title: Forty-two novel COL7A1 mutations and the role of a frequent single nucleotide polymorphism in the MMP1 promoter in modulation of disease severity in a large European dystrophic epidermolysis bullosa cohort.
abstract: BACKGROUND
  Dystrophic epidermolysis bullosa (DEB) is a severe genetic skin blistering disorder caused by mutations in the gene COL7A1, encoding collagen VII. Recently, the MMP1 promoter single nucleotide polymorphism (SNP) rs1799750, designated as 1G 2G, was shown to be involved in modulation of disease severity in patients with recessive DEB (RDEB), and was proposed as a genetic modifier.
  
  
  OBJECTIVE
  To identify the molecular basis of DEB in 103 individuals and to replicate the results of the MMP1 promoter SNP analysis in an independent patient group, as verification is necessary in such a rare and heterogeneous disorder.
  
  
  METHODS
  To determine the molecular basis of the disease, we performed COL7A1 mutation screening, reverse transcription-polymerase chain reaction (PCR) and real-time quantitative PCR. The status of the MMP1 SNP was analysed by PCR and restriction enzyme digestion and verified by sequencing.
  
  
  RESULTS
  We disclosed 42 novel COL7A1 mutations, including the first large genomic deletion of 4 kb affecting only the COL7A1 gene, and three apparently silent mutations affecting splicing. Even though the frequency of the high-risk allele was increased in patients with RDEB, no statistically significant correlation between disease severity and genotype could be made. Also, no correlation was observed with development of squamous cell carcinoma, a severe complication of DEB.
  
  
  CONCLUSIONS
  Taken together, the results suggest that the MMP1 SNP is not the sole disease modifier in different forms of DEB, and other genetic and environmental factors contribute to the clinical phenotype.
authors.affiliation: Department of Dermatology, University Medical Center Freiburg, 79104 Freiburg, Germany.
authors.forename: J S
authors.initials: JS
authors.lastname: Kern
authors.forename: G
authors.initials: G
authors.lastname: Grüninger
authors.forename: R
authors.initials: R
authors.lastname: Imsak
authors.forename: M L
authors.initials: ML
authors.lastname: Müller
authors.forename: H
authors.initials: H
authors.lastname: Schumann
authors.forename: D
authors.initials: D
authors.lastname: Kiritsi
authors.forename: S
authors.initials: S
authors.lastname: Emmert
authors.forename: W
authors.initials: W
authors.lastname: Borozdin
authors.forename: J
authors.initials: J
authors.lastname: Kohlhase
authors.forename: L
authors.initials: L
authors.lastname: Bruckner-Tuderman
authors.forename: C
authors.initials: C
authors.lastname: Has
mesh_terms: D018389:Codon, Nonsense / Q000235:genetics*; D015331:Cohort Studies; D024143:Collagen Type VII / Q000235:genetics*; D004252:DNA Mutational Analysis / Q000379:methods; D016108:Epidermolysis Bullosa Dystrophica / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D020781:Matrix Metalloproteinase 1 / Q000235:genetics*; D020125:Mutation, Missense / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D011401:Promoter Regions, Genetic / Q000235:genetics*; D022821:RNA Splice Sites / Q000235:genetics; D017422:Sequence Analysis, DNA; D044465:White People / Q000235:genetics
chemical_list: D018389:Codon, Nonsense; D024143:Collagen Type VII; D022821:RNA Splice Sites; D020781:Matrix Metalloproteinase 1