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Woodall M, Tarran R, Lee R, Anfishi H, Prins S, Counsell J, Vergani P, Hart S, Baines D. Expression of gain-of-function CFTR in cystic fibrosis airway cells restores epithelial function better than wild-type or codon-optimized CFTR. Mol Ther Methods Clin Dev 2023; 30:593-605. [PMID: 37701179 PMCID: PMC10494266 DOI: 10.1016/j.omtm.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/10/2023] [Indexed: 09/14/2023]
Abstract
Class Ia/b cystic fibrosis transmembrane regulator (CFTR) variants cause severe lung disease in 10% of cystic fibrosis (CF) patients and are untreatable with small-molecule pharmaceuticals. Genetic replacement of CFTR offers a cure, but its effectiveness is limited in vivo. We hypothesized that enhancing protein levels (using codon optimization) and/or activity (using gain-of-function variants) of CFTR would more effectively restore function to CF bronchial epithelial cells. Three different variants of the CFTR protein were tested: codon optimized (high codon adaptation index [hCAI]), a gain-of-function (GOF) variant (K978C), and a combination of both (hˆK978C). In human embryonic kidney (HEK293T) cells, initial results showed that hCAI and hˆK978C produced greater than 10-fold more CFTR protein and displayed ∼4-fold greater activity than wild-type (WT) CFTR. However, functionality was profoundly different in CF bronchial epithelial cells. Here, K978C CFTR more potently restored essential epithelial functions (anion transport, airway surface liquid height, and pH) than WT CFTR. hCAI and hˆK978C CFTRs had limited impact because of mislocalization in the cell. These data provide a proof of principle showing that GOF variants may be more effective than codon-optimized forms of CFTR for CF gene therapy. Video abstract
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Affiliation(s)
- Maximillian Woodall
- Institute for Infection and Immunity, St George’s, University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK
| | - Robert Tarran
- Department of Cell Biology & Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7248, USA
| | - Rhianna Lee
- Department of Cell Biology & Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7248, USA
| | - Hafssa Anfishi
- Institute for Infection and Immunity, St George’s, University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK
| | - Stella Prins
- Neuroscience, Physiology, & Pharmacology, Division of Biosciences, University College London, London WC1E 6BT, UK
| | - John Counsell
- Genetics & Genomic Medicine Department, Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Paola Vergani
- Neuroscience, Physiology, & Pharmacology, Division of Biosciences, University College London, London WC1E 6BT, UK
| | - Stephen Hart
- Genetics & Genomic Medicine Department, Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Deborah Baines
- Institute for Infection and Immunity, St George’s, University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK
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Fratelli N, Prefumo F, Maggi C, Cavalli C, Sciarrone A, Garofalo A, Viora E, Vergani P, Ornaghi S, Betti M, Vaglio Tessitore I, Cavaliere AF, Buongiorno S, Vidiri A, Fabbri E, Ferrazzi E, Maggi V, Cetin I, Frusca T, Ghi T, Kaihura C, Di Pasquo E, Stampalija T, Belcaro C, Quadrifoglio M, Veneziano M, Mecacci F, Simeone S, Locatelli A, Consonni S, Chianchiano N, Labate F, Cromi A, Bertucci E, Facchinetti F, Fichera A, Granata D, D'Antonio F, Foti F, Avagliano L, Bulfamante G, Calì G. Third-trimester ultrasound for antenatal diagnosis of placenta accreta spectrum in women with placenta previa: results from the ADoPAD study. Ultrasound Obstet Gynecol 2022; 60:381-389. [PMID: 35247287 PMCID: PMC9544821 DOI: 10.1002/uog.24889] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/27/2022] [Accepted: 03/05/2022] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the performance of third-trimester ultrasound for the diagnosis of clinically significant placenta accreta spectrum disorder (PAS) in women with low-lying placenta or placenta previa. METHODS This was a prospective multicenter study of pregnant women aged ≥ 18 years who were diagnosed with low-lying placenta (< 20 mm from the internal cervical os) or placenta previa (covering the internal cervical os) on ultrasound at ≥ 26 + 0 weeks' gestation, between October 2014 and January 2019. Ultrasound suspicion of PAS was raised in the presence of at least one of these signs on grayscale ultrasound: (1) obliteration of the hypoechogenic space between the uterus and the placenta; (2) interruption of the hyperechogenic interface between the uterine serosa and the bladder wall; (3) abnormal placental lacunae. Histopathological examinations were performed according to a predefined protocol, with pathologists blinded to the ultrasound findings. To assess the ability of ultrasound to detect clinically significant PAS, a composite outcome comprising the need for active management at delivery and histopathological confirmation of PAS was considered the reference standard. PAS was considered to be clinically significant if, in addition to histological confirmation, at least one of these procedures was carried out after delivery: use of hemostatic intrauterine balloon, compressive uterine suture, peripartum hysterectomy, uterine/hypogastric artery ligation or uterine artery embolization. The diagnostic performance of each ultrasound sign for clinically significant PAS was evaluated in all women and in the subgroup who had at least one previous Cesarean section and anterior placenta. Post-test probability was assessed using Fagan nomograms. RESULTS A total of 568 women underwent transabdominal and transvaginal ultrasound examinations during the study period. Of these, 95 delivered in local hospitals, and placental pathology according to the study protocol was therefore not available. Among the 473 women for whom placental pathology was available, clinically significant PAS was diagnosed in 99 (21%), comprising 36 cases of placenta accreta, 19 of placenta increta and 44 of placenta percreta. The median gestational age at the time of ultrasound assessment was 31.4 (interquartile range, 28.6-34.4) weeks. A normal hypoechogenic space between the uterus and the placenta reduced the post-test probability of clinically significant PAS from 21% to 5% in women with low-lying placenta or placenta previa in the third trimester of pregnancy and from 62% to 9% in the subgroup with previous Cesarean section and anterior placenta. The absence of placental lacunae reduced the post-test probability of clinically significant PAS from 21% to 9% in women with low-lying placenta or placenta previa in the third trimester of pregnancy and from 62% to 36% in the subgroup with previous Cesarean section and anterior placenta. When abnormal placental lacunae were seen on ultrasound, the post-test probability of clinically significant PAS increased from 21% to 59% in the whole cohort and from 62% to 78% in the subgroup with previous Cesarean section and anterior placenta. An interrupted hyperechogenic interface between the uterine serosa and bladder wall increased the post-test probability for clinically significant PAS from 21% to 85% in women with low-lying placenta or placenta previa and from 62% to 88% in the subgroup with previous Cesarean section and anterior placenta. When all three sonographic markers were present, the post-test probability for clinically significant PAS increased from 21% to 89% in the whole cohort and from 62% to 92% in the subgroup with previous Cesarean section and anterior placenta. CONCLUSIONS Grayscale ultrasound has good diagnostic performance to identify pregnancies at low risk of PAS in a high-risk population of women with low-lying placenta or placenta previa. Ultrasound may be safely used to guide management decisions and concentrate resources on patients with higher risk of clinically significant PAS. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- N. Fratelli
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - F. Prefumo
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - C. Maggi
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - C. Cavalli
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - A. Sciarrone
- Obstetrics–Gynecological Ultrasound and Prenatal Diagnosis Unit, Department of Obstetrics and GynecologyCittà della Salute e della ScienzaTurinItaly
| | - A. Garofalo
- Obstetrics–Gynecological Ultrasound and Prenatal Diagnosis Unit, Department of Obstetrics and GynecologyCittà della Salute e della ScienzaTurinItaly
| | - E. Viora
- Obstetrics–Gynecological Ultrasound and Prenatal Diagnosis Unit, Department of Obstetrics and GynecologyCittà della Salute e della ScienzaTurinItaly
| | - P. Vergani
- University of Milan‐Bicocca, School of Medicine and Surgery, Department of Obstetrics and GynecologyFondazione MBBM Onlus, San Gerardo HospitalMonzaItaly
| | - S. Ornaghi
- University of Milan‐Bicocca, School of Medicine and Surgery, Department of Obstetrics and GynecologyFondazione MBBM Onlus, San Gerardo HospitalMonzaItaly
| | - M. Betti
- Obstetrics and Gynaecology Unit, A. Manzoni Hospital, ASST LeccoLeccoItaly
| | - I. Vaglio Tessitore
- University of Milan‐Bicocca, School of Medicine and Surgery, Department of Obstetrics and GynecologyFondazione MBBM Onlus, San Gerardo HospitalMonzaItaly
| | - A. F. Cavaliere
- Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità PubblicaFondazione Policlinico Universitario ‘A. Gemelli’ IRCCS‐Università Cattolica del Sacro CuoreRomeItaly
| | - S. Buongiorno
- Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità PubblicaFondazione Policlinico Universitario ‘A. Gemelli’ IRCCS‐Università Cattolica del Sacro CuoreRomeItaly
| | - A. Vidiri
- Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità PubblicaFondazione Policlinico Universitario ‘A. Gemelli’ IRCCS‐Università Cattolica del Sacro CuoreRomeItaly
| | - E. Fabbri
- Obstetrics and Gynecology UnitBuzzi Children's Hospital, University of MilanMilanItaly
| | - E. Ferrazzi
- Fondazione IRCCS Ca Granda Ospedale Maggiore PoliclinicoMilano, Unit of ObstetricsMilanItaly
- Department of Clinical and Community SciencesUniversity of MilanMilanItaly
| | - V. Maggi
- Fondazione IRCCS Ca Granda Ospedale Maggiore PoliclinicoMilano, Unit of ObstetricsMilanItaly
| | - I. Cetin
- Obstetrics and Gynecology UnitBuzzi Children's Hospital, University of MilanMilanItaly
| | - T. Frusca
- Department of Medicine and Surgery, Obstetrics and Gynaecology UnitUniversity of ParmaParmaItaly
| | - T. Ghi
- Department of Medicine and SurgeryUniversity of ParmaParmaItaly
| | - C. Kaihura
- Department of Medicine and Surgery, Obstetrics and Gynaecology UnitUniversity of ParmaParmaItaly
| | - E. Di Pasquo
- Department of Medicine and Surgery, Obstetrics and Gynaecology UnitUniversity of ParmaParmaItaly
| | - T. Stampalija
