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Jackson CL, Bottier M. Methods for the assessment of human airway ciliary function. Eur Respir J 2022; 60:13993003.02300-2021. [PMID: 35595315 DOI: 10.1183/13993003.02300-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 04/19/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Claire L Jackson
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK .,School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton, UK
| | - Mathieu Bottier
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
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2
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Lee DDH, Cardinale D, Nigro E, Butler CR, Rutman A, Fassad MR, Hirst RA, Moulding D, Agrotis A, Forsythe E, Peckham D, Robson E, Smith CM, Somavarapu S, Beales PL, Hart SL, Janes SM, Mitchison HM, Ketteler R, Hynds RE, O'Callaghan C. Higher throughput drug screening for rare respiratory diseases: readthrough therapy in primary ciliary dyskinesia. Eur Respir J 2021; 58:13993003.00455-2020. [PMID: 33795320 PMCID: PMC8514977 DOI: 10.1183/13993003.00455-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Development of therapeutic approaches for rare respiratory diseases is hampered by the lack of systems that allow medium-to-high-throughput screening of fully differentiated respiratory epithelium from affected patients. This is a particular problem for primary ciliary dyskinesia (PCD), a rare genetic disease caused by mutations in genes that adversely affect ciliary movement and consequently mucociliary transport. Primary cell culture of basal epithelial cells from nasal brush biopsies followed by ciliated differentiation at the air-liquid interface (ALI) has proven to be a useful tool in PCD diagnostics but the technique's broader utility, including in pre-clinical PCD research, has been restricted by the limited number of basal cells that can be expanded from such biopsies. METHODS We describe an immunofluorescence screening method, enabled by extensive expansion of basal cells from PCD patients and the directed differentiation of these cells into ciliated epithelium in miniaturised 96-well transwell format ALI cultures. As proof-of-principle, we performed a personalised investigation in a patient with a rare and severe form of PCD (reduced generation of motile cilia), in this case caused by a homozygous nonsense mutation in the MCIDAS gene. RESULTS Initial analyses of ciliary ultrastructure, beat pattern and beat frequency in the 96-well transwell format ALI cultures indicate that a range of different PCD defects can be retained in these cultures. The screening system in our proof-of-principal investigation allowed drugs that induce translational readthrough to be evaluated alone or in combination with nonsense-mediated decay inhibitors. We observed restoration of basal body formation but not the generation of cilia in the patient's nasal epithelial cells in vitro. CONCLUSION: Our study provides a platform for higher throughput analyses of airway epithelia that is applicable in a range of settings and suggests novel avenues for drug evaluation and development in PCD caused by nonsense mutations.
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Affiliation(s)
- Dani Do Hyang Lee
- UCL Great Ormond Street Institute of Child Health, London, UK
- D.D.H. Lee and D. Cardinale contributed equally
| | - Daniela Cardinale
- UCL Great Ormond Street Institute of Child Health, London, UK
- D.D.H. Lee and D. Cardinale contributed equally
| | - Ersilia Nigro
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Colin R Butler
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Andrew Rutman
- Centre for PCD Diagnosis and Research, Dept of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Mahmoud R Fassad
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
- Dept of Human Genetics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Robert A Hirst
- Centre for PCD Diagnosis and Research, Dept of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Dale Moulding
- Developmental Biology and Cancer, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alexander Agrotis
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK
| | - Elisabeth Forsythe
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Daniel Peckham
- Leeds Institute for Medical Research, University of Leeds, Leeds, UK
| | - Evie Robson
- Leeds Institute for Medical Research, University of Leeds, Leeds, UK
| | - Claire M Smith
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Philip L Beales
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Stephen L Hart
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Hannah M Mitchison
- Ciliary Disease Section, Genetics and Genomic Medicine Research and Teaching Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Robin Ketteler
- MRC Laboratory for Molecular Cell Biology, University College London, London, UK
| | - Robert E Hynds
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, UK
- UCL Cancer Institute, University College London, London, UK
- R.E. Hynds and C. O'Callaghan contributed equally to this article as lead authors and supervised the work
| | - Christopher O'Callaghan
- UCL Great Ormond Street Institute of Child Health, London, UK
- Centre for PCD Diagnosis and Research, Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- R.E. Hynds and C. O'Callaghan contributed equally to this article as lead authors and supervised the work
