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Gentzsch M, Baker B, Cholon DM, Kam CW, McKinzie CJ, Despotes KA, Boyles SE, Quinney NL, Esther CR, Ribeiro CM. Cystic fibrosis airway inflammation enables elexacaftor/tezacaftor/ivacaftor-mediated rescue of N1303K CFTR mutation. ERJ Open Res 2024; 10:00746-2023. [PMID: 38226069 PMCID: PMC10789252 DOI: 10.1183/23120541.00746-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 01/17/2024] Open
Abstract
Rescue of N1303K CFTR by highly effective modulator therapy (HEMT) is enabled by CF airway inflammation. These findings suggest that evaluation of HEMT for rare CFTR mutations must be performed under inflammatory conditions relevant to CF airways. https://bit.ly/3tTcoJE.
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Affiliation(s)
- Martina Gentzsch
- Marsico Lung Institute and Cystic Fibrosis Research Center, The University of North Carolina, Chapel Hill, NC, USA
- Department of Pediatrics, The University of North Carolina, Chapel Hill, NC, USA
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC, USA
- Joint first authors
| | - Brooke Baker
- Department of Pharmacy, Duke University Medical Center, Durham, NC, USA
- Joint first authors
| | - Deborah M. Cholon
- Marsico Lung Institute and Cystic Fibrosis Research Center, The University of North Carolina, Chapel Hill, NC, USA
| | - Charissa W. Kam
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC, USA
| | - Cameron J. McKinzie
- Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC, USA
| | | | - Susan E. Boyles
- Marsico Lung Institute and Cystic Fibrosis Research Center, The University of North Carolina, Chapel Hill, NC, USA
| | - Nancy L. Quinney
- Marsico Lung Institute and Cystic Fibrosis Research Center, The University of North Carolina, Chapel Hill, NC, USA
| | - Charles R. Esther
- Marsico Lung Institute and Cystic Fibrosis Research Center, The University of North Carolina, Chapel Hill, NC, USA
- Department of Pediatrics, The University of North Carolina, Chapel Hill, NC, USA
- Joint senior authors
| | - Carla M.P. Ribeiro
- Marsico Lung Institute and Cystic Fibrosis Research Center, The University of North Carolina, Chapel Hill, NC, USA
- Department of Cell Biology and Physiology, The University of North Carolina, Chapel Hill, NC, USA
- Department of Medicine, The University of North Carolina, Chapel Hill, NC, USA
- Joint senior authors
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CFTR mutation enhances Dishevelled degradation and results in impairment of Wnt-dependent hematopoiesis. Cell Death Dis 2018; 9:275. [PMID: 29449653 PMCID: PMC5833403 DOI: 10.1038/s41419-018-0311-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/04/2018] [Accepted: 01/08/2018] [Indexed: 01/16/2023]
Abstract
Mutations of cystic fibrosis transmembrane conductance regulator (CFTR) cause cystic fibrosis (CF) with a multitude of clinical manifestations. Some CF patients develop clinically significant anemia, suggesting that CFTR may regulate hematopoiesis. Here, we report that cftr mutant zebrafish model exhibits primitive and definitive hematopoietic defects with impaired Wnt signaling. Cftr is found to interact, via its PDZ-binding domain (PDZBD), with Dishevelled (Dvl), a key component of Wnt signaling required for hematopoietic progenitor specification, thus protecting Dvl from Dapper1 (Dpr1)-induced lysosomal degradation. Defective hematopoiesis and impaired Wnt signaling in cftr mutant can be rescued by overexpression of wild-type or channel function-defective G551D mutant CFTR with an intact PDZBD, but not Cftr with mutations in the PDZBD. Analysis of human database (http://r2.amc.nl) shows that CFTR is positively correlated with DVL2 and Wnt-related hematopoietic factors in human blood system. The results reveal a previously unrecognized role of CFTR, which is independent of its channel function, in regulating DVL degradation and thus Wnt signaling required for hematopoiesis in both zebrafish and humans, providing an explanation for the anemic phenotype of CF patients.
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Early severe anemia as the first sign of cystic fibrosis. Eur J Pediatr 2016; 175:1157-1163. [PMID: 27496146 DOI: 10.1007/s00431-016-2752-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 06/27/2016] [Accepted: 07/12/2016] [Indexed: 01/17/2023]
Abstract
UNLABELLED Severe anemia is reported to occur rarely in patients with cystic fibrosis (CF). This study aimed to determine the factors associated with early severe anemia in infants with CF. This study included 231 infants with CF from 3 pediatric CF centers ten year period that were retrospectively reviewed in terms of severe anemia as the first sign of CF. Factors that could affect anemia, such as age, pancreatic insufficiency, mutations, vitamin A and E, and albumin level were evaluated. Clinical and laboratory findings in CF patients that presented with severe anemia and no respiratory symptoms were compared to those in CF patients that did not present with severe anemia. Severe anemia as the first sign of CF was noted in 17 of 231 patients. Patient age, prolonged PT/INR and the albumin level differed significantly between the 2 groups of patients (P < 0.001). Feeding pattern, pancreatic insufficiency, vitamin E and A levels, and the types of genetic mutations did not differ between the 2 groups. The mean hemoglobin level was 5.59 ± 0.21 g/dL and respiratory symptoms began a mean 6.3 months after diagnosis of CF in the anemia group. CONCLUSION In early infancy severe anemia in the absence of respiratory symptoms can be the first sign of CF. CF should be considered in the differential diagnosis of severe anemia in infants. Anemia can occur several months before respiratory symptoms in patients with CF and may be caused due to several reasons. WHAT IS KNOWN • Severe anemia as a first sign is reported to occur rarely in patients with cystic fibrosis. • Although anemia is well known in cystic fibrosis, factors that cause severe anemia are not known clearly. What is New: • This study shows the importance of severe anemia as the first sign of cystic fibrosis. • Anemia can occur several months before respiratory symptoms in patients with CF.
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Minasian CC, Sriskandan S, Balfour-Lynn IM, Bush A. Cystic fibrosis presenting with haematological abnormalities. CLINICAL AND LABORATORY HAEMATOLOGY 2006; 28:423-6. [PMID: 17105498 DOI: 10.1111/j.1365-2257.2006.00822.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although cystic fibrosis (CF) is common, the diagnosis (and subsequent treatment) may be delayed if the presentation is atypical. We present three cases of children with CF who presented with haematological abnormalities. In all cases, they underwent extensive and invasive investigations prior to the diagnosis.
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Affiliation(s)
- C C Minasian
- Department of Paediatric Respiratory Medicine, Imperial College and Royal Brompton Hospital, Sydney Street, London, UK.
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