1. Mechanisms of CFTR Functional Variants That Impair Regulated Bicarbonate Permeation and Increase Risk for Pancreatitis but Not for Cystic Fibrosis
- Author
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LaRusch, Jessica, Jung, Jinsei, General, Ignacio, Lewis, Michele D., Park, Hyun Woo, Brand, Randall E., Gelrud, Andres, Anderson, Michelle A., Banks, Peter A., Conwell, Darwin, Lawrence, Christopher, Romagnuolo, Joseph, Baillie, John, Alkaade, Samer, Cote, Gregory, Gardner, Timothy B., Amann, Stephen T., Slivka, Adam, Sandhu, Bimaljit, Aloe, Amy, Kienholz, Michelle L., Yadav, Dhiraj, Barmada, M. Michael, Bahar, Ivet, Lee, Min Goo, Whitcomb, David C., and North American Pancreatitis Study Group
- Subjects
Male ,Cancer Research ,Cell Membrane Permeability ,Cystic Fibrosis ,Pulmonology ,Physiology ,Cystic Fibrosis Transmembrane Conductance Regulator ,Medicina Clínica ,medicine.disease_cause ,Cystic fibrosis ,Biochemistry ,chemistry.chemical_compound ,0302 clinical medicine ,purl.org/becyt/ford/3.2 [https] ,Medicine and Health Sciences ,Genetics (clinical) ,0303 health sciences ,Mutation ,Reproduction ,PANCREATITIS ,Genetic disorder ,MOLECULAR MODELLING ,respiratory system ,3. Good health ,ION CHANNEL ,Electrophysiology ,medicine.anatomical_structure ,Phenotype ,030211 gastroenterology & hepatology ,purl.org/becyt/ford/3 [https] ,Medicina Critica y de Emergencia ,Anatomy ,Pancreas ,Genetic Dominance ,Research Article ,medicine.medical_specialty ,CIENCIAS MÉDICAS Y DE LA SALUD ,lcsh:QH426-470 ,Genotype ,Bicarbonate ,Urology ,Endocrine System ,Gastroenterology and Hepatology ,Biology ,Molecular Dynamics Simulation ,03 medical and health sciences ,Chlorides ,Internal medicine ,medicine ,Genetics ,Upper Respiratory Tract Infections ,Humans ,Secretion ,Molecular Biology ,Ecology, Evolution, Behavior and Systematics ,Genetic Association Studies ,030304 developmental biology ,Clinical Genetics ,Autosomal Recessive Traits ,HEK 293 cells ,Biology and Life Sciences ,Proteins ,Human Genetics ,medicine.disease ,Fibrosis ,lcsh:Genetics ,Bicarbonates ,Endocrinology ,HEK293 Cells ,chemistry ,Pancreatitis ,Infertility ,Respiratory Infections ,CYSTIC FIBROSIS ,Developmental Biology - Abstract
CFTR is a dynamically regulated anion channel. Intracellular WNK1-SPAK activation causes CFTR to change permeability and conductance characteristics from a chloride-preferring to bicarbonate-preferring channel through unknown mechanisms. Two severe CFTR mutations (CFTRsev) cause complete loss of CFTR function and result in cystic fibrosis (CF), a severe genetic disorder affecting sweat glands, nasal sinuses, lungs, pancreas, liver, intestines, and male reproductive system. We hypothesize that those CFTR mutations that disrupt the WNK1-SPAK activation mechanisms cause a selective, bicarbonate defect in channel function (CFTRBD) affecting organs that utilize CFTR for bicarbonate secretion (e.g. the pancreas, nasal sinus, vas deferens) but do not cause typical CF. To understand the structural and functional requirements of the CFTR bicarbonate-preferring channel, we (a) screened 984 well-phenotyped pancreatitis cases for candidate CFTRBD mutations from among 81 previously described CFTR variants; (b) conducted electrophysiology studies on clones of variants found in pancreatitis but not CF; (c) computationally constructed a new, complete structural model of CFTR for molecular dynamics simulation of wild-type and mutant variants; and (d) tested the newly defined CFTRBD variants for disease in non-pancreas organs utilizing CFTR for bicarbonate secretion. Nine variants (CFTR R74Q, R75Q, R117H, R170H, L967S, L997F, D1152H, S1235R, and D1270N) not associated with typical CF were associated with pancreatitis (OR 1.5, p = 0.002). Clones expressed in HEK 293T cells had normal chloride but not bicarbonate permeability and conductance with WNK1-SPAK activation. Molecular dynamics simulations suggest physical restriction of the CFTR channel and altered dynamic channel regulation. Comparing pancreatitis patients and controls, CFTRBD increased risk for rhinosinusitis (OR 2.3, p, Author Summary Genetic disorders of ion channels can affect the body's ability to function properly in many ways. CFTR, an ion channel regulating movement of chloride and bicarbonate across cell membranes, is important for absorbing and secreting fluids. If the gene responsible for the CFTR channel is mutated severely, the result is cystic fibrosis, a hereditary disorder in which the patient develops thick mucus, especially in the lungs, as well as scarring (fibrosis) in the pancreas. Cystic fibrosis also affects the sweat glands, nasal sinuses, intestines, liver, and male reproductive system. Mutations to the CFTR gene that do not cause cystic fibrosis have been considered benign. However, we discovered 9 CFTR mutations that do not cause cystic fibrosis but do cause inflammation and scarring of the pancreas (chronic pancreatitis). These mutant CFTR channels secrete chloride, which is important in the sweat glands, lungs, and intestines, but not bicarbonate, which is important in the pancreas, sinuses, and male reproductive tract. We found patients with any of these 9 mutations had chronic pancreatitis, and often sinus infections, and male infertility, but not other symptoms of cystic fibrosis. Our computer models and data will help researchers develop better drugs and help physicians treating patients with chronic pancreatitis.
- Published
- 2014
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