- Unit of Fetal Medicine and Prenatal DiagnosisInstitute for Maternal and Child Health, IRCCS Burlo GarofoloTriesteItaly
- Department of Medical, Surgical and Health ScienceUniversity of TriesteTriesteItaly
| | - C. Belcaro
- Unit of Fetal Medicine and Prenatal DiagnosisInstitute for Maternal and Child Health, IRCCS Burlo GarofoloTriesteItaly
| | - M. Quadrifoglio
- Unit of Fetal Medicine and Prenatal DiagnosisInstitute for Maternal and Child Health, IRCCS Burlo GarofoloTriesteItaly
| | - M. Veneziano
- Obstetrics and Gynecology UnitBolzano HospitalBolzanoItaly
| | - F. Mecacci
- Department of Woman and Child's HealthCareggi University HospitalFlorenceItaly
| | - S. Simeone
- Department of Woman and Child's HealthCareggi University HospitalFlorenceItaly
| | - A. Locatelli
- University of Milan‐Bicocca, School of Medicine and Surgery, Obstetrics and Gynecology Unit, Carate Brianza Hospital, ASST BrianzaCarate BrianzaItaly
| | - S. Consonni
- Obstetrics and Gynecology Unit, Carate Brianza Hospital, ASST BrianzaCarate BrianzaItaly
| | - N. Chianchiano
- Fetal Medicine Unit, Bucchieri La Ferla–Fatebenefratelli HospitalPalermoItaly
| | - F. Labate
- Department of Obstetrics and GynaecologyAzienda Ospedaliera Villa Sofia CervelloPalermoItaly
| | - A. Cromi
- Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
| | - E. Bertucci
- Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Children and AdultsUniversity of Modena and Reggio Emilia School of MedicineModenaItaly
| | - F. Facchinetti
- Obstetrics and Gynecology Unit, Department of Medical and Surgical Sciences for Children and AdultsUniversity of Modena and Reggio Emilia School of MedicineModenaItaly
| | - A. Fichera
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - D. Granata
- Obstetrics and Gynecology UnitBolognini HospitalSeriateItaly
| | - F. D'Antonio
- Center for Fetal Care and High‐Risk Pregnancy, Department of Obstetrics and GynecologyUniversity of ChietiChietiItaly
| | - F. Foti
- Obstetrics and Gynecology Unit, Civico Hospital of PartinicoPalermoItaly
| | - L. Avagliano
- Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - G. P. Bulfamante
- Department of Health SciencesUniversità degli Studi di MilanoMilanItaly
| | - G. Calì
- Department of Obstetrics and GynaecologyArnas Civico HospitalPalermoItaly
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Prins S, Corradi V, Sheppard DN, Tieleman DP, Vergani P. Can two wrongs make a right? F508del-CFTR ion channel rescue by second-site mutations in its transmembrane domains. J Biol Chem 2022; 298:101615. [PMID: 35065958 PMCID: PMC8861112 DOI: 10.1016/j.jbc.2022.101615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 11/20/2022] Open
Abstract
Deletion of phenylalanine 508 (F508del) in the cystic fibrosis transmembrane conductance regulator (CFTR) anion channel is the most common cause of cystic fibrosis. The F508 residue is located on nucleotide-binding domain 1 (NBD1) in contact with the cytosolic extensions of the transmembrane helices, in particular intracellular loop 4 (ICL4). To investigate how absence of F508 at this interface impacts the CFTR protein, we carried out a mutagenesis scan of ICL4 by introducing second-site mutations at 11 positions in cis with F508del. Using an image-based fluorescence assay, we measured how each mutation affected membrane proximity and ion-channel function. The scan strongly validated the effectiveness of R1070W at rescuing F508del defects. Molecular dynamics simulations highlighted two features characterizing the ICL4/NBD1 interface of F508del/R1070W-CFTR: flexibility, with frequent transient formation of interdomain hydrogen bonds, and loosely stacked aromatic sidechains (F1068, R1070W, and F1074, mimicking F1068, F508, and F1074 in WT CFTR). F508del-CFTR displayed a distorted aromatic stack, with F1068 displaced toward the space vacated by F508, while in F508del/R1070F-CFTR, which largely retained F508del defects, R1070F could not form hydrogen bonds and the interface was less flexible. Other ICL4 second-site mutations which partially rescued F508del-CFTR included F1068M and F1074M. Methionine side chains allow hydrophobic interactions without the steric rigidity of aromatic rings, possibly conferring flexibility to accommodate the absence of F508 and retain a dynamic interface. These studies highlight how both hydrophobic interactions and conformational flexibility might be important at the ICL4/NBD1 interface, suggesting possible structural underpinnings of F508del-induced dysfunction.
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Affiliation(s)
- Stella Prins
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Valentina Corradi
- Department of Biological Sciences, Centre for Molecular Simulation, University of Calgary, Calgary, Alberta, Canada
| | - David N Sheppard
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - D Peter Tieleman
- Department of Biological Sciences, Centre for Molecular Simulation, University of Calgary, Calgary, Alberta, Canada
| | - Paola Vergani
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
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Chiossi G, Facchinetti F, Vergani P, Di Tommaso M, Marozio L, Acaia B, Pignatti L, Locatelli A, Spitaleri M, Benedetto C, Zaina B, D'Amico R. Serial cervical-length measurements after first episode of threatened preterm labor improve prediction of spontaneous delivery prior to 37 weeks' gestation. Ultrasound Obstet Gynecol 2021; 57:298-304. [PMID: 32851714 DOI: 10.1002/uog.22188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To assess whether repeat cervical-length (CL) measurement in women discharged from hospital after their first episode of threatened preterm labor can predict their risk of spontaneous preterm birth. METHODS This was a secondary analysis of a randomized controlled trial of maintenance tocolysis, in which CL was measured on transvaginal ultrasound at the time of hospital discharge and after 2, 4, 8 and 12 weeks, in women who remained undelivered after their first episode of threatened preterm labor. After univariate analysis, multivariate logistic regression analysis was used to assess whether CL < 10 mm at the time of hospital discharge or at any follow-up evaluation could predict spontaneous delivery prior to 37 weeks of gestation. RESULTS Of 226 women discharged after a diagnosis of threatened preterm labor, 57 (25.2%) delivered spontaneously prior to 37 weeks' gestation. The risk of spontaneous preterm birth was higher among women with CL < 10 mm at hospital discharge compared to those with CL ≥ 10 mm (adjusted odds ratio (aOR), 3.3; 95% CI, 1.2-9.2). Moreover, spontaneous preterm delivery was more common when CL < 10 mm was detected up to 2 weeks (aOR, 2.9; 95% CI, 1.1-7.3) or up to 4 weeks (aOR, 7.3; 95% CI, 2.3-22.8) post discharge, as compared with when CL was persistently ≥ 10 mm. The association was not significant when considering CL measurements at 8 weeks, and there was insufficient information to assess the effect of measurements obtained at 12 weeks. CONCLUSIONS Women who remain undelivered after their first episode of threatened preterm labor continue to be at high risk of spontaneous preterm birth if their CL is below 10 mm at the time of hospital discharge or at any follow-up visit up to 4 weeks later. CL measurement could be included in the antenatal care of these women in order to stratify their risk of preterm birth, rationalize resource utilization and help clinicians improve pregnancy outcome. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- G Chiossi
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - F Facchinetti
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - P Vergani
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - M Di Tommaso
- Health Science Department, Obstetrics and Gynecology Branch, University of Florence, Florence, Italy
| | - L Marozio
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - B Acaia
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - L Pignatti
- Division of Obstetrics, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy
| | - A Locatelli
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - M Spitaleri
- Health Science Department, Obstetrics and Gynecology Branch, University of Florence, Florence, Italy
| | - C Benedetto
- Department of Surgical Sciences, Gynecology and Obstetrics 1, University of Turin, Turin, Italy
| | - B Zaina
- Department of Medicine and Surgery, Obstetrics and Gynecology Branch, University of Milano-Bicocca Health Science, Milan, Italy
| | - R D'Amico
- Statistics Unit, Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, Italy
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5
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Prins S, Langron E, Hastings C, Hill EJ, Stefan AC, Griffin LD, Vergani P. Fluorescence assay for simultaneous quantification of CFTR ion-channel function and plasma membrane proximity. J Biol Chem 2020; 295:16529-16544. [PMID: 32934006 PMCID: PMC7864054 DOI: 10.1074/jbc.ra120.014061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/21/2020] [Indexed: 11/21/2022] Open
Abstract
The cystic fibrosis transmembrane conductance regulator (CFTR) is a plasma membrane anion channel that plays a key role in controlling transepithelial fluid movement. Excessive activation results in intestinal fluid loss during secretory diarrheas, whereas CFTR mutations underlie cystic fibrosis (CF). Anion permeability depends both on how well CFTR channels work (permeation/gating) and on how many are present at the membrane. Recently, treatments with two drug classes targeting CFTR-one boosting ion-channel function (potentiators) and the other increasing plasma membrane density (correctors)-have provided significant health benefits to CF patients. Here, we present an image-based fluorescence assay that can rapidly and simultaneously estimate both CFTR ion-channel function and the protein's proximity to the membrane. We monitor F508del-CFTR, the most common CF-causing variant, and confirm rescue by low temperature, CFTR-targeting drugs and second-site revertant mutation R1070W. In addition, we characterize a panel of 62 CF-causing mutations. Our measurements correlate well with published data (electrophysiology and biochemistry), further confirming validity of the assay. Finally, we profile effects of acute treatment with approved potentiator drug VX-770 on the rare-mutation panel. Mapping the potentiation profile on CFTR structures raises mechanistic hypotheses on drug action, suggesting that VX-770 might allow an open-channel conformation with an alternative arrangement of domain interfaces. The assay is a valuable tool for investigation of CFTR molecular mechanisms, allowing accurate inferences on gating/permeation. In addition, by providing a two-dimensional characterization of the CFTR protein, it could better inform development of single-drug and precision therapies addressing the root cause of CF disease.
