Cutis laxa (CL), a disease characterized by redundant and inelastic
skin, displays extensive locus heterogeneity. Together with geroderma
osteodysplasticum and arterial tortuosity syndrome, which show phenotypic
overlap with CL, eleven CL-related genes have been identified to date, which
encode proteins within 3 groups. Elastin, fibulin-4, fibulin-5 and and latent
transforming growth factor-beta-binding protein 4 are secreted proteins which
form elastic fibers and are involved in the sequestration and subsequent
activation of transforming growth factor-beta (TGFβ). Proteins within the
second group, localized to the secretory pathway, perform transport and membrane
trafficking functions necessary for the modification and secretion of elastic
fiber components. Key proteins include a subunit of the vacuolar-type proton
pump, which ensures the efficient secretion of tropoelastin, the precursor or
elastin. A copper transporter is required for the activity of lysyl oxidases,
which crosslink collagen and elastin. A Rab6-interacting goglin recruits kinesin
motors to Golgi-vesicles facilitating the transport from the Golgi to the plasma
membrane. The Rab and Ras interactor 2 regulates the activity of Rab5, a small
guanosine triphosphatase essential for the endocytosis of various cell surface
receptors, including integrins. Proteins of the third group related to CL
perform metabolic functions within the mitochondria, inhibiting the accumulation
of reactive oxygen species. Two of these proteins catalyze subsequent steps in
the conversion of glutamate to proline. The third transports dehydroascorbate
into mitochondria. Recent studies on CL-related proteins highlight the intricate
connections among membrane trafficking, metabolism, extracellular matrix
assembly, and TGFβ signaling.