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Characterization of the cystic fibrosis transmembrane conductance regulator in a colonocyte cell line.

An anti-peptide antibody raised to the C-terminal sequence of the cystic fibrosis transmembrane conductance regulator (CFTR) was used to examine CFTR immunoreactivity in the T84 colonocyte cell line. Immunoblots of T84 cell lysates detected CFTR as a 170-kDa protein that appeared as a broad band or doublet in SDS/PAGE. This protein comigrated with the predominant immunoblot signal detected in human pancreas and colon. An equivalent protein was detected as a prominent substrate for protein kinase A and for protein kinase C in T84 cell immunoprecipitates with this antibody. The immunoprecipitated protein resembled the protein detected by immunoblot in that both proteins showed the same change in electrophoretic mobility after digestion by N-Glycanase. The precipitated protein was indentified as CFTR by two criteria. First, the same protein was immunoprecipitated with an antibody to a different CFTR peptide, [Lys102]CFTR-(102-116). Second, two-dimensional phosphopeptide mapping was used to compare the immunoprecipitated protein with a bacterially expressed protein known to contain most of the predicted protein kinase A phosphorylation sites in CFTR. Because the six most prominent peptides in each map were equivalent, these maps confirm that the precipitated protein is CFTR. By using these antibodies for immunofluorescence and immunoperoxidase staining, CFTR was localized to the apical region of T84 cells grown in tumors and in monolayers. Thus, T84 cells express CFTR at sufficient levels to permit identification and immunochemical studies of this protein in its endogenously occurring form.

Amino Acid Sequence↗

Gene expression from adeno-associated virus vectors in airway epithelial cells.

Lung diseases such as cystic fibrosis (CF) might be treated by gene therapy using viral vectors delivered to the airway. One potential vector is the defective human parvovirus, adeno-associated virus (AAV). We examined the AAV p5 transcription promoter for gene expression in immortalized cell lines derived from the airway (IB3-1) or pancreas (CFPAC-1) of CF patients. AAV vectors expressing the prokaryotic genes cat (pAAVp5cat) or neo (pAAVp5neo) from the p5 promoter were evaluated after introduction into IB3-1 or CFPAC-1 cells by lipofection. In transient assays in both cell lines, the cat gene was expressed 5- to 10-fold more efficiently from the p5 promoter than from a simian virus 40 early gene promoter (pSVcat). IB3-1 cells were transformed stably to geneticin resistance by pAAVp5neo at a 5-fold higher efficiency than by an SVneo vector. The AAV inverted terminal repeat (ITR) region immediately upstream of the p5 promoter appears to have an enhancer effect and the promoter also contains a CREB site which confers a response to forskolin. In IB3-1 cells, expression of the cat gene from a p5 promoter was decreased about 5-fold by deletion of both the upstream ITR and the CREB site. The AAVp5neo vector was also packaged into AAV particles and used to infect IB3-1 cells as a transducing virus. Under these conditions, 60 to 70% of the cells could be stably transformed to geneticin resistance. Thus, AAV transducing vectors appear to be a highly efficient delivery system for stable integration and expression of genes in cultured airway epithelial cells.

Base Sequence↗

A missense cystic fibrosis transmembrane conductance regulator mutation with variable phenotype.

OBJECTIVE: Cystic fibrosis (CF) has variable clinical presentation. Disease severity is partially associated with the type of mutation. The aim of this study was to report genotype-phenotype analysis of the G85E mutation. PATIENTS: The phenotype of 12 patients (8 were from the same extended family, and 5 of them were siblings from 2 families) carrying at least one copy of the G85E mutation was evaluated and compared with the phenotype of 40 patients carrying the two severe mutations, W1282X and/or DeltaF508 (group 1), and with 20 patients carrying the splicing mutation, 3849+10kb C->T, which was found to be associated with milder disease (group 2). RESULTS: A high phenotypic variability was found among the patients carrying the G85E mutation. This high variability was found among patients carrying the same genotype and among siblings. All the studied chromosomes carrying the G85E mutation had the 7T variant in the polythymidine tract at the branch/acceptor site in intron 8. Of the G85E patients, 25% had pancreatic sufficiency and none had meconium ileus, compared with 0% and 32%, respectively, of patients from group 1, and 80% and 0%, respectively, from group 2. Two patients carrying the G85E mutation had sweat chloride levels <60 mmol/L whereas all the others had typically elevated levels >80 mmol/L. Compared with group 2, patients carrying the G85E mutation were diagnosed at an earlier age and had higher sweat chloride levels, with mean values similar to group 1 but significantly more variable. Forced expiratory volume in 1 second (FEV1) was similar in the three groups, with no differences in the slope or in age-adjusted mean values of FEV1. The levels of transcripts lacking exon 9 transcribed from the G85E allele measured in 3 patients were 55%, 49%, and 35% and their FEV1 values were 82%, 83%, and 50% predicated, respectively. CONCLUSIONS: The G85E mutation shows variable clinical presentation in all clinical parameters. This variability could be seen among patients carrying on the other chromosome the same CFTR mutation, and also among siblings. This variability is not associated with the level of exon 9 skipping. Thus, the G85E mutation cannot be classified either as a severe or as a mild mutation.