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Affiliation(s)
- Stella Prins
- Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom
| | - Emily Langron
- Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom
| | - Cato Hastings
- CoMPLEX, University College London, London, United Kingdom
| | - Emily J Hill
- Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom
| | - Andra C Stefan
- Natural Sciences, University College London, London, United Kingdom
| | | | - Paola Vergani
- Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom.
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de Jonge HR, Ardelean MC, Bijvelds MJC, Vergani P. Strategies for cystic fibrosis transmembrane conductance regulator inhibition: from molecular mechanisms to treatment for secretory diarrhoeas. FEBS Lett 2020; 594:4085-4108. [PMID: 33113586 PMCID: PMC7756540 DOI: 10.1002/1873-3468.13971] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/22/2020] [Accepted: 10/15/2020] [Indexed: 02/06/2023]
Abstract
Cystic fibrosis transmembrane conductance regulator (CFTR) is an unusual ABC transporter. It acts as an anion‐selective channel that drives osmotic fluid transport across many epithelia. In the gut, CFTR is crucial for maintaining fluid and acid‐base homeostasis, and its activity is tightly controlled by multiple neuro‐endocrine factors. However, microbial toxins can disrupt this intricate control mechanism and trigger protracted activation of CFTR. This results in the massive faecal water loss, metabolic acidosis and dehydration that characterize secretory diarrhoeas, a major cause of malnutrition and death of children under 5 years of age. Compounds that inhibit CFTR could improve emergency treatment of diarrhoeal disease. Drawing on recent structural and functional insight, we discuss how existing CFTR inhibitors function at the molecular and cellular level. We compare their mechanisms of action to those of inhibitors of related ABC transporters, revealing some unexpected features of drug action on CFTR. Although challenges remain, especially relating to the practical effectiveness of currently available CFTR inhibitors, we discuss how recent technological advances might help develop therapies to better address this important global health need.
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Affiliation(s)
- Hugo R. de Jonge
- Department of Gastroenterology & HepatologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Maria C. Ardelean
- Department of Neuroscience, Physiology and PharmacologyUniversity College LondonUK
- Department of Natural SciencesUniversity College LondonUK
| | - Marcel J. C. Bijvelds
- Department of Gastroenterology & HepatologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Paola Vergani
- Department of Neuroscience, Physiology and PharmacologyUniversity College LondonUK
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7
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Moscheni M, Vergani P, Cetin I, Cromi A, Ghezzi F, Locatelli A, Iurlano E, Marconi A, Auxilia F, Bevilacqua L, Dell'Oro S, Picchetti CM, Scotti L, Trivelli M, Burato E. [The use of RCGO triggers in the obstetric - gynecological procedures: the impact on the reduction of adeverse events. The experience of the Lombardia Region]. Ig Sanita Pubbl 2020; 76:241-255. [PMID: 33161421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The last few weeks of pregnancy are critical to a baby's health because important organs, including the brain and lungs, are not completely developed until the end of pregnancy. The adverse events during labor and childbirth can have very serious physical, psychological and financial consequences for the child, the family, health professionals and the whole community. These events can be reduced through interventions aimed at improving the safety and quality of care, based on evidence-based knowledge, guidelines and practices that must be widely and effectively applied. This work reports the experience of the Lombardy Region on improvement actions in the obstetric and gynecological procedures for the reduction of adverse events and sentinel events through the monitoring and management of the RCGS trigger tool.
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Affiliation(s)
- M Moscheni
- Coordinatore del Gruppo di Lavoro regionale Trigger in sala parto
| | - P Vergani
- Direttore della Scuola di Specialità di Ostetricia e Ginecologia Università degli Studi di Milano Bicocca
| | - I Cetin
- Professore Ordinario di Ostetricia e Ginecologia, Università degli Studi di Milano
| | - A Cromi
- Professore Associato Ostetricia e Ginecologia Università degli Studi dell'Insubria
| | - F Ghezzi
- Professore Ordinario di Ostetricia e Ginecologia, Università degli Studi dell'Insubria
| | - A Locatelli
- Direttore S.C. Ostetricia e Ginecologia ASST Vimercate
| | - E Iurlano
- Dirigente Medico. Responsabile Sala Parto IRCCS Policlinico Milano
| | - A Marconi
- Professore Ordinario di Ostetricia e Ginecologia, Università degli Studi di Milano
| | - F Auxilia
- Risk Manager, ASST Fatebenefratelli Sacco
| | | | - S Dell'Oro
- Scuola di Specializzazione in Ostetricia e Ginecologia Università degli studi Milano Biccocca
| | - C M Picchetti
- Centro Regionale gestione del rischio in sanità e sicurezza del paziente, DG Welfare - Regione Lombardia
| | - L Scotti
- Centro Regionale gestione del rischio in sanità e sicurezza del paziente, DG Welfare - Regione Lombardia
| | - M Trivelli
- Direttore DG Welfare - Regione Lombardia
| | - E Burato
- Coordinatore Centro Regionale gestione del rischio in sanità e sicurezza del paziente, DG Welfare - Regione Lombardia
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8
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Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, Bianchi S, Ciriello E, Facchinetti F, Gervasi MT, Iurlaro E, Kustermann A, Mangili G, Mosca F, Patanè L, Spazzini D, Spinillo A, Trojano G, Vignali M, Villa A, Zuccotti GV, Parazzini F, Cetin I. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG 2020; 127:1116-1121. [PMID: 32339382 PMCID: PMC7267664 DOI: 10.1111/1471-0528.16278] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To report mode of delivery and immediate neonatal outcome in women infected with COVID-19. DESIGN Retrospective study. SETTING Twelve hospitals in northern Italy. PARTICIPANTS Pregnant women with COVID-19-confirmed infection who delivered. EXPOSURE COVID 19 infection in pregnancy. METHODS SARS-CoV-2-infected women who were admitted and delivered from 1 to 20 March 2020 were eligible. Data were collected from the clinical records using a standardised questionnaire on maternal general characteristics, any medical or obstetric co-morbidity, course of pregnancy, clinical signs and symptoms, treatment of COVID 19 infection, mode of delivery, neonatal data and breastfeeding. MAIN OUTCOME AND MEASURES Data on mode of delivery and neonatal outcome. RESULTS In all, 42 women with COVID-19 delivered at the participating centres; 24 (57.1%, 95% CI 41.0-72.3) delivered vaginally. An elective caesarean section was performed in 18/42 (42.9%, 95% CI 27.7-59.0) cases: in eight cases the indication was unrelated to COVID-19 infection. Pneumonia was diagnosed in 19/42 (45.2%, 95% CI 29.8-61.3) cases: of these, 7/19 (36.8%, 95% CI 16.3-61.6) required oxygen support and 4/19 (21.1%, 95% CI 6.1-45.6) were admitted to a critical care unit. Two women with COVID-19 breastfed without a mask because infection was diagnosed in the postpartum period: their newborns tested positive for SARS-Cov-2 infection. In one case, a newborn had a positive test after a vaginal operative delivery. CONCLUSIONS Although postpartum infection cannot be excluded with 100% certainty, these findings suggest that vaginal delivery is associated with a low risk of intrapartum SARS-Cov-2 transmission to the newborn. TWEETABLE ABSTRACT This study suggests that vaginal delivery may be associated with a low risk of intrapartum SARS-Cov-2 transmission to the newborn.
