Recessive Dystrophic Epidermolysis Bullosa (RDEB) is one of the most severe rare inherited skin disorders affecting children and adults. Current medical care protocols for RDEB patients are limited to palliative procedures to treat blistering and erosive lesions, wounds, and severe local and systemic complications such as fusion and contracture of the digits, skin cancer, esophageal stricture, severe anemia, infections, malnutrition and growth retardation. However, current medical treatments still cannot prevent the recurrence of the lesions arising from defective expression of type VII collagen (COL7A1), the main constituent of anchoring fibrils which form essential structures for dermal-epidermal adherence. The purpose of this study is to investigate the capacity of keratinocytes and fibroblasts to repair skin wounds in patients suffering from Recessive Dystrophic Epidermolysis Bullosa (RDEB).
In the perspective of future therapeutic interventions, which could involve protein, cellular and/or gene therapy, it is essential to investigate RDEB patients with regards to their immune tolerance to type VII collagen and their capacity of their cells for tissue reconstruction.
Study Type
OBSERVATIONAL
Enrollment
30
* 5 ml of blood on dry tube: Verification of the absence of auto-antibodies to type VII collagen. * 10 ml of blood sample on heparin: Verification of the absence of circulating reactive T-Lymphocytes clones to type VII collagen * 5 ml of Blood samples on ethylenediaminetetraacetic acid (EDTA): HLA genotyping of patient selected on the clinical and molecular criteria.
* A 5-mm punch skin biopsy in the groin region performed under local anaesthesic will be undertaken during visit 1. * During the second visit, two additional 5-mm punch skin biopsies will be taken to assess stem cells proliferative capacity in 10 shortlisted patients
Service de dermatologie Necker Hospital for sick children
Paris, France
Inserm U781 Service de Génétique Necker Hospital for sick children
Paris, France
Guy's and ST Thomas NHS Foundation trust/Guy's Hospital
London, United Kingdom
Determination of the proliferative capacity of keratinocytes and fibroblasts in characterized RDEB patients
Populations of keratinocytes and fibroblasts isolated from punch biopsies will be analyzed for their proliferative capacity.
Time frame: Month 23
Clinical evaluation and scoring
Clinical evaluation and scoring will be assessed using The Birmingham Epidermolysis Bullosa Severity score.
Time frame: Month 9
Identification of COL7A1 mutations
COL7A1 mutations will be screened by direct sequencing of peripheral blood DNA using a set of primers designed to sequence the 118 COL7A1 exons and their intronic junctions.
Time frame: Month 9
Assessment of type VII collagen expression and anchoring fibrils formation in the skin
Punch biopsies of the patient skin will be taken and processed for cell culture (keratinocytes and fibroblasts) and for histological and ultrastructural analyses.
Time frame: Month 9
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