| Autor: |
Erfinanda, Lasti, Zou, Lin, Gutbier, Birgitt, Kneller, Laura, Weidenfeld, Sarah, Michalick, Laura, Lei, Disi, Reppe, Katrin, Teixeira Alves, Luiz Gustavo, Schneider, Bill, Zhang, Qi, Li, Caihong, Fatykhova, Diana, Schneider, Paul, Liedtke, Wolfgang, Sohara, Eisei, Mitchell, Timothy J., Gruber, Achim D., Hocke, Andreas, Hippenstiel, Stefan |
| Předmět: |
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| Zdroj: |
Science Translational Medicine; 12/7/2022, Vol. 14 Issue 674, p1-16, 16p |
| Abstrakt: |
Pneumonia is the most common cause of the acute respiratory distress syndrome (ARDS). Here, we identified loss of endothelial cystic fibrosis transmembrane conductance regulator (CFTR) as an important pathomechanism leading to lung barrier failure in pneumonia-induced ARDS. CFTR was down-regulated after Streptococcus pneumoniae infection ex vivo or in vivo in human or murine lung tissue, respectively. Analysis of isolated perfused rat lungs revealed that CFTR inhibition increased endothelial permeability in parallel with intracellular chloride ion and calcium ion concentrations ([Cl−]i and [Ca2+]i). Inhibition of the chloride ion–sensitive with-no-lysine kinase 1 (WNK1) protein with tyrphostin 47 or WNK463 replicated the effect of CFTR inhibition on endothelial permeability and endothelial [Ca2+]i, whereas WNK1 activation by temozolomide attenuated it. Endothelial [Ca2+]i transients and permeability in response to inhibition of either CFTR or WNK1 were prevented by inhibition of the cation channel transient receptor potential vanilloid 4 (TRPV4). Mice deficient in Trpv4 (Trpv4−/−) developed less lung edema and protein leak than their wild-type littermates after infection with S. pneumoniae. The CFTR potentiator ivacaftor prevented lung CFTR loss, edema, and protein leak after S. pneumoniae infection in wild-type mice. In conclusion, lung infection caused loss of CFTR that promoted lung edema formation through intracellular chloride ion accumulation, inhibition of WNK1, and subsequent disinhibition of TRPV4, resulting in endothelial calcium ion influx and vascular barrier failure. Ivacaftor prevented CFTR loss in the lungs of mice with pneumonia and may, therefore, represent a possible therapeutic strategy in people suffering from ARDS due to severe pneumonia. A potent(iator) treatment for ARDS: A potent(iator) treatment for ARDSPneumonia can result in development of acute respiratory distress syndrome (ARDS), characterized by increased permeability of lung endothelial barriers to fluid and protein. However targeted treatments for ARDS are limited. Here, Erfinanda and colleagues noted downregulation of the cystic fibrosis transmembrane conductance regulator (CFTR) in pneumonia, resulting in increased endothelial permeability. The authors identified the mechanisms involved and showed that the CFTR potentiator ivacaftor stabilized CFTR abundance and rescued CFTR function in vitro. In wild-type mice, treatment with ivacaftor before or six hours after initiation of Streptococcus pneumoniae pneumonia resulted in improved barrier function and CFTR abundance, with reduced signs of lung injury, suggesting a role for ivacaftor in the treatment of ARDS in humans.-MN [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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