mutation in type VII collagen in two affected siblings with recessive dystrophic epidermolysis bullosa. Nat Genet. 1993 May;4(1):62–66. doi: 10.1038/ng0593-62. [DOI] [PubMed] [Google Scholar]
- Christiano A. M., Greenspan D. S., Lee S., Uitto J. Cloning of human type VII collagen. Complete primary sequence of the alpha 1(VII) chain and identification of intragenic polymorphisms. J Biol Chem. 1994 Aug 12;269(32):20256–20262. [PubMed] [Google Scholar]
- Christiano A. M., Hoffman G. G., Chung-Honet L. C., Lee S., Cheng W., Uitto J., Greenspan D. S. Structural organization of the human type VII collagen gene (COL7A1), composed of more exons than any previously characterized gene. Genomics. 1994 May 1;21(1):169–179. doi: 10.1006/geno.1994.1239. [DOI] [PubMed] [Google Scholar]
- Christiano A. M., Ryynänen M., Uitto J. Dominant dystrophic epidermolysis bullosa: identification of a Gly-->Ser substitution in the triple-helical domain of type VII collagen. Proc Natl Acad Sci U S A. 1994 Apr 26;91(9):3549–3553. doi: 10.1073/pnas.91.9.3549. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Christiano A. M., Suga Y., Greenspan D. S., Ogawa H., Uitto J. Premature termination codons on both alleles of the type VII collagen gene (COL7A1) in three brothers with recessive dystrophic epidermolysis bullosa. J Clin Invest. 1995 Mar;95(3):1328–1334. doi: 10.1172/JCI117783. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Christiano A. M., Uitto J. DNA-based prenatal diagnosis of heritable skin diseases. Arch Dermatol. 1993 Nov;129(11):1455–1459. [PubMed] [Google Scholar]
- Christiano A. M., Uitto J. Molecular diagnosis of inherited skin diseases: the paradigm of dystrophic epidermolysis bullosa. Adv Dermatol. 1996;11:199–214. [PubMed] [Google Scholar]
- Dunnill M. G., Richards A. J., Milana G., Mollica F., Atherton D., Winship I., Farrall M., al-Imara L., Eady R. A., Pope F. M. Genetic linkage to the type VII collagen gene (COL7A1) in 26 families with generalised recessive dystrophic epidermolysis bullosa and anchoring fibril abnormalities. J Med Genet. 1994 Oct;31(10):745–748. doi: 10.1136/jmg.31.10.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eady R. A., Gunner D. B., Tidman M. J., Nicolaides K. H., Rodeck C. H. Rapid processing of fetal skin for prenatal diagnosis by light and electron microscopy. J Clin Pathol. 1984 Jun;37(6):633–638. doi: 10.1136/jcp.37.6.633. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fuchs E. Genetic skin disorders of keratin. J Invest Dermatol. 1992 Dec;99(6):671–674. doi: 10.1111/1523-1747.ep12613737. [DOI] [PubMed] [Google Scholar]
- Heagerty A. H., Kennedy A. R., Gunner D. B., Eady R. A. Rapid prenatal diagnosis and exclusion of epidermolysis bullosa using novel antibody probes. J Invest Dermatol. 1986 May;86(5):603–605. doi: 10.1111/1523-1747.ep12355579. [DOI] [PubMed] [Google Scholar]
- Hovnanian A., Duquesnoy P., Blanchet-Bardon C., Knowlton R. G., Amselem S., Lathrop M., Dubertret L., Uitto J., Goossens M. Genetic linkage of recessive dystrophic epidermolysis bullosa to the type VII collagen gene. J Clin Invest. 1992 Sep;90(3):1032–1036. doi: 10.1172/JCI115916. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hovnanian A., Hilal L., Blanchet-Bardon C., Bodemer C., de Prost Y., Stark C. A., Christiano A. M., Dommergues M., Terwilliger J. D., Izquierdo L. DNA-based prenatal diagnosis of generalized recessive dystrophic epidermolysis bullosa in six pregnancies at risk for recurrence. J Invest Dermatol. 1995 Apr;104(4):456–461. doi: 10.1111/1523-1747.ep12605893. [DOI] [PubMed] [Google Scholar]
- Hovnanian A., Hilal L., Blanchet-Bardon C., de Prost Y., Christiano A. M., Uitto J., Goossens M. Recurrent nonsense mutations within the type VII collagen gene in patients with severe recessive dystrophic epidermolysis bullosa. Am J Hum Genet. 1994 Aug;55(2):289–296. [PMC free article] [PubMed] [Google Scholar]
- McGrath J. A., Ishida-Yamamoto A., O'Grady A., Leigh I. M., Eady R. A. Structural variations in anchoring fibrils in dystrophic epidermolysis bullosa: correlation with type VII collagen expression. J Invest Dermatol. 1993 Apr;100(4):366–372. doi: 10.1111/1523-1747.ep12471830. [DOI] [PubMed] [Google Scholar]
- Parente M. G., Chung L. C., Ryynänen J., Woodley D. T., Wynn K. C., Bauer E. A., Mattei M. G., Chu M. L., Uitto J. Human type VII collagen: cDNA cloning and chromosomal mapping of the gene. Proc Natl Acad Sci U S A. 1991 Aug 15;88(16):6931–6935. doi: 10.1073/pnas.88.16.6931. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pulkkinen L., Christiano A. M., Airenne T., Haakana H., Tryggvason K., Uitto J. Mutations in the gamma 2 chain gene (LAMC2) of kalinin/laminin 5 in the junctional forms of epidermolysis bullosa. Nat Genet. 1994 Mar;6(3):293–297. doi: 10.1038/ng0394-293. [DOI] [PubMed] [Google Scholar]
- Pulkkinen L., Christiano A. M., Gerecke D., Wagman D. W., Burgeson R. E., Pittelkow M. R., Uitto J. A homozygous nonsense mutation in the beta 3 chain gene of laminin 5 (LAMB3) in Herlitz junctional epidermolysis bullosa. Genomics. 1994 Nov 15;24(2):357–360. doi: 10.1006/geno.1994.1627. [DOI] [PubMed] [Google Scholar]
- Uitto J., Christiano A. M. Molecular basis for the dystrophic forms of epidermolysis bullosa: mutations in the type VII collagen gene. Arch Dermatol Res. 1994;287(1):16–22. doi: 10.1007/BF00370713. [DOI] [PubMed] [Google Scholar]
- Uitto J., Christiano A. M. Molecular genetics of the cutaneous basement membrane zone. Perspectives on epidermolysis bullosa and other blistering skin diseases. J Clin Invest. 1992 Sep;90(3):687–692. doi: 10.1172/JCI115938. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Uitto J., Pulkkinen L., Christiano A. M. Molecular basis of the dystrophic and junctional forms of epidermolysis bullosa: mutations in the type VII collagen and kalinin (laminin 5) genes. J Invest Dermatol. 1994 Nov;103(5 Suppl):39S–46S. doi: 10.1111/1523-1747.ep12398967. [DOI] [PubMed] [Google Scholar]