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Update on Albinism

Part of the Updates in Clinical Dermatology book series (UCD)

Abstract

Albinism is a generic clinical term that describes conditions characterized by hypopigmentation of skin, hair, and eyes or eyes alone of affected individuals. It is caused by pathologic variants of genes that are associated with melanin synthesis, melanocyte differentiation/migration, or membrane trafficking. Although these are generally rare conditions, some types of albinism are seen more frequently in certain regions as a result of the founder effect (Ito et al., J Invest Dermatol 125(4):715–720, 2005; Okoro, Br J Dermatol 92(5):485–492, 1975).

Albinism is classified into two subtypes, non-syndromic albinism, with symptoms restricted to impaired melanin biosynthesis (hypopigmentation of skin and hair and ocular changes such as reduced pigmentation of the iris, nystagmus, impaired visual acuity, and foveal hypoplasia), and syndromic albinism, which displays various non-pigmentary symptoms including bleeding diathesis, lung fibrosis, and immunodeficiency. Non-syndromic albinism is subdivided into two types: oculocutaneous albinism (OCA) and ocular albinism (OA). OCA is characterized by hypopigmentation of skin and hair and ocular changes. OA is restricted to ocular changes that significantly overlap with those of OCA, although some individuals with OA may display mild to moderate hypopigmentation of skin and eyes compared to unaffected male siblings (Lewis RA. Ocular albinism, X-linked. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, et al., editors. GeneReviews(R). Seattle: University of Washington, Seattle, University of Washington, Seattle. All rights reserved; 1993). Syndromic albinism encompasses many heterogeneous conditions including Hermansky-Pudlak syndrome (HPS), Chediak-Higashi syndrome (CHS), and Griscelli syndrome (GS). These conditions are characterized by various systemic symptoms because the responsible genes are involved in intracellular membrane and vesicle trafficking. Recent advances in genetic analysis enable us to detect additional types of albinism and the genes responsible for these disorders (Kausar et al., Clin Genet 84(1):91–93,2013; Wei et al., J Invest Dermatol 133(7):1834–1840, 2013; Gronskov et al., Am J Hum Genet 92(3):415–421, 2013, Okamura et al., Pigment Cell Melanoma Res. 2017. doi:10.1111/pcmr.12662; Montoliu et al., Pigment Cell Melanoma Res 27(1):11–18, 2014). On the other hand, no mutations in known albinism-related genes are detected in around 20% of affected individuals (Montoliu et al., Pigment Cell Melanoma Res 27(1):11–18, 2014). A genome-wide association study has shown that a single nucleotide polymorphism (SNP) in the regulatory region upstream of the KIT ligand (KITLG) gene is involved in blond hair in Northern Europeans (Sulem et al., Nat Genet 39(12):1443–1452, 2007), suggesting that genetic alterations in noncoding regions near albinism-related genes can also be involved in the pathogenesis of albinism, as well as potential albinism genes yet to be identified (Montoliu et al., Pigment Cell Melanoma Res 27(1):11–18, 2014).

Keywords

  • Non-syndromic albinism
  • Melanin synthesis
  • Oculocutaneous albinism
  • Syndromic albinism
  • Membrane trafficking
  • Hermansky-Pudlak syndrome
  • Chediak-Higashi syndrome
  • Griscelli syndrome

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Hayashi, M., Suzuki, T. (2018). Update on Albinism. In: Kumarasinghe, P. (eds) Pigmentary Skin Disorders. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-70419-7_7

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