将二碳酸盐放在现场:对空气道上皮质中CFTR校正的药理见解
Miroslaw Zajac1,2,3,4, Agathe Lepissier1,2,3, Elise Dréano1,2,3
1INSERM U1151, Institut Necker Enfants Malades, Paris, France.
Frontiers in pharmacology
|December 27, 2023
概括
囊性纤维化 (CF) 治疗部分恢复二碳酸盐分泌,但不能完全纠正酸性气道. 气道炎症显著影响二碳酸盐的运输,这是CFTR调节器治疗有效性的关键因素.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 细胞生物学 细胞生物学
- 遗传学 是一个遗传学.
背景情况:
- 囊性纤维化 (CF) 由缺陷的囊性纤维化跨膜导电调节器 (CFTR) 蛋白引起,损害了气道表面液体 (ASL) 中的化物和碳酸盐运输.
- 了解CFTR功能障碍和潜在的治疗干预对ASL pH和二碳酸盐分泌的影响,对于治疗CF肺部疾病至关重要.
研究的目的:
- 研究F508del-CFTR校正对人类呼吸道上皮细胞中二碳酸盐分泌的影响.
- 评估CFTR调节剂和炎症对体双碳酸盐运输和ASLpH的综合影响.
主要方法:
- 使用来自健康受试者和CF患者 (携带F508del变体) 的初级人类呼吸道上皮细胞.
- 通过pH-stat技术测量了体双碳酸盐分泌量.
- 细胞被用三重CFTR调节器组合 (VX-445/661/770) 和/或炎症刺激 (TNF-α + IL-17) 治疗,随后对CFTR和二碳酸盐载体 (SLC26A4,SLC26A9,NBCe1) 转录水平进行分析.
主要成果:
- 在F508del细胞中缺少CFTR介导的二碳酸盐分泌,但在三重调节器治疗中恢复到大约80%的野生类型水平.
- 炎症 (TNF-α + IL-17) 通过向上调节SLC26A4和CFTR转录物,使体双碳酸盐运输正常化并增加ASL pH.
- 只有在炎症存在时,CFTR调节剂疗法才会增加ASL的pH值,在同卵性和复合异卵性F508del基因型之间没有发现显著差异.
结论:
- 仅仅对F508del-CFTR的纠正不足以使CF中的酸性ASL正常化.
- 气道炎症是CF气道二碳酸盐分泌的关键调节剂,影响CFTR调节器的有效性.
- 预测CFTR调节器反应的类型化策略应包括评估气道炎症.
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