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3
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Sampaio P, da Silva MF, Vale I, Roxo-Rosa M, Pinto A, Constant C, Pereira L, Quintão CM, Lopes SS. CiliarMove: new software for evaluating ciliary beat frequency helps find novel mutations by a Portuguese multidisciplinary team on primary ciliary dyskinesia. ERJ Open Res 2021; 7:00792-2020. [PMID: 34104642 PMCID: PMC8174773 DOI: 10.1183/23120541.00792-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/09/2020] [Indexed: 11/21/2022] Open
Abstract
Evaluation of ciliary beat frequency (CBF) performed by high-speed videomicroscopy analysis (HVMA) is one of the techniques required for the correct diagnosis of primary ciliary dyskinesia (PCD). Currently, due to lack of open-source software, this technique is widely performed by visually counting the ciliary beatings per a given time-window. Our aim was to generate open-source, fast and intuitive software for evaluating CBF, validated in Portuguese PCD patients and healthy volunteers. Nasal brushings collected from 17 adult healthy volunteers and 34 PCD-referred subjects were recorded using HVMA. Evaluation of CBF was compared by two different methodologies: the new semi-automated computer software CiliarMove and the manual observation method using slow-motion movies. Clinical history, nasal nitric oxide and transmission electron microscopy were performed for diagnosis of PCD in the patient group. Genetic analysis was performed in a subset (n=8) of suspected PCD patients. The correlation coefficient between the two methods was R2=0.9895. The interval of CBF values obtained from the healthy control group (n=17) was 6.18-9.17 Hz at 25°C. In the PCD-excluded group (n=16), CBF ranged from 6.84 to 10.93 Hz and in the PCD group (n=18), CBF ranged from 0 to 14.30 Hz. We offer an automated open-source programme named CiliarMove, validated by the manual observation method in a healthy volunteer control group, a PCD-excluded group and a PCD-confirmed group. In our hands, comparisons between CBF intervals alone could discern between healthy and PCD groups in 78% of the cases.
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Affiliation(s)
- Pedro Sampaio
- iNOVA4HEALTH, CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Mónica Ferro da Silva
- iNOVA4HEALTH, CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Inês Vale
- Departamento de Física, Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Monte da Caparica, Caparica, Portugal
| | - Mónica Roxo-Rosa
- iNOVA4HEALTH, CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Andreia Pinto
- iNOVA4HEALTH, CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Carolina Constant
- Unidade de Pneumologia Pediátrica, Departamento de Pediatria, Hospital de Santa Maria CHLN, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Luisa Pereira
- Unidade de Pneumologia Pediátrica, Departamento de Pediatria, Hospital de Santa Maria CHLN, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | - Carla M Quintão
- Departamento de Física, Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa, Monte da Caparica, Caparica, Portugal
- NOVA Laboratório de Instrumentação, Engenharia Biomédica e Física da Radiação (LIBPhys-UNL), Lisboa, Portugal
| | - Susana S Lopes
- iNOVA4HEALTH, CEDOC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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Herbert JA, Deng Y, Hardelid P, Robinson E, Ren L, Moulding D, Smyth RL, Smith CM. β 2-integrin LFA1 mediates airway damage following neutrophil transepithelial migration during respiratory syncytial virus infection. Eur Respir J 2020; 56:13993003.02216-2019. [PMID: 32217648 PMCID: PMC7406857 DOI: 10.1183/13993003.02216-2019] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 03/08/2020] [Indexed: 11/05/2022]
Abstract
Respiratory syncytial virus (RSV) bronchiolitis is the most common cause of infant hospital admissions, but there is limited understanding of the mechanisms of disease, and no specific antiviral treatment. Using a novel in vitro primary transepithelial neutrophil migration model and innovative imaging methods, we show that RSV infection of nasal airway epithelium increased neutrophil transepithelial migration and adhesion to infected epithelial cells, which is associated with epithelial cell damage and reduced ciliary beat frequency, but also with a reduction in infectious viral load.Following migration, RSV infection results in greater neutrophil activation, degranulation and release of neutrophil elastase into the airway surface media compared to neutrophils that migrated across mock-infected nasal epithelial cells. Blocking of the interaction between the ligand on neutrophils (the β2-integrin LFA-1) for intracellular adhesion molecule (ICAM)-1 on epithelial cells reduced neutrophil adherence to RSV-infected cells and epithelial cell damage to pre-infection levels, but did not reduce the numbers of neutrophils that migrated or prevent the reduction in infectious viral load.These findings have provided important insights into the contribution of neutrophils to airway damage and viral clearance, which are relevant to the pathophysiology of RSV bronchiolitis. This model is a convenient, quantitative preclinical model that will further elucidate mechanisms that drive disease severity and has utility in antiviral drug discovery.
