Evidence map›Paper›PMID 42147441›Full record

ArticleMolecular therapy. Advances2026

Systemic clinical-grade recombinant decorin reduces disease burden and fibrosis in advanced recessive dystrophic epidermolysis bullosa.

Christine Gretzmeier, Bing Hang, Gerhard Sengle, Christopher Phillips, Ben Buer, Sarah Fletcher, Arseniy Belov, Gregory Bleck, Ian J Collins, Jürgen Brinckmann and 3 more

Abstract read
In one paragraph

Article in Molecular therapy. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Fragile skin may benefit from decoration.Molecular therapy. Advances · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Christine GretzmeierDepartment of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.
Bing HangDepartment of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.
Gerhard SengleDepartment of Pediatrics and Adolescent Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Christopher PhillipsKamal Therapeutics, Hingham, MA, USA.
Ben BuerPace Laboratories, Woburn, MA, USA.
Sarah FletcherPace Laboratories, Woburn, MA, USA.
Arseniy BelovPace Laboratories, Woburn, MA, USA.
Gregory BleckCatalent Pharma Solutions Inc. Madison, Madison, WI, USA.
Ian J CollinsCatalent Pharma Solutions Inc. Madison, Madison, WI, USA.
Jürgen BrinckmannDepartment of Dermatology, University of Lübeck, Lübeck, Germany.
Mark P de SouzaKamal Therapeutics, Hingham, MA, USA.
Hal LandyKamal Therapeutics, Hingham, MA, USA.
Alexander NyströmDepartment of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recessive dystrophic epidermolysis bullosa (RDEB) is a skin and epithelial fragility disease that progresses with severe fibrosis. This fibrosis is debilitating and promotes the development of aggressive squamous cell carcinomas (SCCs). Effective management of fibrosis may improve quality of life in RDEB and reduce the risk of high-risk SCCs. Decorin, a small leucine-rich proteoglycan, has natural fibrosis-limiting activity. Higher expression of decorin has been linked to milder RDEB, and decorin has shown anti-fibrotic effects in multiple models of experimentally induced fibrosis. However, a short circulating half-life, manufacturing challenges, and broad target engagement have limited the development of systemic decorin therapy. Here, we describe scalable production of recombinant human decorin protein core (rh Decorin) and test repeated intravenous administration in a murine model of advanced RDEB. We show that rh Decorin accumulates in the skin and other injured sites and improves RDEB-related signs. Systemic administration enables decorin-mediated direct and indirect inhibition of TGF-β activity in peripheral tissues. Characterization of the dermal collagen matrix revealed evidence of remodeling capacity of fibrotic lesions in RDEB when cellular contractile activities are targeted, providing an explanation for the anti-fibrotic effects of rh Decorin in advanced disease. These results support further evaluation of intravenous rh Decorin for the treatment of RDEB, especially for fibrotic manifestations.

Indexed as

collagencollagen VIIDecorindystrophic epidermolysis bullosaextracellular matrixfibrosisportein therapyproteoglycan

Identifiers

PMID42147441
PMCPMC13175769

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.