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Affiliation(s)
- E Ferrazzi
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - L Frigerio
- Dept of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - V Savasi
- Department of Woman, Mother and Neonate, Sacco Hospital-ASST Fatebenefratelli-Sacco, Milan, Italy.,Dept of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - P Vergani
- Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, Monza, Italy.,University of Milano Bicocca, Monza, Italy
| | - F Prefumo
- Department of Obstetrics and Gynecology, Spedali Civili di Brescia, Brescia, Italy.,University of Brescia, Brescia, Italy
| | - S Barresi
- Dept of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - S Bianchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - E Ciriello
- Dept of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - F Facchinetti
- Obstetrics Unit, Mother Infant Department, AOU of Modena, Modena, Italy
| | - M T Gervasi
- Obstetrics and Gynecology Unit, Department of Woman's and Child's, Health University Hospital of Padua, Padua, Italy
| | - E Iurlaro
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Kustermann
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Mangili
- Department of Neonatology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - F Mosca
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore, Milano, Italy
| | - L Patanè
- Dept of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - D Spazzini
- Obstetrics and Gynecology Unit, Azienda Ospedaliera Bolognini, Seriate, Italy
| | - A Spinillo
- Department of Obstetrics and Gynecology, University of Pavia, Pavia, Italy.,IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - G Trojano
- Obstetrics and Gynecology Department "Madonna delle Grazie" Hospital, Matera, Italy
| | - M Vignali
- Obstetrics and Gynecology Unit, P.O. Macedonio Melloni-ASST Fatebenefratelli-Sacco, Milan, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - A Villa
- Obstetrics and Gynecology Unit, Hospital of Treviglio-Caravaggio, Bergamo, Italy
| | - G V Zuccotti
- Dept of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Department of Pediatrics, Ospedale dei Bambini V. Buzzi, Milan, Italy
| | - F Parazzini
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - I Cetin
- Dept of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.,Department of Woman, Mother and Neonate, Buzzi Children's Hospital-ASST Fatebenefratelli-Sacco Milan, Italy
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9
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Ornaghi S, Bai J, Santos-Sacchi J, Navaratnam D, Vergani P, van den Pol A, Paidas M. Cytomegalovirus infects the developing Organ of Corti in a mouse model of virally induced deafness. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Tassini S, Langron E, Delang L, Mirabelli C, Lanko K, Crespan E, Kissova M, Tagliavini G, Fontò G, Bertoni S, Palese S, Giorgio C, Ravanetti F, Ragionieri L, Zamperini C, Mancini A, Dreassi E, Maga G, Vergani P, Neyts J, Radi M. Multitarget CFTR Modulators Endowed with Multiple Beneficial Side Effects for Cystic Fibrosis Patients: Toward a Simplified Therapeutic Approach. J Med Chem 2019; 62:10833-10847. [DOI: 10.1021/acs.jmedchem.9b01416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Sabrina Tassini
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
| | - Emily Langron
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, WC1E 6BT London, U.K
| | - Leen Delang
- Laboratory of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium
| | - Carmen Mirabelli
- Laboratory of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium
| | - Kristina Lanko
- Laboratory of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium
| | - Emmanuele Crespan
- Istituto di Genetica Molecolare, IGM-CNR, Via Abbiategrasso 207, 27100 Pavia, Italy
| | - Miroslava Kissova
- Istituto di Genetica Molecolare, IGM-CNR, Via Abbiategrasso 207, 27100 Pavia, Italy
| | - Giulia Tagliavini
- Istituto di Genetica Molecolare, IGM-CNR, Via Abbiategrasso 207, 27100 Pavia, Italy
| | - Greta Fontò
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
| | - Simona Bertoni
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
| | - Simone Palese
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
| | - Carmine Giorgio
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
| | - Francesca Ravanetti
- Dipartimento di Scienze Medico-Veterinarie, Università degli Studi di Parma, Via del Taglio 10, 43126 Parma, Italy
| | - Luisa Ragionieri
- Dipartimento di Scienze Medico-Veterinarie, Università degli Studi di Parma, Via del Taglio 10, 43126 Parma, Italy
| | - Claudio Zamperini
- Lead Discovery Siena S.r.l., Via Vittorio Alfieri 31, Castelnuovo Berardenga, 53019 Siena, Italy
| | - Arianna Mancini
- Dipartimento Biotecnologie, Chimica e Farmacia, Università degli Studi di Siena, 53100 Siena, Italy
| | - Elena Dreassi
- Dipartimento Biotecnologie, Chimica e Farmacia, Università degli Studi di Siena, 53100 Siena, Italy
| | - Giovanni Maga
- Istituto di Genetica Molecolare, IGM-CNR, Via Abbiategrasso 207, 27100 Pavia, Italy
| | - Paola Vergani
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, WC1E 6BT London, U.K
| | - Johan Neyts
- Laboratory of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium
| | - Marco Radi
- Dipartimento di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
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11
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Corradi V, Gu RX, Vergani P, Tieleman DP. Structure of Transmembrane Helix 8 and Possible Membrane Defects in CFTR. Biophys J 2019; 114:1751-1754. [PMID: 29694855 PMCID: PMC5936993 DOI: 10.1016/j.bpj.2018.03.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/30/2018] [Accepted: 03/05/2018] [Indexed: 12/31/2022] Open
Abstract
The cystic fibrosis transmembrane conductance regulator (CFTR) is an ion channel that regulates the flow of anions across epithelia. Mutations in CFTR cause cystic fibrosis. CFTR belongs to the ATP-binding cassette transporter superfamily, and gating is controlled by phosphorylation and ATP binding and hydrolysis. Recently obtained ATP-free and ATP-bound structures of zebrafish CFTR revealed an unwound segment of transmembrane helix (TM) 8, which appears to be a unique feature of CFTR not present in other ATP-binding cassette transporter structures. Here, using μs-long molecular dynamics simulations, we investigate the interactions formed by this TM8 segment with nearby helices in both ATP-free and ATP-bound states. We highlight ATP-dependent interactions as well as the structural role of TM8 in maintaining the functional architecture of the pore via interactions common to both the ATP-bound and ATP-free state. The results of the molecular dynamics simulations are discussed in the context of the gating mechanism of CFTR.
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Affiliation(s)
- Valentina Corradi
- Centre for Molecular Simulation and Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Ruo-Xu Gu
- Centre for Molecular Simulation and Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Paola Vergani
- Research Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - D Peter Tieleman
- Centre for Molecular Simulation and Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada.
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12
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Abstract
The cystic fibrosis transmembrane conductance regulator (CFTR) belongs to the ATP binding cassette (ABC) transporter superfamily but functions as an anion channel crucial for salt and water transport across epithelial cells. CFTR dysfunction, because of mutations, causes cystic fibrosis (CF). The anion-selective pore of the CFTR protein is formed by its two transmembrane domains (TMDs) and regulated by its cytosolic domains: two nucleotide binding domains (NBDs) and a regulatory (R) domain. Channel activation requires phosphorylation of the R domain by cAMP-dependent protein kinase (PKA), and pore opening and closing (gating) of phosphorylated channels is driven by ATP binding and hydrolysis at the NBDs. This review summarizes available information on structure and mechanism of the CFTR protein, with a particular focus on atomic-level insight gained from recent cryo-electron microscopic structures and on the molecular mechanisms of channel gating and its regulation. The pharmacological mechanisms of small molecules targeting CFTR's ion channel function, aimed at treating patients suffering from CF and other diseases, are briefly discussed.
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Affiliation(s)
- László Csanády
- Department of Medical Biochemistry, Semmelweis University , Budapest , Hungary ; MTA-SE Ion Channel Research Group, Budapest , Hungary ; Department of Neuroscience, Physiology and Pharmacology, University College London , London , United Kingdom ; and Laboratory of Cardiac/Membrane Physiology, The Rockefeller University , New York, New York
| | - Paola Vergani
- Department of Medical Biochemistry, Semmelweis University , Budapest , Hungary ; MTA-SE Ion Channel Research Group, Budapest , Hungary ; Department of Neuroscience, Physiology and Pharmacology, University College London , London , United Kingdom ; and Laboratory of Cardiac/Membrane Physiology, The Rockefeller University , New York, New York
| | - David C Gadsby
- Department of Medical Biochemistry, Semmelweis University , Budapest , Hungary ; MTA-SE Ion Channel Research Group, Budapest , Hungary ; Department of Neuroscience, Physiology and Pharmacology, University College London , London , United Kingdom ; and Laboratory of Cardiac/Membrane Physiology, The Rockefeller University , New York, New York
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13
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Langron E, Prins S, Vergani P. Potentiation of the cystic fibrosis transmembrane conductance regulator by VX-770 involves stabilization of the pre-hydrolytic, O 1 state. Br J Pharmacol 2018; 175:3990-4002. [PMID: 30107029 DOI: 10.1111/bph.14475] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/30/2018] [Accepted: 08/05/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Cystic fibrosis (CF) is a debilitating hereditary disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which encodes an anion channel. Wild type-CFTR gating is a non-equilibrium process. After ATP binding, CFTR enters a stable open state (O1 ). ATP hydrolysis leads it to a short-lived post-hydrolytic open state (O2 ), from which channels close. Here, we use mutations to probe the mechanism of VX-770, the first compound directly targeting the CFTR protein approved for treatment of CF. D1370N and K1250R mutations reduce or abolish catalytic activity, simplifying the gating scheme to an equilibrium (C↔O1 ); K464A-CFTR has a destabilized O1 state and rarely closes via hydrolysis. EXPERIMENTAL APPROACH Potentiation by VX-770 was measured using microscopic imaging of HEK293 cells expressing an anion-sensitive YFP-CFTR. A simple mathematical model was used to predict fluorescence quenching following extracellular iodide addition and estimate CFTR conductance. Membrane density of CFTR channels was measured in a parallel assay, using CFTR-pHTomato. KEY RESULTS VX-770 strongly potentiated WT-CFTR, D1370N-CFTR and K1250R-CFTR. K464A-CFTR was also strongly potentiated, regardless of whether it retained catalytic activity or not. CONCLUSIONS AND IMPLICATIONS Similar potentiation of hydrolytic and non-hydrolytic mutants suggests that VX-770 increases CFTR open probability mainly by stabilizing pre-hydrolytic O1 states with respect to closed states. Potentiation of K464A-CFTR channels suggests action of VX-770 did not strongly alter conformational dynamics at site 1. Understanding potentiator mechanism could help develop improved treatment for CF patients. The fluorescence assay presented here is a robust tool for such investigations.
