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CFTR基因c.3453G>C(D1152H)突变导致原发性气道组织出现阴离子选择性缺陷,而依伐卡托可纠正这一缺陷。

The CFTR Mutation c.3453G > C (D1152H) Confers an Anion Selectivity Defect in Primary Airway Tissue that Can Be Rescued by Ivacaftor.

作者信息

Laselva Onofrio, Moraes Theo J, He Gengming, Bartlett Claire, Szàrics Ida, Ouyang Hong, Gunawardena Tarini N A, Strug Lisa, Bear Christine E, Gonska Tanja

机构信息

Programme in Molecular Medicine, Research Institute, Hospital for Sick Children, Toronto, ON M5G 8X4, Canada.

Department of Physiology, University of Toronto, Toronto, ON M5G 8X4, Canada.

出版信息

J Pers Med. 2020 May 13;10(2):40. doi: 10.3390/jpm10020040.

Abstract

The Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene variant, c.3453G > C (D1152H), is associated with mild Cystic Fibrosis (CF) disease, though there is considerable clinical variability ranging from no detectable symptoms to lung disease with early acquisition of The approval extension of ivacaftor, the first CFTR modulator drug approved, to include D1152H was based on a positive drug response of defective CFTR-D1152H chloride channel function when expressed in FRT cells. Functional analyses of primary human nasal epithelial cells (HNE) from an individual homozygous for D1152H now revealed that while CFTR-D1152H demonstrated normal, wild-type level chloride conductance, its bicarbonate-selective conductance was impaired. Treatment with ivacaftor increased this bicarbonate-selective conductance. Extensive genetic, protein and functional analysis of the nasal cells of this D1152H/D1152H patient revealed a 90% reduction of CFTR transcripts due to the homozygous presence of the 5T polymorphism in the poly-T tract forming a complex allele with D1152H. Thus, we confirm previous observation in patient-derived tissue that 10% normal CFTR transcripts confer normal, wild-type level chloride channel activity. Together, this study highlights the benefit of patient-derived tissues to study the functional expression and pharmacological modulation of CF-causing mutations, in order to understand pathogenesis and therapeutic responses.

摘要

囊性纤维化跨膜传导调节因子(CFTR)基因变体c.3453G>C(D1152H)与轻度囊性纤维化(CF)疾病相关,尽管临床变异性很大,从无明显症状到早期出现肺部疾病不等。首个获批的CFTR调节剂药物依伐卡托的获批范围扩大至包括D1152H,这是基于在FRT细胞中表达时缺陷性CFTR-D1152H氯离子通道功能的阳性药物反应。对一名D1152H纯合个体的原代人鼻上皮细胞(HNE)进行功能分析,结果显示,虽然CFTR-D1152H表现出正常的野生型水平的氯电导,但其碳酸氢盐选择性电导受损。用依伐卡托治疗可增加这种碳酸氢盐选择性电导。对这名D1152H/D1152H患者的鼻细胞进行广泛的基因、蛋白质和功能分析发现,由于在多聚T序列中5T多态性的纯合存在,与D1152H形成复合等位基因,CFTR转录本减少了90%。因此,我们证实了之前在患者来源组织中的观察结果,即10%的正常CFTR转录本赋予正常的野生型水平的氯通道活性。总之,本研究强调了患者来源组织在研究CF致病突变的功能表达和药理调节以了解发病机制和治疗反应方面的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a977/7354675/4a1cd9ea4605/jpm-10-00040-g001.jpg

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