Artikel
Long-term clinical outcome and skin quality after life-saving regeneration of the human epidermis by transgenic epidermal stem cells
Suche in Medline nach
Autoren
Veröffentlicht: | 24. September 2019 |
---|
Gliederung
Text
We reported on the life-saving epidermal regeneration in a patient with generalized junctional epidermolysis bullosa by transplantation of autologous transgenic epidermal stem cells. Here we present an in-depth analysis of the skin properties of up to 36 months after initial transplantation.
Skin biopsies were procured and H&E stainings, in-situ hybridization and immunofluorescence stainings were performed to show the structure of the new epidermis as well as the interface between transgenic epidermis and skin appendages. Moreover, we assessed skin hydration, transepidermal water loss, skin elasticity and friction. Quantitative sensory testing was conducted assessing sensory function of the skin. Full-body skin examinations were performed.
During postoperative follow-up, neither scarring nor contractures were observed. Clinical assessment as well as histology showed a reappearance of skin appendages underscoring functionality of the skin. We also demonstrated an intact skin physiology by means of sufficient skin hydration, transepidermal water loss and skin elasticity. Ointment application was tapered during follow-up. Quantitative sensory testing revealed a generalized small fiber neuropathy in transplanted as well as non-transplanted areas. However, sensory function was close to normal in all assessed areas and recovered over time. The full-body skin examinations up to 36 months after transplantation did not show any adverse events regarding skin cancer development.
We provide an in-depth analysis of the first clinically successful life-saving and potentially curative approach for generalized junctional epidermolysis bullosa. We demonstrate good functional results with close to normal skin physiology. Theses outcomes may have far reaching implications for the future treatment of epidermolysis bullosa and other diseases or trauma causing loss of the epidermis.