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Affiliation(s)
- Emily Langron
- Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Stella Prins
- Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Paola Vergani
- Neuroscience, Physiology and Pharmacology, University College London, London, UK
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14
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Algeri P, Vergani P, Casati A, Achilli F. Thoracic aortic aneurism repair, during pregnancy, diagnosed thanks to heart examination at first antenatal visit, is a maternal and fetal safe option. Eur J Obstet Gynecol Reprod Biol 2018; 222:191-193. [PMID: 29398073 DOI: 10.1016/j.ejogrb.2018.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P Algeri
- Department of Obstetrics and Gynecology, Foundation MBBM, University of Milano-Bicocca, Via Pergolesi 33, Monza, Monza e Brianza 20900, Italy; Cardiovascular Department, San Gerardo Hospital, Monza, Italy.
| | - P Vergani
- Department of Obstetrics and Gynecology, Foundation MBBM, University of Milano-Bicocca, Via Pergolesi 33, Monza, Monza e Brianza 20900, Italy; Cardiovascular Department, San Gerardo Hospital, Monza, Italy
| | - A Casati
- Department of Obstetrics and Gynecology, Foundation MBBM, University of Milano-Bicocca, Via Pergolesi 33, Monza, Monza e Brianza 20900, Italy; Cardiovascular Department, San Gerardo Hospital, Monza, Italy
| | - F Achilli
- Department of Obstetrics and Gynecology, Foundation MBBM, University of Milano-Bicocca, Via Pergolesi 33, Monza, Monza e Brianza 20900, Italy; Cardiovascular Department, San Gerardo Hospital, Monza, Italy
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15
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Accordino F, Algeri P, Petrova PV, Mariani EM, Vergani P. Comment on "Contemporary epidemiology and novel predictors of uterine rupture: a nationwide population-based study". Arch Gynecol Obstet 2018; 297:811-812. [PMID: 29349554 DOI: 10.1007/s00404-018-4670-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
Affiliation(s)
- F Accordino
- Department of Obstetrics and Gynecology, San Gerardo Hospital, MBBM Foundation, University of Milano-Bicocca, via Pergolesi 33, Monza, Monza e Brianza, Italy
| | - P Algeri
- Department of Obstetrics and Gynecology, San Gerardo Hospital, MBBM Foundation, University of Milano-Bicocca, via Pergolesi 33, Monza, Monza e Brianza, Italy.
| | - P V Petrova
- Department of Obstetrics and Gynecology, San Gerardo Hospital, MBBM Foundation, University of Milano-Bicocca, via Pergolesi 33, Monza, Monza e Brianza, Italy
| | - E M Mariani
- Department of Obstetrics and Gynecology, San Gerardo Hospital, MBBM Foundation, University of Milano-Bicocca, via Pergolesi 33, Monza, Monza e Brianza, Italy
| | - P Vergani
- Department of Obstetrics and Gynecology, San Gerardo Hospital, MBBM Foundation, University of Milano-Bicocca, via Pergolesi 33, Monza, Monza e Brianza, Italy
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16
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Langron E, Simone MI, Delalande CMS, Reymond JL, Selwood DL, Vergani P. Improved fluorescence assays to measure the defects associated with F508del-CFTR allow identification of new active compounds. Br J Pharmacol 2017; 174:525-539. [PMID: 28094839 DOI: 10.1111/bph.13715] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 01/06/2017] [Accepted: 01/10/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND PURPOSE Cystic fibrosis (CF) is a debilitating disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which codes for a Cl-/HCO3 - channel. F508del, the most common CF-associated mutation, causes both gating and biogenesis defects in the CFTR protein. This paper describes the optimization of two fluorescence assays, capable of measuring CFTR function and cellular localization, and their use in a pilot drug screen. EXPERIMENTAL APPROACH HEK293 cells expressing YFP-F508del-CFTR, in which halide sensitive YFP is tagged to the N-terminal of CFTR, were used to screen a small library of compounds based on the VX-770 scaffold. Cells expressing F508del-CFTR-pHTomato, in which a pH sensor is tagged to the fourth extracellular loop of CFTR, were used to measure CFTR plasma membrane exposure following chronic treatment with the novel potentiators. KEY RESULTS Active compounds with efficacy ~50% of VX-770, micromolar potency, and structurally distinct from VX-770 were identified in the screen. The F508del-CFTR-pHTomato assay suggests that the hit compound MS131A, unlike VX-770, does not decrease membrane exposure of F508del-CFTR. CONCLUSIONS AND IMPLICATIONS Most known potentiators have a negative influence on F508del-CFTR biogenesis/stability, which means membrane exposure needs to be monitored early during the development of drugs targeting CFTR. The combined use of the two fluorescence assays described here provides a useful tool for the identification of improved potentiators and correctors. The assays could also prove useful for basic scientific investigations on F508del-CFTR, and other CF-causing mutations.
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Affiliation(s)
- Emily Langron
- Research Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Michela I Simone
- Discipline of Chemistry, School of Environmental and Life Sciences, Priority Research Centre for Chemical Biology and Clinical Pharmacology, The University of Newcastle, Callaghan, NSW, Australia
| | | | - Jean-Louis Reymond
- Department of Chemistry and Biochemistry, University of Bern, Bern, Switzerland
| | - David L Selwood
- Wolfson Institute for Biomedical Research, University College London, London, UK
| | - Paola Vergani
- Research Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
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17
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Tassini S, Sun L, Lanko K, Crespan E, Langron E, Falchi F, Kissova M, Armijos-Rivera JI, Delang L, Mirabelli C, Neyts J, Pieroni M, Cavalli A, Costantino G, Maga G, Vergani P, Leyssen P, Radi M. Discovery of Multitarget Agents Active as Broad-Spectrum Antivirals and Correctors of Cystic Fibrosis Transmembrane Conductance Regulator for Associated Pulmonary Diseases. J Med Chem 2017; 60:1400-1416. [DOI: 10.1021/acs.jmedchem.6b01521] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Sabrina Tassini
- P4T Group, Dipartimento
di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
| | - Liang Sun
- Laboratory
of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000, Leuven, Belgium
| | - Kristina Lanko
- Laboratory
of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000, Leuven, Belgium
| | - Emmanuele Crespan
- Istituto di Genetica Molecolare, IGM-CNR, Via Abbiategrasso 207, 27100 Pavia, Italy
| | - Emily Langron
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, WC1E
6BT London, U.K
| | - Federico Falchi
- CompuNet, Istituto Italiano di Tecnologia, Via Morego 30, I-16163 Genova, Italy
- Department of Pharmacy
and Biotechnology, University of Bologna, Via Belmeloro 6, I-40126 Bologna, Italy
| | - Miroslava Kissova
- Istituto di Genetica Molecolare, IGM-CNR, Via Abbiategrasso 207, 27100 Pavia, Italy
| | | | - Leen Delang
- Laboratory
of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000, Leuven, Belgium
| | - Carmen Mirabelli
- Laboratory
of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000, Leuven, Belgium
| | - Johan Neyts
- Laboratory
of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000, Leuven, Belgium
| | - Marco Pieroni
- P4T Group, Dipartimento
di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
| | - Andrea Cavalli
- CompuNet, Istituto Italiano di Tecnologia, Via Morego 30, I-16163 Genova, Italy
- Department of Pharmacy
and Biotechnology, University of Bologna, Via Belmeloro 6, I-40126 Bologna, Italy
| | - Gabriele Costantino
- P4T Group, Dipartimento
di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
| | - Giovanni Maga
- Istituto di Genetica Molecolare, IGM-CNR, Via Abbiategrasso 207, 27100 Pavia, Italy
| | - Paola Vergani
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, WC1E
6BT London, U.K
| | - Pieter Leyssen
- Laboratory
of Virology and Experimental Chemotherapy, Rega Institute for Medical Research, KU Leuven, Minderbroedersstraat 10, 3000, Leuven, Belgium
| | - Marco Radi
- P4T Group, Dipartimento
di Scienze degli Alimenti e del Farmaco, Università degli Studi di Parma, Viale delle Scienze, 27/A, 43124 Parma, Italy
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Ferrazzi E, Zullino S, Stampalija T, Vener C, Cavoretto P, Gervasi MT, Vergani P, Mecacci F, Marozio L, Oggè G, Algeri P, Ruffatti A, Milani S, Todros T. Bedside diagnosis of two major clinical phenotypes of hypertensive disorders of pregnancy. Ultrasound Obstet Gynecol 2016; 48:224-231. [PMID: 26350023 DOI: 10.1002/uog.15741] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 08/04/2015] [Accepted: 09/03/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the hypothesis that fetal abdominal circumference (AC) and uterine artery (UtA) Doppler pulsatility index (PI) could be used to select two homogeneous subgroups of women affected by hypertensive disorders of pregnancy (HDP), characterized by the coexistence of maternal hypertension with and without intrauterine growth restriction (IUGR). METHODS This was a multicenter retrospective study of cases affected by HDP in whom fetal AC and UtA-PI had been measured at admission to fetomaternal medicine units. Maternal characteristics, pregnancy complications and outcome were recorded. These data allowed us to model the characteristics of fetal growth in cases affected by HDP, and to design composite indicators of risk factors for maternal metabolic syndrome and of severity for maternal functional organ damage. RESULTS Measurements of fetal AC and UtA-PI allowed us to define a group of HDP cases with appropriate-for-gestational-age (AGA) fetuses (HDP-AGA), diagnosed by normal fetal AC and UtA-PI (n = 205), and a group of HDP cases with IUGR fetuses (HDP-IUGR), diagnosed by fetal AC < 5(th) centile and UtA-PI > 95(th) centile (n = 124). Curves fitted to the birth weights of these two groups were significantly different, but gestational age at admission for HDP (< 34 or ≥ 34 weeks) did not show an independent association with birth weight. When birth weight was expressed as a Z-score with respect to local reference charts, the average corresponded to the 6(th) and 48(th) centiles, respectively. The occurrence of HDP-AGA (as compared with HDP-IUGR) was significantly associated with risk factors for maternal metabolic syndrome (odds ratio, 2.79 (95% CI, 1.57-4.97)), independent of gestational age. The same risk factors yielded non-significant odds ratios for the development of late-onset (vs early-onset) HDP. Women with HDP-IUGR had worse clinical outcomes. CONCLUSIONS This study provides new information based on simple prenatal bedside examinations that might help to differentiate HDP-IUGR from HDP-AGA fetuses. These groups are associated with different fetal growth patterns and risk factors, independent of gestational age at onset of the disease. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- E Ferrazzi
- Department of Woman, Mother and Neonate, Buzzi Hospital, Biomedical and Clinical Sciences School of Medicine, University of Milan, Milan, Italy
| | - S Zullino
- Department of Woman, Mother and Neonate, Buzzi Hospital, Biomedical and Clinical Sciences School of Medicine, University of Milan, Milan, Italy
| | - T Stampalija
- Unit of Prenatal Diagnosis, IRCCS Burlo Garofolo, Trieste, Italy
| | - C Vener
- Laboratory 'GA Maccacaro' Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - P Cavoretto
- Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - M T Gervasi
- Ob/Gyn Unit, Department for Health of Mothers and Children, Padua City Hospital, Padua, Italy
| | - P Vergani
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy
| | - F Mecacci
- High Risk Pregnancy Unit, University Hospital of Careggi, Florence, Italy
| | - L Marozio
- Department of Surgical Sciences, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - G Oggè
- Department of Surgical Sciences, Sant'Anna Hospital, University of Turin, Turin, Italy
| | - P Algeri
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy
| | - A Ruffatti
- Ob/Gyn Unit, Department for Health of Mothers and Children, Padua City Hospital, Padua, Italy
| | - S Milani
- Laboratory 'GA Maccacaro' Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - T Todros
- Department of Surgical Sciences, Sant'Anna Hospital, University of Turin, Turin, Italy
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Corradi V, Vergani P, Tieleman DP. Cystic Fibrosis Transmembrane Conductance Regulator (CFTR): CLOSED AND OPEN STATE CHANNEL MODELS. J Biol Chem 2015; 290:22891-906. [PMID: 26229102 PMCID: PMC4645605 DOI: 10.1074/jbc.m115.665125] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Indexed: 01/06/2023] Open
Abstract
The cystic fibrosis transmembrane conductance regulator (CFTR) is a member of the ATP-binding cassette (ABC) transporter superfamily. CFTR controls the flow of anions through the apical membrane of epithelia. Dysfunctional CFTR causes the common lethal genetic disease cystic fibrosis. Transitions between open and closed states of CFTR are regulated by ATP binding and hydrolysis on the cytosolic nucleotide binding domains, which are coupled with the transmembrane (TM) domains forming the pathway for anion permeation. Lack of structural data hampers a global understanding of CFTR and thus the development of "rational" approaches directly targeting defective CFTR. In this work, we explored possible conformational states of the CFTR gating cycle by means of homology modeling. As templates, we used structures of homologous ABC transporters, namely TM(287-288), ABC-B10, McjD, and Sav1866. In the light of published experimental results, structural analysis of the transmembrane cavity suggests that the TM(287-288)-based CFTR model could correspond to a commonly occupied closed state, whereas the McjD-based model could represent an open state. The models capture the important role played by Phe-337 as a filter/gating residue and provide structural information on the conformational transition from closed to open channel.