Age of Onset↗

Analysis of delta F508 mutation in cystic fibrosis pathology specimens.

Incidence of delta F508, a severe mutation of the CFTR gene is found to be 36.3% in paraffin block cystic fibrosis liver tissues. Samples are histologically grouped according to severity of pancreatic involvement. Two families where delta F508 was detected postmortem and who have no living children, will have the chance for a prenatal diagnosis in the future pregnancies.

Age Factors↗

Pathophysiology of cystic fibrosis with emphasis on salivary gland involvement.

Cystic fibrosis (CF) is a fatal autosomal recessive disorder which affects all exocrine glands, or perhaps all epithelial surfaces. The three organs most consistently affected are the eccrine sweat gland, which produces excessively salty sweat; the lung, in which chronic obstructive pulmonary disease invariably develops and is usually the cause of mortality; and the pancreas, which fails to produce adequate bicarbonate ion and water in nearly all patients, and produces inadequate digestive enzymes in most, giving rise to pancreatic insufficiency. However, the liver, reproductive tracts, intestine, sinuses, and salivary glands are also regularly affected. In the sweat gland and in the airways, passive chloride permeability is reduced, accounting for the salty sweat and probably contributing to the dehydrated mucus in the airways. In organs apart from the sweat gland, a common feature of the disease is the plugging of glandular acini and ductules by precipitated secretions. Salivary glands have been extensively studied in CF because of both the accessibility of the glands and their products, and the mix of mucous and serous components in the salivary glands. However, there is no unanimity in the results from parotid and submandibular glands. In the labial (mucous) glands, the sodium content of secreted product and in the secretory granules is markedly elevated, and histologically the acini are plugged with eosinophilic material. Functional studies of CF salivary glands have also yielded inconsistent data. Cultured cell systems combined with molecular biologic approaches offer promise in tracing the fundamental CF defect in salivary and other epithelial systems.

Animals↗

[Epidural chemical denervation as a component of palliative therapy of patients with non-inflammatory pancreatic disease].

In 16 patients with noninflammatory disease of pancreas, cancer, fibrosis of pancreas efficacy of application of epidural chemical denervation (ECD) was studied. In comparison with conventional medicinal anesthesia there was noted the lowering of necessity in analgetic preparations using morphine equivalent dosage by 75%. In such patients the ECD technology may be recommended as a component of palliative therapy.

Cystic Fibrosis↗

CFTR!

Cystic fibrosis (CF) is a fatal genetic disease primarily affecting Caucasians, although cases have been reported from other ethnic groups. CF has a complex etiology, but it is chiefly a disease of electrolyte transport and is characterized by defects in fluid secretion by several epithelia, including the sweat duct, exocrine pancreas, and the pulmonary airways. The link between CF and a defect in cAMP-mediated Cl- transport in secretory epithelia was established in the early 1980s. Since then, numerous electrophysiological studies have focused on the characterization and regulation of individual Cl- channels underlying the macroscopic Cl- currents of secretory epithelia in the airways, sweat ducts, and gut. In this review the results of these studies in the light of current knowledge of the function of the CF gene product, the CF transmembrane conductance regulator (CFTR) protein, will be analyzed. The CFTR protein is a member of a family of ATP-binding proteins that act as unidirectional solute pumps. These proteins are membrane spanning, are found in both prokaryotic and eukaryotic cells, and have two ATP-binding domains. The family includes the p-glycoproteins that are involved with the expression of multidrug resistance in certain tumor cells. The majority of CF chromosomes (70%) have a single codon deletion that translates to a missing phenylalanine residue at position 508 (delta F508) of the protein. Unique for this family of proteins, the CFTR protein possesses an additional highly charged domain (the R domain) containing several consensus polypeptide sequences for kinase phosphorylation. Although CFTR bears structural resemblance to this family of ATP-dependent pumps, overexpression of the protein in a variety of different cell types is associated with the appearence of a cAMP-sensitive Cl- channel. We critically examine current information concerning the structure-function relationships of the CFTR protein obtained from both electrophysiological and biochemical approaches. We also summarize recent evidence suggesting that the CFTR protein may act as a pump and a channel, a hypothesis in keeping with the multifaceted nature of the disease.

