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      Molecular Therapeutics in Development for Epidermolysis Bullosa: Update 2020

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          Abstract

          Epidermolysis bullosa (EB) is a group of rare genetic disorders for which significant progress has been achieved in the development of molecular therapies in the last few decades. Such therapies require knowledge of mutant genes and specific mutations, some of them being allele specific. A relatively large number of clinical trials are ongoing and ascertaining the clinical efficacy of gene, protein or cell therapies or of repurposed drugs, mainly in recessive dystrophic EB. It is expected that some new drugs may emerge in the near future and that combinations of different approaches may result in improved treatment outcomes for individuals with EB.

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          PD-1 Blockade with Cemiplimab in Advanced Cutaneous Squamous-Cell Carcinoma

          No systemic therapies have been approved for the treatment of advanced cutaneous squamous-cell carcinoma. This cancer may be responsive to immune therapy, because the mutation burden of the tumor is high and the disease risk is strongly associated with immunosuppression. In the dose-escalation portion of the phase 1 study of cemiplimab, a deep and durable response was observed in a patient with metastatic cutaneous squamous-cell carcinoma.
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            Regeneration of the entire human epidermis using transgenic stem cells

            Autologous transgenic epidermal stem cell cultures are used to reconstitute almost the entire epidermis of a patient with severe junctional epidermolysis bullosa.
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              Inherited epidermolysis bullosa: updated recommendations on diagnosis and classification.

              Several new targeted genes and clinical subtypes have been identified since publication in 2008 of the report of the last international consensus meeting on diagnosis and classification of epidermolysis bullosa (EB). As a correlate, new clinical manifestations have been seen in several subtypes previously described. We sought to arrive at an updated consensus on the classification of EB subtypes, based on newer data, both clinical and molecular. In this latest consensus report, we introduce a new approach to classification ("onion skinning") that takes into account sequentially the major EB type present (based on identification of the level of skin cleavage), phenotypic characteristics (distribution and severity of disease activity; specific extracutaneous features; other), mode of inheritance, targeted protein and its relative expression in skin, gene involved and type(s) of mutation present, and--when possible--specific mutation(s) and their location(s). This classification scheme critically takes into account all published data through June 2013. Further modifications are likely in the future, as more is learned about this group of diseases. The proposed classification scheme should be of value both to clinicians and researchers, emphasizing both clinical and molecular features of each EB subtype, and has sufficient flexibility incorporated in its structure to permit further modifications in the future. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
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                Author and article information

                Contributors
                cristina.has@uniklinik-freiburg.de
                Journal
                Mol Diagn Ther
                Mol Diagn Ther
                Molecular Diagnosis & Therapy
                Springer International Publishing (Cham )
                1177-1062
                1179-2000
                23 April 2020
                23 April 2020
                2020
                : 24
                : 3
                : 299-309
                Affiliations
                [1 ]GRID grid.5963.9, Department of Dermatology, Faculty of Medicine, , University of Freiburg, ; Hauptstr. 7, 79104 Freiburg, Germany
                [2 ]GRID grid.265008.9, ISNI 0000 0001 2166 5843, Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and The Joan and Joel Rosenbloom Research Center for Fibrotic Diseases, and Jefferson Institute of Molecular Medicine, , Thomas Jefferson University, ; Philadelphia, PA USA
                Author information
                http://orcid.org/0000-0001-6066-507X
                Article
                466
                10.1007/s40291-020-00466-7
                7264085
                32328988
                42b1f05a-e1cb-49fb-a713-b0f1c6b8e8c9
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002347, Bundesministerium für Bildung und Forschung;
                Award ID: MutaEB
                Award Recipient :
                Categories
                Review Article
                Custom metadata
                © Springer Nature Switzerland AG 2020

                Molecular medicine
                Molecular medicine

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