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August 1996

Absence of Detectable a6 Integrin in Pyloric Atresia-Junctional Epidermolysis Bullosa Syndrome: Application for Prenatal Diagnosis in a Family at Risk for Recurrence

Author Affiliations

From the Department of Dermatology, Keio University School of Medicine, Tokyo, Japan (Drs Shimizu and Nishikawa); Department of Obstetrics and Gynecology, Nagoya (Japan) City University Medical School (Dr Suzumori); and Department of Dermatology, Kanazawa (Japan) University School of Medicine (Dr Hatta).

Arch Dermatol. 1996;132(8):919-925. doi:10.1001/archderm.1996.03890320067011

Background and Design:  The expression of basement membrane—related antigens was surveyed in 2 Japanese siblings who died of pyloric atresia—junctional epidermolysis bullosa syndrome in early infancy.

Results:  The skin specimens of both patients demonstrated complete absence of detectable α6 integrin and markedly reduced amounts of β4 integrin. All the other subtypes of epidermolysis bullosa used as controls demonstrated normal intensity of expression of α6 and β4 integrin. In contrast to the negative immunoreactivity of monoclonal antibody GB3 in gravis-Herlitz junctional epidermolysis bullosa (n=4), a bright linear pattern along the epidermal basement membrane was demonstrated in the skin of both siblings with pyloric atresia—junctional epidermolysis bullosa syndrome. Based on these data, a monoclonal antibody against α6 integrin was successfully used as a prenatal diagnostic probe for a skin biopsy specimen from a fetus at risk for pyloric atresia— junctional epidermolysis bullosa syndrome in this family.

Conclusion:  The absence of detectable α6 integrin, but not β4 integrin, in these cases raises the possibility that α6 integrin or its ligands are responsible for the pyloric atresia—junctional epidermolysis bullosa syndrome phenotype seen in this family.Arch Dermatol. 1996;132:919-925

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