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Affiliation(s)
- Valentina Corradi
- From the Department of Biological Sciences and Centre for Molecular Simulation, University of Calgary, Calgary, Alberta T2N 1N4, Canada and
| | - Paola Vergani
- Research Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - D Peter Tieleman
- From the Department of Biological Sciences and Centre for Molecular Simulation, University of Calgary, Calgary, Alberta T2N 1N4, Canada and
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Persico G, Vergani P, Cestaro C, Grandolfo M, Nespoli A. Assessment of postpartum perineal pain after vaginal delivery: prevalence, severity and determinants. A prospective observational study. Minerva Ginecol 2013; 65:669-678. [PMID: 24346253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Perineal pain is present, after birth, in almost all (95-100%) women who have experienced perineal trauma. It has been shown that women with spontaneous vaginal delivery and minimal or absent perineal trauma will have better recoveries: less pain, more tonic perineal muscles, improved sexual function and lower rates of depression. The purpose of the present study was to prospectively assess the prevalence of perineal pain in a population of women with vaginal birth at term and physiological single newborn. METHODS Pain assessment was performed using two subjective scales: the Verbal Numeric Scale (VNS) of 11 points and the Verbal Rating Score (VRS) of 4 points. Data collection period ran from the first postnatal day until 6 months after delivery, with two intermediate measurements at 1 and 7 weeks after birth. RESULTS The study enrolled 451 women: 239 primiparous and 212 multiparous, with a response rate of 92% at 6 months. The prevalence of pain was found 88.2% in the first day postpartum, 62.3% one week after birth, 8.0% at seven weeks and 0.7% at six months. With regard to the resumption of sexual activity at 6 months postpartum, a dyspareunia rate of 27% was observed in the Episiotomy group (OR 5.72, P<0.001). CONCLUSION The study found that an increase in the extent of trauma is associated with the highest scores in the self-assessment of perceived pain, with long term persistent symptoms. Furthermore, the presence of an episiotomy is a conditioning factor for the sexual function after childbirth (OR 0.43, P<0.001).
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Affiliation(s)
- G Persico
- Department of Surgery and Interdisciplinary Medicine University of Milano Bicocca, Monza, Italy -
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Csanády L, Mihályi C, Szollosi A, Töröcsik B, Vergani P. Conformational changes in the catalytically inactive nucleotide-binding site of CFTR. ACTA ACUST UNITED AC 2013; 142:61-73. [PMID: 23752332 PMCID: PMC3691448 DOI: 10.1085/jgp.201210954] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A central step in the gating of the cystic fibrosis transmembrane conductance regulator (CFTR) chloride channel is the association of its two cytosolic nucleotide-binding domains (NBDs) into a head-to-tail dimer, with two nucleotides bound at the interface. Channel opening and closing, respectively, are coupled to formation and disruption of this tight NBD dimer. CFTR is an asymmetric adenosine triphosphate (ATP)-binding cassette protein in which the two interfacial-binding sites (composite sites 1 and 2) are functionally different. During gating, the canonical, catalytically active nucleotide-binding site (site 2) cycles between dimerized prehydrolytic (state O1), dimerized post-hydrolytic (state O2), and dissociated (state C) forms in a preferential C→O1→O2→C sequence. In contrast, the catalytically inactive nucleotide-binding site (site 1) is believed to remain associated, ATP-bound, for several gating cycles. Here, we have examined the possibility of conformational changes in site 1 during gating, by studying gating effects of perturbations in site 1. Previous work showed that channel closure is slowed, both under hydrolytic and nonhydrolytic conditions, by occupancy of site 1 by N6-(2-phenylethyl)-ATP (P-ATP) as well as by the site-1 mutation H1348A (NBD2 signature sequence). Here, we found that P-ATP prolongs wild-type (WT) CFTR burst durations by selectively slowing (>2×) transition O1→O2 and decreases the nonhydrolytic closing rate (transition O1→C) of CFTR mutants K1250A (∼4×) and E1371S (∼3×). Mutation H1348A also slowed (∼3×) the O1→O2 transition in the WT background and decreased the nonhydrolytic closing rate of both K1250A (∼3×) and E1371S (∼3×) background mutants. Neither P-ATP nor the H1348A mutation affected the 1:1 stoichiometry between ATP occlusion and channel burst events characteristic to WT CFTR gating in ATP. The marked effect that different structural perturbations at site 1 have on both steps O1→C and O1→O2 suggests that the overall conformational changes that CFTR undergoes upon opening and coincident with hydrolysis at the active site 2 include significant structural rearrangement at site 1.
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Affiliation(s)
- László Csanády
- Department of Medical Biochemistry, Semmelweis University, Budapest H-1094, Hungary.
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O'Donoghue DL, Dua V, Moss GWJ, Vergani P. Increased apical Na+ permeability in cystic fibrosis is supported by a quantitative model of epithelial ion transport. J Physiol 2013; 591:3681-92. [PMID: 23732645 PMCID: PMC3752450 DOI: 10.1113/jphysiol.2013.253955] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Cystic fibrosis (CF) is caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which encodes an anion channel. In the human lung CFTR loss causes abnormal ion transport across airway epithelial cells. As a result CF individuals produce thick mucus, suffer persistent bacterial infections and have a much reduced life expectancy. Trans-epithelial potential difference (Vt) measurements are routinely carried out on nasal epithelia of CF patients in the clinic. CF epithelia exhibit a hyperpolarised basal Vt and a larger Vt change in response to amiloride (a blocker of the epithelial Na+ channel, ENaC). Are these altered bioelectric properties solely a result of electrical coupling between the ENaC and CFTR currents, or are they due to an increased ENaC permeability associated with CFTR loss? To examine these issues we have developed a quantitative mathematical model of human nasal epithelial ion transport. We find that while the loss of CFTR permeability hyperpolarises Vt and also increases amiloride-sensitive Vt, these effects are too small to account for the magnitude of change observed in CF epithelia. Instead, a parallel increase in ENaC permeability is required to adequately fit observed experimental data. Our study provides quantitative predictions for the complex relationships between ionic permeabilities and nasal Vt, giving insights into the physiology of CF disease that have important implications for CF therapy.
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Affiliation(s)
- Donal L O'Donoghue
- Centre for Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, Gower Street, London, WC1E 6BT, United Kingdom
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Corradi V, Vergani P, Tieleman DP. Molecular Models of the Closed State of the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR). Biophys J 2013. [DOI: 10.1016/j.bpj.2012.11.3459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Mihalyi C, Szollosi A, Vergani P, Csanady L. Conformational Changes in the Catalytically Inactive Nucleotide Binding Site of CFTR. Biophys J 2013. [DOI: 10.1016/j.bpj.2012.11.3463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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di Giacomo E, Colmegna F, Vergani P, Pucci B, Tabacchi T, Clerici M. 1739 – Obsessive symptoms onset ay childbirth. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76719-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Ornaghi S, Tyurmorezova A, Giardini V, Algeri P, Ceruti P, Vertemati E, Vergani P. O4. Predisposing factors for early- and late-onset preclampsia. Pregnancy Hypertens 2011; 1:259. [DOI: 10.1016/j.preghy.2011.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Szollosi A, Muallem DR, Csanády L, Vergani P. Mutant cycles at CFTR's non-canonical ATP-binding site support little interface separation during gating. ACTA ACUST UNITED AC 2011; 137:549-62. [PMID: 21576373 PMCID: PMC3105517 DOI: 10.1085/jgp.201110608] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Cystic fibrosis transmembrane conductance regulator (CFTR) is a chloride channel belonging to the adenosine triphosphate (ATP)-binding cassette (ABC) superfamily. ABC proteins share a common molecular mechanism that couples ATP binding and hydrolysis at two nucleotide-binding domains (NBDs) to diverse functions. This involves formation of NBD dimers, with ATP bound at two composite interfacial sites. In CFTR, intramolecular NBD dimerization is coupled to channel opening. Channel closing is triggered by hydrolysis of the ATP molecule bound at composite site 2. Site 1, which is non-canonical, binds nucleotide tightly but is not hydrolytic. Recently, based on kinetic arguments, it was suggested that this site remains closed for several gating cycles. To investigate movements at site 1 by an independent technique, we studied changes in thermodynamic coupling between pairs of residues on opposite sides of this site. The chosen targets are likely to interact based on both phylogenetic analysis and closeness on structural models. First, we mutated T460 in NBD1 and L1353 in NBD2 (the corresponding site-2 residues become energetically coupled as channels open). Mutation T460S accelerated closure in hydrolytic conditions and in the nonhydrolytic K1250R background; mutation L1353M did not affect these rates. Analysis of the double mutant showed additive effects of mutations, suggesting that energetic coupling between the two residues remains unchanged during the gating cycle. We next investigated pairs 460–1348 and 460–1375. Although both mutations H1348A and H1375A produced dramatic changes in hydrolytic and nonhydrolytic channel closing rates, in the corresponding double mutants these changes proved mostly additive with those caused by mutation T460S, suggesting little change in energetic coupling between either positions 460–1348 or positions 460–1375 during gating. These results provide independent support for a gating model in which ATP-bound composite site 1 remains closed throughout the gating cycle.
