Harlequin ichthyosis (HI) is caused by loss-of-function mutations in the keratinocyte lipid transporter ABCA12. The patients often die in the first 1 or 2 weeks of life, although HI survivors' phenotypes improve within several weeks after birth. In order to clarify the mechanisms of phenotypic recovery, we studied grafted skin and keratinocytes from Abca12-disrupted (Abca12 ؊/؊ ) mice showing abnormal lipid transport. Abca12 ؊/؊ neonatal epidermis showed significantly reduced total ceramide amounts and aberrant ceramide composition. Immunofluorescence and immunoblotting of Abca12 ؊/؊ neonatal epidermis revealed defective profilaggrin/filaggrin conversion and reduced protein expression of the differentiation-specific molecules, loricrin, kallikrein 5, and transglutaminase 1, although their mRNA expression was up-regulated. In contrast, Abca12 ؊/؊ skin grafts kept in a dry environment exhibited dramatic improvements in all these abnormalities. Increased transepidermal water loss, a parameter representing barrier defect, was remarkably decreased in grafted Abca12 ؊/؊ skin. Ten-passage sub-cultured Abca12 Harlequin ichthyosis (HI) (OMIM 242500) is one of the most severe genetic skin disorders, and its clinical features at birth include severe ectropion, eclabium, flattening of the ears, and large thick plate-like scales over the entire body.
1Infants affected with HI frequently die within the early neonatal period, although an increasing survival rate for HI newborns has recently been highlighted. 2 In 2005, we and another independent research group identified mutations in the ATP-binding cassette transporter A12 (ABCA12) gene as the cause of HI. 3,4 We previously demonstrated that a severe ABCA12 deficiency causes defective lipid transport in lamellar granules in the upper spinous and granular layer keratinocytes, resulting in malformation of intercellular lipid layers at the granular/cornified layer interface and epidermal lipid barrier disruption resulting in HI phenotype. 3 We recently generated Abca12-disrupted (Abca12 Ϫ/Ϫ ) mice by targeting Abca12, which closely reproduced the human HI phenotype and died soon after birth. 5 We tried systemic retinoid administration to the pregnant female mice as a form of fetal therapy, although no therapeutic effect was