Adenosine Triphosphate↗

Analyses of Pseudomonas aeruginosa lectin binding to alpha-galactosylated glycans.

The specificity and binding capacity of the galactophilic lectin from the Gram negative bacterium Pseudomonas aeruginosa (PA-IL) was determined by solid phase measurements using galactosylated neoglycoproteins immobilized on microtiter plates. The bacterial lectin reacted with both short chain (monosaccharide) and long chain (pentasaccharide) glycoconjugates. Among the Galalpha1-XGal disaccharides, the highest affinity was observed towards the Galalpha1-3Gal structure. Raising the incubation temperature enhanced the lectin-polysaccharide agglutination, and it is suggested that binding to certain conformations of polysaccharides could vary between lectins with the same monocarbohydrate specificity and that this activity may, in part, be temperature dependent. Histochemical examination of lectin binding to different porcine tissues suggests a differential glycosylation of the carbohydrate antigens on endothelial cells in various parts of the vascular system. In the pancreas, PA-IL also adhered to the excretory ducts. These observations on PA-IL binding could be of importance both to determine infection foci in P. aeruginosa-mediated vacuities and to determine its role for pancreatic involvement in cystic fibrosis.

Animals↗

Influence of steroids on the exocrine pancreas: presence of laminated bodies in the acinar lumen following castration and adrenalectomy.

The influences of combined adrenalectomy and castration and of a replacement therapy with estradiol and glucocorticoids were examined in the rat pancreas. At the light microscope level, the surgical treatment changed the overall shape of the acini and caused widening of intralobular and interlobular spaces as well as partial depletion of zymogen granules. A significant reduction of the acinar lumen size was observed in castrated-adrenalectomized (CasX-AdreX) animals. This could be reversed by a replacement therapy with glucocorticoids. Moreover, triamcinolone even caused a significant lumen enlargement as compared to sham-operated animals. Such an enlargement was not observed with dexamethasone. Both these glucocorticoids caused an increase in zymogen granule content of the acinar cell. At the ultrastructural level, hitherto undescribed type of precipitates was observed in the acinar lumen of CasX-AdreX rats. Precipitates that exhibited a laminated aspect were identified as luminal laminated bodies. The latter could have some interest from the etiological point of view of certain pancreatic diseases, such as cystic fibrosis and pancreatitis. Replacement therapy with estradiol did not affect the frequency of these precipitates, but glucocorticoid had a significantly inhibitory effect. From our observation, it is clear that some steroid exert a profound influence on the acinar cell and that a replacement therapy with glucocorticoids or estradiol do not totally restore the normal aspect of the pancreas acinar tissue. It suggests that some unknown factors from adrenals or testis are still required in addition to glucocorticoids and estrogens for the maintenance of the structural integrity of the gland.

Adrenalectomy↗

Hypothesis revisited: cystic fibrosis: a disturbance of water and electrolyte movement in exocrine secretory tissue associated with altered prostaglandin (PGE2) metabolism?

An earlier hypothesis based on the results of pancreatic studies in cystic fibrosis (CF) patients without steatorrhoea suggesting that the basic defect was related to an abnormality in control of electrolyte movement, particularly the bicarbonate ion, and water in exocrine secretory tissue is reviewed in light of recent advances in knowledge of secretory mechanisms. Evidence for defective bicarbonate-chloride exchange in a variety of CF exocrine tissues other than the pancreas is cited. Recent recognition of the close relationship between bicarbonate and mucus secretion and their stimulation by prostaglandin E2 is discussed. Consideration is given to the possibility of altered metabolism of PGE2 because of abnormal handling of essential fatty acids in CF, and an attempt is made to relate such a defect to the recent confirmation of oligosaccharide side chain differences such as an increased fucose-sialic acid ratio in CF gastrointestinal mucus and other glycoproteins. It is suggested that membrane permeability to chloride, bicarbonate-chloride exchange, and movement of water through extra- and intracellular exocrine tissues depends on modifications of the carbohydrate structure of glycoproteins during secretion and that these changes are stimulated by coordination of cell messengers PGE2, calcium, and cyclic AMP. Disturbed PGE2 metabolism in CF could inhibit these changes rendering resulting secretions dry, concentrated, and readily able to block ducts or tubes.

