1. Nonlinear optical microscopy is a novel tool for the analysis of cutaneous alterations in pseudoxanthoma elasticum
- Author
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Róbert Szipőcs, Márta Medvecz, Olivier Vanakker, Tamás Arányi, Anikó Ilona Nagy, Norbert Wikonkál, Bernadett Hidvégi, Viktória Szabó, Norbert Kiss, Ludovic Martin, Béla Merkely, Luca Fésűs, Szabolcs Bozsányi, Matthias Van Gils, and Flóra Szeri
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Nonlinear Optical Microscopy ,CLINICAL-MANIFESTATIONS ,ABCC6 ,Connective tissue ,ABCC6 GENE ,Dermatology ,PHENOTYPE ,CLASSIFICATION ,Multiphoton microscopy ,Calcification ,03 medical and health sciences ,0302 clinical medicine ,In vivo ,Image Processing, Computer-Assisted ,Medicine and Health Sciences ,Humans ,Medicine ,MUTATION ,Skin ,030304 developmental biology ,0303 health sciences ,PYROPHOSPHATE ,biology ,business.industry ,Nonlinear optical microscopy ,HISTOPATHOLOGY ,Pseudoxanthoma elasticum ,medicine.disease ,Elastin ,medicine.anatomical_structure ,Connective Tissue ,Case-Control Studies ,030220 oncology & carcinogenesis ,biology.protein ,Original Article ,Female ,Surgery ,Histopathology ,Collagen ,business ,SYSTEM ,Ex vivo - Abstract
Pseudoxanthoma elasticum (PXE, OMIM 264800) is a rare autosomal recessive disorder with ectopic mineralization and fragmentation of elastin fibers. It is caused by mutations of the ABCC6 gene that leads to decreased serum levels of inorganic pyrophosphate (PPi) anti-mineralization factor. The occurrence of severe complications among PXE patients highlights the importance of early diagnosis so that prompt multidisciplinary care can be provided to patients. We aimed to examine dermal connective tissue with nonlinear optical (NLO) techniques, as collagen emits second-harmonic generation (SHG) signal, while elastin can be excited by two-photon excitation fluorescence (TPF). We performed molecular genetic analysis, ophthalmological and cardiovascular assessment, plasma PPi measurement, conventional histopathological examination, and ex vivo SHG and TPF imaging in five patients with PXE and five age- and gender-matched healthy controls. Pathological mutations including one new variant were found in the ABCC6 gene in all PXE patients and their plasma PPi level was significantly lower compared with controls. Degradation and mineralization of elastin fibers and extensive calcium deposition in the mid-dermis was visualized and quantified together with the alterations of the collagen structure in PXE. Our data suggests that NLO provides high-resolution imaging of the specific histopathological features of PXE-affected skin. In vivo NLO may be a promising tool in the assessment of PXE, promoting early diagnosis and follow-up.
- Published
- 2020
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