title: Chronic colitis due to an epithelial barrier defect: the role of kindlin-1 isoforms.
abstract: Kindlin-1 is an epithelium-specific phosphoprotein and focal adhesion adaptor component. Mutations in the corresponding gene (KIND1) cause Kindler syndrome (KS), which is manifested by skin blistering, poikiloderma, photosensitivity and carcinogenesis. Some patients also exhibit gastrointestinal symptoms, but it has remained unclear whether these represent a feature of Kindler syndrome or a coincidence. We examined kindlin-1 in human gastrointestinal epithelia and showed that it is involved in the aetiopathology of Kindler syndrome-associated colitis. Kindlin-1 expression was assessed by indirect immunofluorescence, western blot and RT-PCR. Kindlin-1 is expressed in oral mucosa, colon and rectum. Both the full-length 74 kDa kindlin-1 protein and a 43 kDa isoform were detected in CaCo2 cells, the latter resulting from alternative splicing. In the first months of life, patients (homozygous for null mutations) had severe intestinal involvement with haemorrhagic diarrhoea and showed morphological features of severe ulcerative colitis. Later in childhood, histopathology demonstrated focal detachment of the epithelium in all segments of the colon, chronic inflammation and mucosal atrophy. These findings define an intestinal phenotype for Kindler syndrome as a consequence of a primary epithelial barrier defect. The different clinical intestinal manifestations in Kindler syndrome patients may be explained by partial functional compensation of kindlin-1 deficiency by the intestinal isoform or by the presence of truncated mutant kindlin-1.
authors.affiliation: Department of Dermatology, University Medical Center, Freiburg, Germany.
authors.forename: J S
authors.initials: JS
authors.lastname: Kern
authors.forename: C
authors.initials: C
authors.lastname: Herz
authors.forename: E
authors.initials: E
authors.lastname: Haan
authors.forename: D
authors.initials: D
authors.lastname: Moore
authors.forename: S
authors.initials: S
authors.lastname: Nottelmann
authors.forename: T
authors.initials: T
authors.lastname: von Lilien
authors.forename: P
authors.initials: P
authors.lastname: Greiner
authors.forename: A
authors.initials: A
authors.lastname: Schmitt-Graeff
authors.forename: O G
authors.initials: OG
authors.lastname: Opitz
authors.forename: L
authors.initials: L
authors.lastname: Bruckner-Tuderman
authors.forename: C
authors.initials: C
authors.lastname: Has
mesh_terms: D001768:Blister / Q000235:genetics / Q000378:metabolism; D002648:Child; D002908:Chronic Disease; D003093:Colitis, Ulcerative / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008565:Membrane Proteins / Q000235:genetics / Q000378:metabolism / Q000502:physiology*; D009154:Mutation; D009363:Neoplasm Proteins / Q000235:genetics / Q000378:metabolism / Q000502:physiology*; D020033:Protein Isoforms / Q000235:genetics / Q000378:metabolism / Q000502:physiology; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D011038:Rothmund-Thomson Syndrome / Q000235:genetics / Q000378:metabolism; D012873:Skin Diseases, Genetic / Q000235:genetics / Q000378:metabolism; D013577:Syndrome
chemical_list: C475301:FERMT1 protein, human; D008565:Membrane Proteins; D009363:Neoplasm Proteins; D020033:Protein Isoforms