Correction of Dog Dystrophic Epidermolysis Bullosa by Transplantation of Genetically Modified Epidermal Autografts Yannick Gache, Didier Pin, Laurent.

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Correction of Dog Dystrophic Epidermolysis Bullosa by Transplantation of Genetically Modified Epidermal Autografts Yannick Gache, Didier Pin, Laurent Gagnoux-Palacios, Claude Carozzo, Guerrino Meneguzzi Journal of Investigative Dermatology Volume 131, Issue 10, Pages 2069-2078 (October 2011) DOI: 10.1038/jid.2011.172 Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 1 Recombinant Col7 expression in transduced keratinocytes. (a) Immunofluorescence staining: mAb LH7.2 to Col7 strongly reacts to transduced cells. (b) Immunoblots of the culture media detect a strong immunoreactive 320-kDa dog Col7 band in transduced keratinocytes and a fainter corresponding band in parental D1 and D2 cells. A lower unspecific 124-kDa band is also visible. (c) PCR analysis of genomic DNA using primers specific to WT Col7 detects a 635-bp cDNA fragment in reverted cells. (d) RT-PCR and sequencing of total mRNA detect expression of WT (GGC) and mutated (AGC) mRNA in the reverted keratinocytes. (e) RDEB keratinocytes display a comparable colony-forming ability in culture before (D1 and D2) and after (r-D1 and r-D2) transduction. (f) PCR analysis of genomic DNA purified from highly proliferating clones detects the WT 635-bp Col7 cDNA fragment in 100% of r-D1 and 65% of r-D2 keratinocytes. Col7, collagen type VII; RDEB, recessive dystrophic epidermolysis bullosa; RT-PCR, reverse transcriptase-PCR; WT, wild type. Journal of Investigative Dermatology 2011 131, 2069-2078DOI: (10.1038/jid.2011.172) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 2 Analysis of transplantable epithelial sheets before grafting onto RDEB dogs. H&E staining visualizes the stratified epithelia composed of 4–5 keratinocyte layers. Immunohistochemistry using mAb KL1 detects epidermal keratins in all layers of the reconstructed epidermal sheets; mAb Ki67 detects the presence of numerous proliferating cells in the basal cell layer, and mAb LH7.2 to Col7 (green) is strongly reactive to basal and suprabasal cells in the reverted r-D1 and r-D2 epithelia, and to basal cells in the D1 and D2 (not shown) non-reverted epithelia. Nuclei stained with DAPI (blue). Bar=20μm. DAPI, 4′,6-diamidino-2-phenylindolel; H&E, hematoxylin–eosin; RDEB, recessive dystrophic epidermolysis bullosa. Journal of Investigative Dermatology 2011 131, 2069-2078DOI: (10.1038/jid.2011.172) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 3 Histopathology of the reconstructed epithelia after transplantation. (a) H&E staining of control (CTL) and reverted (Rev) grafts. At month 1, a differentiated epidermis is generated that adheres to the underlying dermis. The dermal–epidermal junction appears intact for the entire follow-up in D1, but blistered at month 5 in D2 and at month 1 in CTL grafts. Bar=20μm. (b) Immunostaining at month 2: laminin 332 (red) displays a linear staining of the basement membrane. DAPI (blue) stains nuclei. Involucrin (green) is expressed in the upper spinous layers. Nuclei stained with DAPI (red). KL1 mAb stains suprabasal cells. mAb Ki67 and mAb Bla 36 identify proliferating keratinocytes and dendritic cells, respectively. pAb anti-FVIII detects neovessels in the underlying dermis. Bar=50μm. DAPI, 4′,6-diamidino-2-phenylindolel; H&E, hematoxylin–eosin. Journal of Investigative Dermatology 2011 131, 2069-2078DOI: (10.1038/jid.2011.172) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 4 R-Col7 in the regenerated epidermis. (a) Immunofluorescence analysis of Col7 in reverted (r-D1, r-D2) and control (D1, D2) epithelia: besides the DEJ, mAb LH7.2 stains the cytoplasm of suprabasal cells until month 2 in r-D2 and throughout follow-up in r-D1. Blister roofs (asterisks) in controls. Nuclei (blue). Bar=50μm. (b) r-Col7 gDNA and (c) mRNA are detected in grafted skin biopsies throughout follow-up in r-D1, but only at month 1 in r-D2. (d) Clonogenic cells account for 22% of total r-D1 cell population derived from a graft biopsy. (e) PCR analysis of genomic DNA extracted from isolated r-D1 cell colonies demonstrates that 100% of the clones contain the transgene. Col7, collagen type VII; DEJ, dermal–epidermal junction. The color reproduction of the figure is available at the Journal of Investigative Dermatology journal online. Journal of Investigative Dermatology 2011 131, 2069-2078DOI: (10.1038/jid.2011.172) Copyright © 2011 The Society for Investigative Dermatology, Inc Terms and Conditions