About Dystrophic Epidermolysis Bullosa, or DEB
Dystrophic epidermolysis bullosa, or DEB, is an incurable, often fatal skin blistering condition caused by a lack of collagen protein in the skin. It is caused by mutations in the gene coding for type VII collagen, or COL7, a major component of the anchoring fibrils, which anchor the epidermis to the underlying dermis, and provide structural adhesion in a normal individual. The lack of COL7 in DEB patients causes blisters to occur in the dermis as a result of separation from the epidermis. This makes the skin incredibly fragile, leading to blistering or skin loss at the slightest friction or knock. It is progressive and incredibly painful.
The most severe form of DEB is recessive DEB, or RDEB, which is caused by null mutations in the COL7A1 gene. DEB also occurs in the form of dominant DEB, or DDEB, which is considered to be a milder form of DEB. There are no known treatments which affect the outcome of either form of the disease, and the current standard of care for DEB patients is limited to palliative treatments. Krystal is developingKB-103 for the treatment of the broad DEB population, including both recessive and dominant forms of the disease.
About KB105
KB105 is Krystal’s second product candidate, currently in clinical development, seeks to use gene therapy to treat patients withTGM-1 deficient ARCI. KB105 is a replication-defective,non-integrating viral vector that has been engineered employing Krystal’sSTAR-D platform to deliver functional humanTGM-1 gene directly to the patients’ dividing andnon-dividing skin cells.
About Autosomal Recessive Congenital Ichthyosis
Transglutaminase 1(TGM-1) is an essential epidermal enzyme that facilitates the formation of the epidermal barrier, which prevents dehydration, and protects the skin from unwanted toxins and surface microorganisms. The loss ofTGM-1-activity results in the severe genetic skin disease autosomal recessive congenital ichthyosis (ARCI). Most patients with aTGM-1-deficiency exhibit life-long pronounced scaling with increased trans epidermal water loss (TEWL). The scales are plate-like, often of a dark color, and cover the whole-body surface area. Erythroderma is either absent or minimal. Such patients usually have ectropion and, at times, eclabium, hypoplasia of joint and nasal cartilage, scarring alopecia, especially at the edge of the scalp, and palmoplantar keratoderma. Additional complications include episodes of sepsis, fluid and electrolyte imbalances due to impaired skin barrier function, and failure to thrive, especially during neonatal period and infancy. Severe heat intolerance, and nail dystrophy are also frequently observed.TGM-1-deficient ARCI is associated with increased mortality in the neonatal period and has a dramatic impact on quality of life. No efficient treatment is available; current therapy only relieves some symptoms. There are approximately 23,000 cases of TGM1 deficient ARCI worldwide and about 400 new cases per year globally.
About theSTAR-D Gene Therapy Platform
Krystal has developed a proprietary gene therapy platform, the Skin TARgeted Delivery platform, orSTAR-D platform, that consists of an engineeredHSV-1 viral vector and skin-optimized gene transfer technology, to developoff-the-shelf treatments for dermatological diseases. We believe that theSTAR-D platform provides an optimal approach for treating dermatological conditions due to the nature of the vector. Certain inherent features of theHSV-1 virus, combined with the ability to strategically modify the virus in the form employed as a gene delivery backbone, provide theSTAR-D platform with several advantages over other viral vector platforms for use in dermatological applications.