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Affiliation(s)
| | - Yu Deng
- UCL Great Ormond Street Institute of Child Health, London, UK.,Dept of Respiratory Medical Centre, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Pia Hardelid
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Luo Ren
- UCL Great Ormond Street Institute of Child Health, London, UK.,Dept of Respiratory Medical Centre, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Dale Moulding
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Claire Mary Smith
- UCL Great Ormond Street Institute of Child Health, London, UK .,Joint senior author
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5
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Hamilton NJI, Lee DDH, Gowers KHC, Butler CR, Maughan EF, Jevans B, Orr JC, McCann CJ, Burns AJ, MacNeil S, Birchall MA, O'Callaghan C, Hynds RE, Janes SM. Bioengineered airway epithelial grafts with mucociliary function based on collagen IV- and laminin-containing extracellular matrix scaffolds. Eur Respir J 2020; 55:1901200. [PMID: 32444408 PMCID: PMC7301290 DOI: 10.1183/13993003.01200-2019] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 02/26/2020] [Indexed: 12/15/2022]
Abstract
Current methods to replace damaged upper airway epithelium with exogenous cells are limited. Existing strategies use grafts that lack mucociliary function, leading to infection and the retention of secretions and keratin debris. Strategies that regenerate airway epithelium with mucociliary function are clearly desirable and would enable new treatments for complex airway disease.Here, we investigated the influence of the extracellular matrix (ECM) on airway epithelial cell adherence, proliferation and mucociliary function in the context of bioengineered mucosal grafts. In vitro, primary human bronchial epithelial cells (HBECs) adhered most readily to collagen IV. Biological, biomimetic and synthetic scaffolds were compared in terms of their ECM protein content and airway epithelial cell adherence.Collagen IV and laminin were preserved on the surface of decellularised dermis and epithelial cell attachment to decellularised dermis was greater than to the biomimetic or synthetic alternatives tested. Blocking epithelial integrin α2 led to decreased adherence to collagen IV and to decellularised dermis scaffolds. At air-liquid interface (ALI), bronchial epithelial cells cultured on decellularised dermis scaffolds formed a differentiated respiratory epithelium with mucociliary function. Using in vivo chick chorioallantoic membrane (CAM), rabbit airway and immunocompromised mouse models, we showed short-term preservation of the cell layer following transplantation.Our results demonstrate the feasibility of generating HBEC grafts on clinically applicable decellularised dermis scaffolds and identify matrix proteins and integrins important for this process. The long-term survivability of pre-differentiated epithelia and the relative merits of this approach against transplanting basal cells should be assessed further in pre-clinical airway transplantation models.
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Affiliation(s)
- Nick J I Hamilton
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- UCL Ear Institute, The Royal National Throat Nose and Ear Hospital, London, UK
- Nick J.I. Hamilton and Sam M. Janes are joint-senior authors
| | - Dani Do Hyang Lee
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Kate H C Gowers
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Colin R Butler
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Elizabeth F Maughan
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Benjamin Jevans
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jessica C Orr
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Conor J McCann
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alan J Burns
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sheila MacNeil
- Dept of Materials and Science Engineering, The Kroto Research Institute, North Campus, University of Sheffield, Sheffield, UK
| | - Martin A Birchall
- UCL Ear Institute, The Royal National Throat Nose and Ear Hospital, London, UK
| | - Christopher O'Callaghan
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Robert E Hynds
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Nick J.I. Hamilton and Sam M. Janes are joint-senior authors
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6
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Rumman N, Jackson C, Collins S, Goggin P, Coles J, Lucas JS. Diagnosis of primary ciliary dyskinesia: potential options for resource-limited countries. Eur Respir Rev 2017; 26:26/143/160058. [DOI: 10.1183/16000617.0058-2016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/02/2016] [Indexed: 11/05/2022] Open
Abstract
Primary ciliary dyskinesia is a genetic disease of ciliary function leading to chronic upper and lower respiratory tract symptoms. The diagnosis is frequently overlooked because the symptoms are nonspecific and the knowledge about the disease in the primary care setting is poor. Additionally, none of the available tests is accurate enough to be used in isolation. These tests are expensive, and need sophisticated equipment and expertise to analyse and interpret results; diagnosis is therefore only available at highly specialised centres. The diagnosis is particularly challenging in countries with limited resources due to the lack of such costly equipment and expertise.In this review, we discuss the importance of early and accurate diagnosis especially for countries where the disease is clinically prevalent but diagnostic tests are lacking. We review the diagnostic tests available in specialised centres (nasal nitric oxide, high-speed video microscopy, transmission electron microscopy, immunofluorescence and genetics). We then consider modifications that might be considered in less well-resourced countries whilst maintaining acceptable accuracy.
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