Measurements of CFTR-Mediated Cl- Secretion in Human Rectal Biopsies Constitute a Robust Biomarker for Cystic Fibrosis Diagnosis and Prognosis

Sousa, Marisa and Servidoni, Maria F. and Vinagre, Adriana M. and Ramalho, Anabela S. and Bonadia, Luciana C. and Felicio, Veronica and Ribeiro, Maria A. and Uliyakina, Inna and Marson, Fernando A. and Kmit, Arthur and Cardoso, Silvia R. and Ribeiro, Jose D. and Bertuzzo, Carmen S. and Sousa, Lisete and Kunzelmann, Karl and Ribeiro, Antonio F. and Amaral, Margarida D. (2012) Measurements of CFTR-Mediated Cl- Secretion in Human Rectal Biopsies Constitute a Robust Biomarker for Cystic Fibrosis Diagnosis and Prognosis. PLOS ONE, 7 (10): e47708. -. ISSN 1932-6203,

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Abstract

Background: Cystic Fibrosis (CF) is caused by similar to 1,900 mutations in the CF transmembrane conductance regulator (CFTR) gene encoding for a cAMP-regulated chloride (Cl-) channel expressed in several epithelia. Clinical features are dominated by respiratory symptoms, but there is variable organ involvement thus causing diagnostic dilemmas, especially for non-classic cases. Methodology/Principal Findings: To further establish measurement of CFTR function as a sensitive and robust biomarker for diagnosis and prognosis of CF, we herein assessed cholinergic and cAMP-CFTR-mediated Cl- secretion in 524 freshly excised rectal biopsies from 118 individuals, including patients with confirmed CF clinical diagnosis (n = 51), individuals with clinical CF suspicion (n = 49) and age-matched non-CF controls (n = 18). Conclusive measurements were obtained for 96% of cases. Patients with "Classic CF'', presenting earlier onset of symptoms, pancreatic insufficiency, severe lung disease and low Shwachman-Kulczycki scores were found to lack CFTR-mediated Cl- secretion (<5%). Individuals with milder CF disease presented residual CFTR-mediated Cl- secretion (10-57%) and non-CF controls show CFTR-mediated Cl- secretion >= 30-35% and data evidenced good correlations with various clinical parameters. Finally, comparison of these values with those in "CF suspicion'' individuals allowed to confirm CF in 16/49 individuals (33%) and exclude it in 28/49 (57%). Statistical discriminant analyses showed that colonic measurements of CFTR-mediated Cl- secretion are the best discriminator among Classic/Non-Classic CF and non-CF groups. Conclusions/Significance: Determination of CFTR-mediated Cl- secretion in rectal biopsies is demonstrated here to be a sensitive, reproducible and robust predictive biomarker for the diagnosis and prognosis of CF. The method also has very high potential for (pre-) clinical trials of CFTR-modulator therapies.

Item Type: Article
Uncontrolled Keywords: TRANSMEMBRANE CONDUCTANCE REGULATOR; NASAL POTENTIAL DIFFERENCE; AIRWAY ION-TRANSPORT; PULMONARY-DISEASE; LUNG-FUNCTION; MUTATION; IDENTIFICATION; CONSENSUS; GENOTYPE; GENE;
Subjects: 500 Science > 570 Life sciences
Divisions: Biology, Preclinical Medicine > Institut für Physiologie > Prof. Dr. Karl Kunzelmann
Depositing User: Dr. Gernot Deinzer
Date Deposited: 05 May 2020 05:45
Last Modified: 05 May 2020 05:45
URI: https://pred.uni-regensburg.de/id/eprint/17942

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