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WNT10A mutation causes ectodermal dysplasia by impairing progenitor cell proliferation and KLF4-mediated differentiation
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Adult mice with global or constitutive epithelial Wnt10a deletion displayed increasingly sparse hair with age. HFs undergo periodic cycles of growth (anagen), regression (catagen) and rest (telogen), driven by rarely proliferating epithelial stem cells in the permanent KRT15+ CD34+ bulge region, and rapidly proliferating progenitors in the adjacent KRT15+ CD34− secondary hair germ (SHG)30. Immunofluorescence for pan-hair shaft keratins produced a signal in mutant HFs, and cuticle structure appeared grossly normal by scanning electron microscope (SEM); however, mutant hair shafts were shorter and thinner than controls, with disorganized internal structures (Supplementary Fig. 2a–j). To investigate the mechanisms underlying these defects, we induced epithelial Wnt10a deletion at successive time points in K5-rtTA tetO-Cre Wnt10afl/fl mice. Wnt10a loss from P9 (embryonic anagen) caused premature HF regression, cessation of matrix cell proliferation and decreased cyclin D1 expression (Fig. 5a–b′ and Supplementary Fig. 2k,l). Deletion at P18 delayed initiation of anagen, indicated by histology and absent SHG proliferation (Fig. 5c–d′), and prevented timely TL-GFP activation and external hair growth (Fig. 5k–m). These phenotypes mimicked the effects of Wnt/β-catenin inhibition16. Mutant HFs eventually entered anagen by P29 (Fig. 5e,f), but proliferation and cyclin D1 expression remained lower than in controls (Fig. 5e′ and Supplementary Fig. 2m–p). Wnt10a deletion in full postnatal anagen slightly reduced proliferation but did not cause HF regression (Fig. 5g–i and Supplementary Fig. 2q,r), suggesting compensatory activity of other Wnts. Thus, epithelial WNT10A/β-catenin signalling maintains embryonic anagen and promotes anagen onset.
By 6 months of age, Wnt10a mutant HFs became miniaturized with enlarged sebaceous glands and elevated lipid production (Fig. 5n–s). Dominant negative Lef1 also causes sebaceous gland expansion31, consistent with decreased Wnt/β-catenin signalling in Wnt10a mutant HFs. Despite HF miniaturization in Wnt10a mutants, CD34+ KRT15+ bulge stem cells were retained (Fig. 5t–w). Miniaturized HFs in human androgenetic alopecia similarly display enlarged sebaceous glands and bulge stem cell retention32. As data from genome-wide association studies indicate association of a WNT10A variant with androgenetic alopecia6, decreased WNT10A/β-catenin signalling may contribute to this condition.
In normal aged mice (18–34 months), HFs miniaturize via loss of stem cells due to COL17A1 proteolysis33. Miniaturized HFs of 6-month-old Wnt10a mutants expressed COL17A1 (Supplementary Fig. 2s,t), consistent with maintenance of stem cell markers and suggesting that miniaturization was not caused by accelerated aging. In line with this, levels of Axin2 expression are similar in young and aged HFs33.
Using genetic mouse models, we show that long-term absence of WNT10A causes HF miniaturization and sebaceous gland enlargement, with retention of bulge stem cells. This phenomenon is also observed in human androgenetic alopecia, consistent with identification of a WNT10A variant associated with lower expression levels and male pattern baldness. Functional studies of the WNT10A variant may shed further light on the aetiology of this common condition.