Bicarbonates↗

Expression of cystic fibrosis transmembrane regulator Cl- channels in heart.

Cyclic AMP (cAMP)-dependent chloride channels modulate changes in resting membrane potential and action potential duration in response to autonomic stimulation in heart. A growing body of evidence suggests that there are marked similarities in the properties of the cAMP-dependent chloride channels in heart and cystic fibrosis transmembrane regulator (CFTR) chloride channels found in airway epithelia or in cells expressing the CFTR gene product. We isolated poly A+ mRNA from rabbit ventricle and converted it to cDNA for amplification using the polymerase chain reaction (PCR). A fragment corresponding to the nucleotide-binding domain 1 (NBD1) of the CFTR transcript was cloned. Comparison of the amino acid sequence of NBD1 of human CFTR with the deduced sequence of the rabbit heart PCR product indicated 98% identity. Northern blot analysis, using the heart amplification product as a cDNA probe, demonstrated expression of homologous transcripts in human atrium, guinea pig and rabbit ventricle, and dog pancreas. Xenopus oocytes injected with poly A+ mRNA extracted from rabbit and guinea pig ventricle or dog pancreas expressed robust time-independent chloride currents in response to an elevation of cAMP. We conclude that CFTR chloride channels are expressed in heart and are responsible for the observed cAMP-dependent chloride conductance.

Animals↗

Incidence and expression of the N1303K mutation of the cystic fibrosis (CFTR) gene.

The N1303K mutation was identified in the second nucleotide binding fold of the cystic fibrosis (CF) gene last year. We have gathered data from laboratories throughout Europe and the United States of America in order to estimate its frequency and to attempt to characterise the clinical manifestations of this mutation. N1303K, identified on 216 of nearly 15,000 CF chromosomes tested, accounts for 1.5% of all CF chromosomes. The frequency of the N1303K allele varies significantly between countries and ethnic groups, being more common in Southern than in Northern Europe. This variation is independent of the delta F508 allele. It was not found on UK Asian, American Black or Australian chromosomes. N1303K is associated with four different linked marker haplotypes for the polymorphic markers XV-2c, KM.19 and pMP6d-9. Ten patients are homozygous for this mutation, whereas 106 of the remainder carry one of 12 known CF mutations in the other CF allele. We classify N1303K as a "severe" mutation with respect to the pancreas, but can find no correlation between this mutation, in either the homozygous or heterozygous state, and the severity of lung disease.

Base Sequence↗

Genetics of pancreatitis.

There was some recent progress in the understanding of genetic risk factors in chronic pancreatitis. Due to this progress some of the traditional views of the subject will change. Today, genetic risk factors are attributed a much more important role that in the past. The frequency and strength of mutations were higher than expected. Strong variants were the rare autosomal-dominant mutations N29I and R122H of PRSS1 (cationic trypsinogen) and homozygous N34S of SPINK1 (pancreatic secretory trypsin inhibitor). Other mutations (heterozygous N34S, CFTR) were of lower relevance but still mediate a higher risk than alcohol consumption. The course of genetically determined pancreatitis is rather mild. In the long term pancreas cancer was found in some patients but apart from non-smoking no adequate prophylactic strategy is available up to now.

Carrier Proteins↗

Trace metals in cystic fibrosis.

Serum zinc and copper concentration, 24 hrs urinary zinc and copper excretion, plasma selenium and red blood cell glutathione peroxidase activity were measured in 13 cystic fibrosis patients aged 6 to 15 years. The mean serum zinc value +/- S.D. (17.3 mumol/l +/- 4.6) did not differ from that of the control group (17.9 mumol/l +/- 3.1). Urinary zinc excretion in 12 out of 13 patients was within the normal range (1.53-13.8 mumol/24 hrs). The mean serum copper +/- S.D. (23.8 mumol/l +/- 4.2) was not significantly elevated as compared to the value found in the control group (19.2 mumol/l +/- 3.5), but 4 children, including 1 with documented portal hypertension, showed an urinary copper excretion greater than 0.94 mumol/24 hrs (normal: 0.16-0.80 mumol/24 hrs). Mean plasma selenium +/- S.D. (0.84 mumol/l +/- 0.25) was significantly reduced as compared to the control group (1.0 mumol/l +/- 0.15) (p less than 0.05). The correlation between selenium concentration and RBC glutathione peroxidase activity was significant (p less than 0.01). A negative correlation was also found between plasma selenium and 24 hrs faecal fat excretion (p less than 0.05). It is concluded that CF children with severe dysfunction of the exocrine pancreas are at increased risk to develop symptoms of subclinical or manifest zinc and/or selenium deficiency. Appropriate supplementation should therefore systematically be considered.

