Abstract

Xeroderma Pigmentosum (XP) is a rare genetic syndrome with a defective DNA nucleotide excision repair. It is characterized by (i) an extreme sensitivity to ultraviolet (UV)-induced damages in the skin and eyes; (ii) high risk to develop multiple skin tumours; and (iii) neurologic alterations in the most severe form. To date, the management of XP patients consists of (i) early diagnosis; (ii) a long-life protection from ultraviolet radiation, including avoidance of unnecessary UV exposure, wearing UV blocking clothing, and use of topical sunscreens; and (iii) surgical resections of skin cancers. No curative treatment is available at present. Thus, in the last decade, in order to prevent or delay the progression of the clinical signs of XP, numerous strategies have been proposed and tested, in some cases, with adverse effects. The present review provides an overview of the molecular mechanisms featuring the development of XP and highlights both advantages and disadvantages of the clinical approaches developed throughout the years. The intention of the authors is to sensitize scientists to the crucial aspects of the pathology that could be differently targeted. In this context, the exploration of the process underlining the conception of liposomal nanocarriers is reported to focus the attention on the potentialities of liposomal technology to optimize the administration of chemoprotective agents in XP patients.

Highlights

  • In the last decades, nanoparticle-mediated drug delivery has been considered as a successful approach in numerous medical fields, including dermatology

  • The present review has been designed to explore the molecular basis of Xeroderma Pigmentosum (XP) and to present the history of the therapeutic approaches proposed as sunlight protection systems in healthy and sensitive people, such as XP patients

  • nucleotide excision repair (NER) damage recognition (TC-NER) triggers the rapid removal of base lesions from transcribed strands, whereas the global genome NER (GG-NER) is generally slower and detects bulky lesions anywhere in the genome promoting the repair of DNA independently of transcription [47,48], throughout the entire cell cycle [45,49,50]

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Summary

Introduction

Nanoparticle-mediated drug delivery has been considered as a successful approach in numerous medical fields, including dermatology. Rare skin diseases, such as Xeroderma Pigmentosum (XP), have been considered for the application of liposomal nanocarriers of the DNA repair T4 endonuclease 5 (T4N5) enzyme. Both in vitro and in vivo studies have demonstrated high efficiency to minimize UVinduced photolesions with low-adverse effects in comparison to the most popular XP treatments. Due to the involvement of each gene in a specific step of NER process, all complementation groups show wide variable and characteristic clinical manifestations (Table 2), with severity grade and age of onset partially dependent on environmental factors, such as the exposure to sunlight [9,10]. The main goal of these mechanisms is to minimize the accumulation of mutations potentially tumorigenic

The Complex Involvement of NER
XP Molecular Insights
First-Generation Intervention Strategies
Dermabrasion and Chemical Peeling
Administration of Retinoids
Phototherapy and Laser Resurfacing
Chemotherapeutic Drugs
Next Generation Approaches
Gene Therapy and Autologous Transplantation
Liposomal Formulations as Nanocarriers for DNA Repair Enzymes
Findings
Conclusions and Future Perspectives
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