In Harlequin Ichthyosis (HI) affected epidermis, several morphologic
abnormalities including abnormal lamellar granules in the keratinocyte granular
layer and a lack of extracellular lipid lamellae within the stratum corneum had
been reported. Lack of ABCA12 function subsequently leads to disruption of
lamellar granule lipid transport in the upper keratinizing epidermal cells
resulting in malformation of the intercellular lipid layers of the stratum corneum
in HI. Cultured epidermal keratinocytes from an HI patient carrying ABCA12 mutations
demonstrated defective glucosylceramide transport, and this phenotype was
recoverable by in vitro ABCA12 corrective gene transfer. To date,
intracytoplasmic glucosylceramide transport has been studied using cultured keratinocytes
from a total of three patients harboring ABCA12 mutations. One patient was a
homozygote for a splice site mutation c.3295_2A4G and another patient was a
compound heterozygote for p.Ser387Asn and p.Thr1387del. Only one heterozygous mutation
p.Ile1494Thr was identified in the other patient. Cultured keratinocytes from
all the three patients showed apparently disturbed glucosylceramide transport, although
this assay is not quantitative.
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