Novel Homozygous and Compound Heterozygous COL17A1 Mutations Associated with Junctional Epidermolysis Bullosa  Michaela Floeth, Heike Schäcke, Nadja Hammami-Hauasli,

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Novel Homozygous and Compound Heterozygous COL17A1 Mutations Associated with Junctional Epidermolysis Bullosa  Michaela Floeth, Heike Schäcke, Nadja Hammami-Hauasli, Leena Bruckner-Tuderman  Journal of Investigative Dermatology  Volume 111, Issue 3, Pages 528-533 (September 1998) DOI: 10.1046/j.1523-1747.1998.00325.x Copyright © 1998 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 1 Pedigrees of the probands and mutations in the COL17A1 gene. Pedigrees demonstrate recessive inheritance of the mutations. (A) family 1; (B) family 2; (C) family 3; (D) family 4. (A) Heteroduplex bands were detected on CSGE gels of PCR product spanning exon 8 (middle panel). Control DNA (lane 1) and the patient’s DNA (lane 2) showed homoduplex bands when tested alone. The faster migration of the patient’s homoduplex band suggested a deletion in this fragment. Heteroduplex bands were seen in mixed samples of the patient’s and control DNA (lane 3). Didesoxynucleotide sequencing of the patient’s DNA revealed a homozygous 2 bp deletion in exon 8, designated 520delAG (right panel), whereas the deletion was absent from a control (left panel). (B) CSGE analysis of PCR product spanning exon 43 (middle panel) revealed a homoduplex band in control DNA (lane 1) and the patient’s DNA (lane 2), but heteroduplex bands when the samples were mixed with each other (lane 3). Direct didesoxynucleotide sequencing of the patients’ PCR products revealed a homozygous 1 bp deletion of nucleotide G in exon 43, designated 2965delG (right panel), which was absent from a control (left panel). (C) CSGE analysis of the PCR products spanning exons 18 and 37 revealed heteroduplex bands with the patient’s DNA, indicating compound heterozygosity of the proband (middle panels). The upper middle panel shows CSGE analysis of PCR product spanning exon 37 (paternal mutation); control DNA (lane 1) showed a homoduplex band and the patient’s DNA (lane 2) homo- and heteroduplex bands. The lower homoduplex band (asterisk) was excised, eluted, reamplified, and subjected to didesoxynucleotide sequencing that revealed a heterozygous 2 bp deletion in exon 37, designated 2666delTT (right panel), which was absent from a control (left panel). This heterozygous deletion was also found in the father’s DNA. The lower middle panel shows CSGE analysis of PCR product spanning exon 18 (maternal mutation); control DNA (lane 1) showed a homoduplex band and the patient’s DNA (lane 2) heteroduplex bands. Direct didesoxynucleotide sequencing of the patients’ PCR products revealed a heterozygous 1721G→A transition in exon 18, designated G539E (right panel), which was absent from a control (left panel). This heterozygous mutation was also found in the mother’s DNA. In the pedigree, the black areas indicate the paternal and the dotted areas the maternal allele. (D) Identification of the paternal mutation. CSGE analysis of PCR product spanning exon 51 (middle panel) revealed a homoduplex band in control (lane 1) and the mother’s DNA (lane 4). In contrast, heteroduplex bands were seen with the patient’s (lane 2), the father’s (lane 3), and the sister’s DNA (lane 5). Direct didesoxynucleotide sequencing of the patient’s PCR products revealed a heterozygous 3781C→T transition in exon 51, designated R1226X (right panel). The mutation was also found in the unaffected father and sister, but not in a control or the mother (left panel). Extensive mutation screening did not reveal other changes in the COL17A1 gene and therefore the maternal mutation remained elusive. Journal of Investigative Dermatology 1998 111, 528-533DOI: (10.1046/j.1523-1747.1998.00325.x) Copyright © 1998 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 2 Northern blotting of collagen XVII mRNA from normal and GABEB keratinocytes. A strong signal of the 6 kb collagen XVII mRNA was found in control keratinocytes (Co). In contrast, collagen XVII mRNA isolated from the patient 1’s keratinocytes (Pat 1) produced a very weak signal, suggesting nonsense-mediated mRNA decay in these cells. The panels were intentionally overexposed to demonstrate the presence of the weak collagen XVII mRNA band in the patient’s cells. A digoxigenin-labeled GAPDH cDNA was used as a reference probe to correct for differences in RNA loading. Journal of Investigative Dermatology 1998 111, 528-533DOI: (10.1046/j.1523-1747.1998.00325.x) Copyright © 1998 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 3 IF staining of the patients’ skin with antibodies to cutaneous basement membrane components. The biopsies and antibodies used were: (a) patient 1, 1A8C; (b) patient 1, laminin 5; (c) patient 2, 1A8C; (d) patient 2, integrin α6; (e) patient 3, 1A8C; (f) patient 3, collagen VII; (g) patient 4, 1A8C; (h) patient 4, collagen VII. In (g), a weak reactivity with the antibody 1A8C was observed in the basal keratinocytes of the detached epidermis. The stainings with antibodies to other basement membrane proteins were normal. In blistered skin of patient 2, antibodies to integrin α6 localized to the blister roof (d). Antibodies to collagen VII stained the blister base in separated skin of patients 3 (f) and 4 (h). The staining patterns were consistent with junctional blistering. Scale bar: 40 μm. Journal of Investigative Dermatology 1998 111, 528-533DOI: (10.1046/j.1523-1747.1998.00325.x) Copyright © 1998 The Society for Investigative Dermatology, Inc Terms and Conditions

Figure 4 Immunodetection of collagen XVII in keratinocytes in vitro. (a–d) IF staining of GABEB keratinocytes with domain-specific antibodies to collagen XVII. In control cells, the antibody 1D1 to the extracellular domain showed a positive reaction in the rough endoplasmatic reticulum and in the cell periphery, corresponding to the transmembrane localization (a). The antibody produced a negative reaction in the keratinocytes of patient 1 (b). Staining of keratinocytes of patient 3 with the antibody 1A8C to the intracellular domain revealed a positive diffuse intracellular fluorescence (c), and with the antibody 1D1 to the extracellular domain a diffuse weak reaction (d). Scale bar: 10 μm. (e) Immunoblotting of keratinocyte extracts with polyclonal antibodies to the NC16a domain. Normal controls contained the 180 kDa α1(XVII)-chain (lanes 1, 3, 5). In contrast, cell extracts of patient 1 (lane 2), patient 3 (lane 4), and patient 4 (lane 6) lacked the band, indicating absence of stable collagen XVII in these cells. The 65 kDa band in lane 6 was occasionally seen with the human autoantiserum used, but its identity has not been characterized. The migration positions of molecular weight markers are indicated on the right. Journal of Investigative Dermatology 1998 111, 528-533DOI: (10.1046/j.1523-1747.1998.00325.x) Copyright © 1998 The Society for Investigative Dermatology, Inc Terms and Conditions