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2014 ; 306
(8
): 731-7
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English Wikipedia
Ultrastructure of skin from Refsum disease with emphasis on epidermal lamellar
bodies and stratum corneum barrier lipid organization
#MMPMID24920240
Menon GK
; Orsó E
; Aslanidis C
; Crumrine D
; Schmitz G
; Elias PM
Arch Dermatol Res
2014[Oct]; 306
(8
): 731-7
PMID24920240
show ga
Classic Refsum disease (RD) is a rare, autosomal recessively-inherited disorder
of peroxisome metabolism due to a defect in the initial step in the alpha
oxidation of phytanic acid (PA), a C16 saturated fatty acid with four methyl side
groups, which accumulates in plasma and lipid enriched tissues (please see van
den Brink and Wanders, Cell Mol Life Sci 63:1752-1765, 2006). It has been
proposed that the disease complex in RD is in part due to the high affinity of
phytanic acid for retinoid X receptors and peroxisome proliferator-activated
receptors. Structurally, epidermal hyperplasia, increased numbers of cornified
cell layers, presence of cells with lipid droplets in stratum basale and
reduction of granular layer to a single layer have been reported by
Blanchet-Bardon et al. (The ichthyoses, SP Medical & Scientific Books, New York,
pp 65-69, 1978). However, lamellar body (LB) density and secretion were
reportedly normal. We recently examined biopsies from four unrelated patients,
using both OsO4 and RuO4 post-fixation to evaluate the barrier lipid structural
organization. Although lamellar body density appeared normal, individual
organelles often had distorted shape, or had non-lamellar domains interspersed
with lamellar structures. Some of the organelles seemed to lack lamellar contents
altogether, showing instead uniformly electron-dense contents. In addition, we
also observed mitochondrial abnormalities in the nucleated epidermis. Stratum
granulosum-stratum corneum junctions also showed co-existence of non-lamellar and
lamellar domains, indicative of lipid phase separation. Also, partial detachment
or complete absence of corneocyte lipid envelopes (CLE) was seen in the stratum
corneum of all RD patients. In conclusion, abnormal LB contents, resulting in
defective lamellar bilayers, as well as reduced CLEs, likely lead to impaired
barrier function in RD.