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Affiliation(s)
- Andras Szollosi
- Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary
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Szollosi A, Muallem DR, Vergani P, Csanády L. Studies on Correlated Pairs at the NBD-NBD and NBD-TMD Interfaces in CFTR. Biophys J 2011. [DOI: 10.1016/j.bpj.2010.12.1653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Muallem DR, Kobayter S, Kelay A, Csanády L, Vergani P. Energetic Coupling at the Nucleotide-Binding Domain/Transmembrane Domain Interface of CFTR. Biophys J 2011. [DOI: 10.1016/j.bpj.2010.12.1651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Szollosi A, Vergani P, Csanády L. Involvement of F1296 and N1303 of CFTR in induced-fit conformational change in response to ATP binding at NBD2. ACTA ACUST UNITED AC 2011; 136:407-23. [PMID: 20876359 PMCID: PMC2947058 DOI: 10.1085/jgp.201010434] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The chloride ion channel cystic fibrosis transmembrane conductance regulator (CFTR) displays a typical adenosine trisphosphate (ATP)-binding cassette (ABC) protein architecture comprising two transmembrane domains, two intracellular nucleotide-binding domains (NBDs), and a unique intracellular regulatory domain. Once phosphorylated in the regulatory domain, CFTR channels can open and close when supplied with cytosolic ATP. Despite the general agreement that formation of a head-to-tail NBD dimer drives the opening of the chloride ion pore, little is known about how ATP binding to individual NBDs promotes subsequent formation of this stable dimer. Structural studies on isolated NBDs suggest that ATP binding induces an intra-domain conformational change termed “induced fit,” which is required for subsequent dimerization. We investigated the allosteric interaction between three residues within NBD2 of CFTR, F1296, N1303, and R1358, because statistical coupling analysis suggests coevolution of these positions, and because in crystal structures of ABC domains, interactions between these positions appear to be modulated by ATP binding. We expressed wild-type as well as F1296S, N1303Q, and R1358A mutant CFTR in Xenopus oocytes and studied these channels using macroscopic inside-out patch recordings. Thermodynamic mutant cycles were built on several kinetic parameters that characterize individual steps in the gating cycle, such as apparent affinities for ATP, open probabilities in the absence of ATP, open probabilities in saturating ATP in a mutant background (K1250R), which precludes ATP hydrolysis, as well as the rates of nonhydrolytic closure. Our results suggest state-dependent changes in coupling between two of the three positions (1296 and 1303) and are consistent with a model that assumes a toggle switch–like interaction pattern during the intra-NBD2 induced fit in response to ATP binding. Stabilizing interactions of F1296 and N1303 present before ATP binding are replaced by a single F1296-N1303 contact in ATP-bound states, with similar interaction partner toggling occurring during the much rarer ATP-independent spontaneous openings.
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Affiliation(s)
- Andras Szollosi
- Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary
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Ornaghi S, Vergani P, Urban G, Giardini V, Moltrasio F, Leone BE. Immunohistochemical expression of Annexin A5 in preeclamptic placentas. Placenta 2011; 32:264-8. [PMID: 21216005 DOI: 10.1016/j.placenta.2010.12.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 12/10/2010] [Accepted: 12/10/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To study the expression of Annexin A5 (A5) in relation to preeclampsia using immunohistochemical Tissue Microarray (TMA) technique. STUDY DESIGN Case-control study of 66 singleton preeclamptic (PE) patients matched for gestational age (GA) at delivery with 63 normotensive controls with normally grown fetuses. Immunohistochemical expression of A5 and other population characteristics were compared between the two groups using Chi-square, One-way ANOVA, Spearman's Correlation, and Linear Regression. RESULTS The two groups were similar for maternal age and rate of corticosteroid administration, but differed for nulliparity, Body Mass Index (BMI), blood pressure, presence of placental histological lesions, and placental weight. Expression of A5 was similar in PE and controls (p = 0.10); however it was found to be lower in PE cases complicated by fetal growth restriction (FGR, n = 34) compared with matched controls (n = 55) (p = 0.04). An inverse correlation was found between A5 and GA in cases but not in controls (p = 0.04 vs p = 0.71). The association was even more significant in the subgroup of PE complicated by FGR (p = 0.02). A5 expression was not influenced by blood pressure, proteinuria, or placental weight. CONCLUSIONS Annexin A5 expression seems to be related only to FGR and not to PE or its clinical severity.
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Affiliation(s)
- S Ornaghi
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Via Pergolesi 33, 20052 Monza, Italy.
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Csanády L, Vergani P, Gulyás-Kovács A, Gadsby DC. Electrophysiological, biochemical, and bioinformatic methods for studying CFTR channel gating and its regulation. Methods Mol Biol 2011; 741:443-469. [PMID: 21594801 DOI: 10.1007/978-1-61779-117-8_28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
CFTR is the only member of the ABC (ATP-binding cassette) protein superfamily known to function as an ion channel. Most other ABC proteins are ATP-driven transporters, in which a cycle of ATP binding and hydrolysis, at intracellular nucleotide binding domains (NBDs), powers uphill substrate translocation across the membrane. In CFTR, this same ATP-driven cycle opens and closes a transmembrane pore through which chloride ions flow rapidly down their electrochemical gradient. Detailed analysis of the pattern of gating of CFTR channels thus offers the opportunity to learn about mechanisms of function not only of CFTR channels but also of their ABC transporter ancestors. In addition, CFTR channel gating is subject to complex regulation by kinase-mediated phosphorylation at multiple consensus sites in a cytoplasmic regulatory domain that is unique to CFTR. Here we offer a practical guide to extract useful information about the mechanisms that control opening and closing of CFTR channels: on how to plan (including information obtained from analysis of multiple sequence alignments), carry out, and analyze electrophysiological and biochemical experiments, as well as on how to circumvent potential pitfalls.
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Affiliation(s)
- László Csanády
- Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary.
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Vergani P, Roncaglia N, Ghidini A, Crippa I, Cameroni I, Orsenigo F, Pezzullo J. Can adverse neonatal outcome be predicted in late preterm or term fetal growth restriction? Ultrasound Obstet Gynecol 2010; 36:166-170. [PMID: 20131337 DOI: 10.1002/uog.7583] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To identify independent predictors of adverse neonatal outcome in cases of fetal growth restriction (FGR) at > or = 34 weeks. METHODS From a cohort of 481 FGR cases delivered at > or = 34 weeks, demographic and obstetric variables, fetal biometry and Doppler indices of the uterine, umbilical and fetal middle cerebral arteries available within 2 weeks of delivery, were related to adverse neonatal outcome, defined as admission to the neonatal intensive care unit for indications other than low birth weight alone. RESULTS Logistic regression analysis showed that gestational age (GA) at delivery (odds ratio (OR) = 0.59; 95% CI, 0.50-0.70), abdominal circumference (AC) centile (OR = 0.69; 95% CI, 0.59-0.81) and umbilical artery (UA) pulsatility index (PI) centile (OR = 1.02; 95% CI, 1.01-1.04) significantly correlated with adverse neonatal outcome. From this model we calculated a score of adverse neonatal outcome expressed by the formula: (UA-PI centile/3) - (10 x AC centile) + (10 x (40 - GA at delivery in weeks)). Receiver-operating characteristics curve analysis demonstrated that a score of > or = 25 optimally predicted adverse neonatal outcome (sensitivity of 75%, false-positive rate of 18%). Beyond 37.5 weeks, gestational age no longer had an independent impact on outcome. CONCLUSIONS In late preterm or term FGR, GA at delivery is the most important predictor of adverse neonatal outcome. At > 37.5 weeks, delivery may be the best option to minimize adverse outcome in all FGR cases. At 34-37 weeks, a score based on GA at delivery, UA-PI centile and AC centile optimally predicts adverse neonatal outcome.
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Affiliation(s)
- P Vergani
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy.
