1. Esomeprazole Increases Airway Surface Liquid pH in Primary Cystic Fibrosis Epithelial Cells
- Author
-
Delpiano, Livia, Thomas, Joseph J., Yates, Annabel R., Rice, Sarah J., Gray, Michael A., Saint-Criq, Vinciane, Institute for Cell and Molecular Biosciences, Newcastle University [Newcastle], Epithelial Research Group, Institute for Cell and Molecular Biosciences, Faculty of Medical Sciences, Skeletal Research Group, Institute of Genetic Medicine, International Centrefor Life, CF Trust Strategic Research Centre grants SRC003 SRC013, Medical Research Council (MRC) Confidence in Concept grant MC_PC_15030, Cystic Fibrosis Foundation BOUCHE15R0, United States Department of Health & Human Services National Institutes of Health (NIH) - USA P30DK065988, Versus Arthritis 20771, Medical Research Council UK (MRC), and Arthritis Research UK as part of the Centre for Integrated Research into Musculoskeletal Ageing (CIMA) JXR 10641 MR/P020941/1 MR/R502182/1
- Subjects
Pharmacology ,congenital, hereditary, and neonatal diseases and abnormalities ,airway surface liquid pH ,proton pump inhibitor ,[SDV]Life Sciences [q-bio] ,lcsh:RM1-950 ,ouabain ,respiratory system ,ATP12A ,respiratory tract diseases ,cystic fibrosis ,lcsh:Therapeutics. Pharmacology ,esomeprazole ,Original Research - Abstract
Respiratory failure, driven by airways mucus obstruction, chronic inflammation and bacterial infections, is the main cause of mortality and morbidity in people with cystic fibrosis (CF) due to defects in the Cl- and HCO3− transport activity of the CF Transmembrane conductance Regulator (CFTR). Most recent pre-clinical and clinical studies have focused on restoring CFTR function by enhancing its trafficking or transport activity and show promising results. However, there are a significant number of patients that will not benefit from these CFTR-targeted therapies and it is therefore important to identify new non-CFTR targets that will restore lung function, by-passing CFTR dysfunction. The H+/K+-ATPase, ATP12A, has recently been identified as a potential novel target for CF therapies, since its acute inhibition by ouabain was shown to help restore mucus viscosity, mucociliary transport, and antimicrobial activity using in vitro CF airway models, and this effect was linked to an increase in the pH of the airway surface liquid (ASL). Here, we have evaluated the potential therapeutic use of ouabain by investigating the effect of chronically treating fully differentiated CF primary human airway epithelial cells (hAECs) with ouabain, under thin film conditions, resembling the in vivo situation. Our results show that although chronic treatment increased ASL pH, this correlated with a deleterious effect on epithelial integrity as assessed by LDH release, transepithelial electrical resistance, fluorescein flux, and ion transport. Since ATP12A shares approximately 65% identity with the gastric H+/K+-ATPase (ATP4A), we investigated the potential of using clinically approved ATP4A proton pump inhibitors (PPIs) for their ability to restore ASL pH in CF hAECs. We show that, despite not expressing ATP4A transcripts, acute exposure to the PPI esomeprezole, produced changes in intracellular pH that were consistent with the inhibition of H+ secretion, but this response was independent of ATP12A. More importantly, chronic exposure of CF hAECs to esomeprazole alkalinized the ASL without disrupting the epithelial barrier integrity, but this increase in ASL pH was consistent with a decrease in mRNA expression of ATP12A. We conclude that PPIs may offer a new approach to restore ASL pH in CF airways, which is independent of CFTR.
- Published
- 2018