Adolescent↗

[Cuban commission of cystic fibrosis. Registration of patients since 1977].

We present the results of the registry of patients of the Cuban Commission of Cystic Fibrosis up to December, 1977. 228 patients from 192 families are reported; 81.58% were Whites and 3% were Negroes. There was no sex difference in incidence. Respiratory manifestations at diagnosis were presnet in 93% of the C.F. patients. The initial Shwachman's score were of "severe" or "moderate" in one third of the patients to whom they were made. Our Commission has followed 205 patients, one third of them died and out of the rest, we consider that 64% has a good outlook; approximately 10% has poor outlook and 26% has an uncertain prognosis. All this having in mind that the Shwachman's score, in a broad sense, has been useful to establish the prognosis. The most frequent findings in the dead pateints to whom autopsies were performed were in the lungs, the pancreas and the liver. It was observed that the lower the initial score, the lower the survival.

Cuba↗

Alternative 5' exons of the CFTR gene show developmental regulation.

The cystic fibrosis transmembrane conductance regulator (CFTR) gene shows a complex mechanism of tissue-specific and temporal regulation. Expression of the sheep and human CFTR genes shows a gradual decline during lung development, from the early mid-trimester through to term. Alternative upstream exons of CFTR have been identified in several species but their functional role remains obscure. We identified a novel 5' exon of the sheep CFTR gene (ov1a) that occurs in two splice forms (ov1aL and ov1aS), which are both mutually exclusive with exon 1. CFTR transcripts including ov1aL and ov1aS are present at low levels in many sheep tissues, however ov1aS shows temporal and spatial regulation during fetal lung development, being most abundant when CFTR expression levels start to decline. Alternative 5' exons -1a and 1a in the human CFTR gene also show changes in expression levels through lung development. Evaluation of ov1aL and ov1aS by Mfold reveals the potential to form extremely stable secondary structures which would cause ribosomal subunit detachment. Further, the loss of exon 1 from the CFTR transcript removes motifs that are crucial for normal trafficking of the CFTR protein. Recruitment of these alternative upstream exons may represent a novel mechanism of developmental regulation of CFTR expression.

Alternative Splicing↗

Cystic fibrosis.

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Adolescent↗

Morphology of the exocrine pancreas related to pancreatitis.

It has been assumed in the past that pancreatic acinar cells represent an irreversible end stage in development. Consequently, when there was an increase in structures that had the morphology of ductules, the interpretation was that they were derived from the proliferation of stem cells and/or pre-existing ductular cells. Pancreatitis, however, is regressive in nature [Bockman (1984) In: Pancreatitis: Concepts and Classification. Gyr, K.E., Singer, M.V., Sarles, H., eds. Elsevier, Amsterdam, pp. 11-15]. That is, it is characterized by parenchymal destruction and loss, rather than by expansion of parenchyma. Furthermore, it was assumed that the organization of the pancreatic parenchyma is like bunches of grapes, with spheroidal acini representing the grapes, and the ductules representing the stems. Given this organization, it would be difficult to understand how regressive changes could lead to clusters of ductular structures. Investigations using three-dimensional reconstruction and retrograde injections have altered our idea of pancreatic organization. In addition to spheroidal acini, there also are other shapes, including tubular acini. Moreover, ductules do not necessarily stop when they encounter an acinus. They may emerge on the other side. Combined ductular and acinar lumina may anastomose with each other. It is now clear that pancreatic acini may undergo redifferentiation, taking on the morphology of ductules and forming tubular complexes during pancreatitis, as well as in response to pancreatic cancer, cystic fibrosis, or blockage of the ductal system. With this understanding of pancreatic architecture and morphological plasticity, it is easier to understand the changes one sees with pancreatic diseases.

Animals↗