Critical involvement of ZEB2 in collagen fibrillogenesis: the molecular similarity between Mowat-Wilson syndrome and Ehlers-Danlos syndrome

Sci Rep. 2017 Apr 19:7:46565. doi: 10.1038/srep46565.

Abstract

Mowat-Wilson syndrome (MOWS) is a congenital disease caused by de novo heterozygous loss of function mutations or deletions of the ZEB2 gene. MOWS patients show multiple anomalies including intellectual disability, a distinctive facial appearance, microcephaly, congenital heart defects and Hirschsprung disease. However, the skin manifestation(s) of patients with MOWS has not been documented in detail. Here, we recognized that MOWS patients exhibit many Ehlers-Danlos syndrome (EDS)-like symptoms, such as skin hyperextensibility, atrophic scars and joint hypermobility. MOWS patients showed a thinner dermal thickness and electron microscopy revealed miniaturized collagen fibrils. Notably, mice with a mesoderm-specific deletion of the Zeb2 gene (Zeb2-cKO) demonstrated redundant skin, dermal hypoplasia and miniaturized collagen fibrils similar to those of MOWS patients. Dermal fibroblasts derived from Zeb2-cKO mice showed a decreased expression of extracellular matrix (ECM) molecules, such as collagens, whereas molecules involved in degradation of the ECM, such as matrix metalloproteinases (MMPs), were up-regulated. Furthermore, bleomycin-induced skin fibrosis was attenuated in Zeb2-cKO mice. We conclude that MOWS patients exhibit an EDS-like skin phenotype through alterations of collagen fibrillogenesis due to ZEB2 mutations or deletions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Child
  • Child, Preschool
  • Collagen* / genetics
  • Collagen* / metabolism
  • Dermis* / metabolism
  • Dermis* / pathology
  • Ehlers-Danlos Syndrome* / genetics
  • Ehlers-Danlos Syndrome* / metabolism
  • Ehlers-Danlos Syndrome* / pathology
  • Extracellular Matrix / genetics
  • Extracellular Matrix / metabolism
  • Facies*
  • Female
  • Fibroblasts / metabolism
  • Fibroblasts / pathology
  • Hirschsprung Disease* / genetics
  • Hirschsprung Disease* / metabolism
  • Hirschsprung Disease* / pathology
  • Humans
  • Intellectual Disability* / genetics
  • Intellectual Disability* / metabolism
  • Intellectual Disability* / pathology
  • Male
  • Mice
  • Mice, Knockout
  • Microcephaly* / genetics
  • Microcephaly* / metabolism
  • Microcephaly* / pathology
  • Proteolysis
  • Zinc Finger E-box Binding Homeobox 2* / genetics
  • Zinc Finger E-box Binding Homeobox 2* / metabolism

Substances

  • ZEB2 protein, human
  • ZEB2 protein, mouse
  • Zinc Finger E-box Binding Homeobox 2
  • Collagen

Supplementary concepts

  • Mowat-Wilson syndrome