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2015 ; 11
(9
): e1005389
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KLK5 Inactivation Reverses Cutaneous Hallmarks of Netherton Syndrome
#MMPMID26390218
Furio L
; Pampalakis G
; Michael IP
; Nagy A
; Sotiropoulou G
; Hovnanian A
PLoS Genet
2015[Sep]; 11
(9
): e1005389
PMID26390218
show ga
Netherton Syndrome (NS) is a rare and severe autosomal recessive skin disease
which can be life-threatening in infants. The disease is characterized by
extensive skin desquamation, inflammation, allergic manifestations and hair shaft
defects. NS is caused by loss-of-function mutations in SPINK5 encoding the LEKTI
serine protease inhibitor. LEKTI deficiency results in unopposed activities of
kallikrein-related peptidases (KLKs) and aberrantly increased proteolysis in the
epidermis. Spink5?/? mice recapitulate the NS phenotype, display enhanced
epidermal Klk5 and Klk7 protease activities and die within a few hours after
birth because of a severe skin barrier defect. However the contribution of these
various proteases in the physiopathology remains to be determined. In this study,
we developed a new murine model in which Klk5 and Spink5 were both knocked out to
assess whether Klk5 deletion is sufficient to reverse the NS phenotype in
Spink5?/? mice. By repeated intercrossing between Klk5?/? mice with Spink5?/?
mice, we generated Spink5?/?Klk5?/? animals. We showed that Klk5 knock-out in
Lekti-deficient newborn mice rescues neonatal lethality, reverses the severe skin
barrier defect, restores epidermal structure and prevents skin inflammation.
Specifically, using in situ zymography and specific protease substrates, we
showed that Klk5 knockout reduced epidermal proteolytic activity, particularly
its downstream targets proteases KLK7, KLK14 and ELA2. By immunostaining, western
blot, histology and electron microscopy analyses, we provide evidence that
desmosomes and corneodesmosomes remain intact and that epidermal differentiation
is restored in Spink5?/?Klk5?/?. Quantitative RT-PCR analyses and immunostainings
revealed absence of inflammation and allergy in Spink5?/?Klk5?/? skin. Notably,
Il-1?, Il17A and Tslp levels were normalized. Our results provide in vivo
evidence that KLK5 knockout is sufficient to reverse NS-like symptoms manifested
in Spink5?/? skin. These findings illustrate the crucial role of protease
regulation in skin homeostasis and inflammation, and establish KLK5 inhibition as
a major therapeutic target for NS.