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Andreani M, Vergani P, Ghidini A, Locatelli A, Ornaghi S, Pezzullo JC. Are ultrasonographic myoma characteristics associated with blood loss at delivery? Ultrasound Obstet Gynecol 2009; 34:322-325. [PMID: 19670350 DOI: 10.1002/uog.7319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The presence of myomas in pregnancy is associated with greater blood loss at delivery. The aim of this study was to evaluate whether the sonographic characteristics of myomas can predict blood loss at delivery in women with large myomas. METHODS Among women who underwent second-trimester ultrasound screening at our department between January 1996 and December 2004, 251 had at least one myoma with a mean diameter > or = 5 cm. Number of myomas (single vs. multiple), maximum diameter of the largest myoma, sum of the maximum diameter of each myoma, change in size of myomas between first and last scan, and location in relation to the placenta and to the presenting part of the fetus (above or below) were analyzed in relation to blood loss at delivery and severe postpartum hemorrhage (> or = 1000 mL). RESULTS Multivariate analysis showed that the presence of multiple myomas was the only parameter independently associated with amount of blood loss at delivery (P = 0.003). The association between the presence of multiple myomas and severe postpartum hemorrhage was of borderline significance for the statistical power of this study (P = 0.08). CONCLUSIONS In women with large myomas, the presence of multiple tumors is independently associated with heavier blood loss at delivery but not with postpartum hemorrhage of > or = 1000 mL.
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Affiliation(s)
- M Andreani
- Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy.
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Muallem D, Vergani P. Review. ATP hydrolysis-driven gating in cystic fibrosis transmembrane conductance regulator. Philos Trans R Soc Lond B Biol Sci 2009; 364:247-55. [PMID: 18957373 DOI: 10.1098/rstb.2008.0191] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Proteins belonging to the ATP-binding cassette superfamily couple ATP binding and hydrolysis at conserved nucleotide-binding domains (NBDs) to diverse cellular functions. Most superfamily members are transporters, while cystic fibrosis transmembrane conductance regulator (CFTR), alone, is an ion channel. Despite this functional difference, recent results have suggested that CFTR shares a common molecular mechanism with other members. ATP binds to partial binding sites on the surface of the two NBDs, which then associate to form a NBD dimer, with complete composite catalytic sites now buried at the interface. ATP hydrolysis and gamma-phosphate dissociation, with the loss of molecular contacts linking the two sides of the composite site, trigger dimer dissociation. The conformational signals generated by NBD dimer formation and dissociation are transmitted to the transmembrane domains where, in transporters, they drive the cycle of conformational changes that translocate the substrate across the membrane; in CFTR, they result in opening and closing (gating) of the ion-permeation pathway.
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Affiliation(s)
- Daniella Muallem
- Neuroscience, Physiology and Pharmacology, Faculty of Life Sciences, University College London, Gower Street, London, UK
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Abstract
Transparent electrodes made of single-component ultrathin (<10 nm) metal films (UTMFs) are obtained by sputtering deposition. We show that the optical transparency of the deposited films (chromium and nickel) is comparable to that of indium tin oxide (ITO) in the visible and near-infrared range (0.4-2.5 microm), while it can be significantly higher in the ultraviolet (175-400 nm) and mid-infrared (2.5-25 microm) regions. Despite their very small thickness, the deposited UTMFs are also uniform and continuous over the 10 cm substrate, as it is confirmed by the measured low electrical resistivity. The excellent optical and electrical properties, stability, compatibility with active materials, process simplicity, and potential low cost make UTMFs high-quality transparent electrodes for the optoelectronics industry, seriously competing with widely used transparent conductive oxides, such as ITO.
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Affiliation(s)
- D S Ghosh
- ICFO-Institut de Ciències Fotòniques, Mediterranean Technology Park, Barcelona, Spain.
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Lucchi F, Janner D, Belmonte M, Balsamo S, Villa M, Giurgiola S, Vergani P, Pruneri V. Very low voltage single drive domain inverted LiNbO(3) integrated electro-optic modulator. Opt Express 2007; 15:10739-10743. [PMID: 19547429 DOI: 10.1364/oe.15.010739] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Domain inversion is used in a simple fashion to improve significantly the performance of a waveguide electro-optic modulator in z-cut LiNbO(3). The waveguide arms of the Mach-Zehnder interferometer are placed in opposite domain-oriented regions under the same, narrower and more efficient electrode, so that opposite phase shifts (push-pull effect) can still be achieved despite the arms being subjected to the same electric field. Switching voltages close to 2 V are obtained, which allow 10Gb/s modulation with inexpensive drivers, such as those used for electro-absorption modulators, which deliver driving voltages well below 3V.
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Mense M, Vergani P, White DM, Altberg G, Nairn AC, Gadsby DC. In vivo phosphorylation of CFTR promotes formation of a nucleotide-binding domain heterodimer. EMBO J 2006; 25:4728-39. [PMID: 17036051 PMCID: PMC1618097 DOI: 10.1038/sj.emboj.7601373] [Citation(s) in RCA: 148] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Accepted: 08/30/2006] [Indexed: 11/08/2022] Open
Abstract
The human ATP-binding cassette (ABC) protein CFTR (cystic fibrosis transmembrane conductance regulator) is a chloride channel, whose dysfunction causes cystic fibrosis. To gain structural insight into the dynamic interaction between CFTR's nucleotide-binding domains (NBDs) proposed to underlie channel gating, we introduced target cysteines into the NBDs, expressed the channels in Xenopus oocytes, and used in vivo sulfhydryl-specific crosslinking to directly examine the cysteines' proximity. We tested five cysteine pairs, each comprising one introduced cysteine in the NH(2)-terminal NBD1 and another in the COOH-terminal NBD2. Identification of crosslinked product was facilitated by co-expression of NH(2)-terminal and COOH-terminal CFTR half channels each containing one NBD. The COOH-terminal half channel lacked all native cysteines. None of CFTR's 18 native cysteines was found essential for wild type-like, phosphorylation- and ATP-dependent, channel gating. The observed crosslinks demonstrate that NBD1 and NBD2 interact in a head-to-tail configuration analogous to that in homodimeric crystal structures of nucleotide-bound prokaryotic NBDs. CFTR phosphorylation by PKA strongly promoted both crosslinking and opening of the split channels, firmly linking head-to-tail NBD1-NBD2 association to channel opening.
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Affiliation(s)
- Martin Mense
- Laboratory of Cardiac/Membrane Physiology, Rockefeller University, New York, NY, USA
| | - Paola Vergani
- Laboratory of Cardiac/Membrane Physiology, Rockefeller University, New York, NY, USA
| | - Dennis M White
- Laboratory of Cardiac/Membrane Physiology, Rockefeller University, New York, NY, USA
| | - Gal Altberg
- Laboratory of Cardiac/Membrane Physiology, Rockefeller University, New York, NY, USA
| | - Angus C Nairn
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - David C Gadsby
- Laboratory of Cardiac/Membrane Physiology, Rockefeller University, New York, NY, USA
- Laboratory of Cardiac/Membrane Physiology, Rockefeller University, 1230 York Avenue, New York, NY 10021-6399, USA. Tel.: +1 212 327 8680; Fax: +1 212 327 7589; E-mail:
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Galateau-Sallé F, Vergani P, Astoul P, Rolland P, Pairon J, Brochard P, Matrat M, Abonnet V, Imbernon E, Gilg Soit Ilg A, Goldberg M, Launoy G. 236 Prolonged survival in malignant mesothelioma: A study of nineteen cases. Lung Cancer 2006. [DOI: 10.1016/s0169-5002(07)70312-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Todros T, Verdiglione P, Oggè G, Paladini D, Vergani P, Cardaropoli S. Low incidence of hypertensive disorders of pregnancy in women treated with spiramycin for toxoplasma infection. Br J Clin Pharmacol 2006; 61:336-40. [PMID: 16487228 PMCID: PMC1885027 DOI: 10.1111/j.1365-2125.2005.02572.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS Toxoplasma infection in pregnancy is usually treated with long-term administration of the macrolide spiramycin to prevent fetal malformations. We had empirically observed that treated patients seldom developed pregnancy-induced hypertension (PIH), a common and severe disorder of pregnancy whose aetiology and pathogenesis are still debated. Some clinical and experimental data suggest that infection could play a role in its development. METHODS To test this hypothesis, we studied a cohort of 417 pregnant women treated with spiramycin because of seroconversion for Toxoplasma gondii and 353 low-risk women who did not take any antibiotic during pregnancy. PIH was defined as blood pressure>140/90 mmHg on two or more occasions, occurring after 20 weeks of gestational age. RESULTS Seventeen (5.2%) women in the control group developed PIH compared with two (0.5%) in the case group. The odds of developing the disease were significantly lower in the treated subjects (odds ratio=0.092, 95% confidence interval 0.021, 0.399; P<0.001). CONCLUSIONS Our results suggest that antibiotic treatment during pregnancy can reduce the incidence of PIH, thus opening new perspectives in its prevention and therapy.
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Affiliation(s)
- T Todros
- Department of Obstetrics and Gynaecology, University of Turin, Turin, Italy.
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Abstract
Unique among ABC (ATP-binding cassette) protein family members, CFTR (cystic fibrosis transmembrane conductance regulator), also termed ABCC7, encoded by the gene mutated in cystic fibrosis patients, functions as an ion channel. Opening and closing of its anion-selective pore are linked to ATP binding and hydrolysis at CFTR's two NBDs (nucleotide-binding domains), NBD1 and NBD2. Isolated NBDs of prokaryotic ABC proteins form homodimers upon binding ATP, but separate after hydrolysis of the ATP. By combining mutagenesis with single-channel recording and nucleotide photolabelling on intact CFTR molecules, we relate opening and closing of the channel gates to ATP-mediated events in the NBDs. In particular, we demonstrate that two CFTR residues, predicted to lie on opposite sides of its anticipated NBD1-NBD2 heterodimer interface, are energetically coupled when the channels open but are independent of each other in closed channels. This directly links ATP-driven tight dimerization of CFTR's cytoplasmic NBDs to opening of the ion channel in the transmembrane domains. Evolutionary conservation of the energetically coupled residues in a manner that preserves their ability to form a hydrogen bond argues that this molecular mechanism, involving dynamic restructuring of the NBD dimer interface, is shared by all members of the ABC protein superfamily.
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Affiliation(s)
- P Vergani
- Laboratory of Cardiac/Membrane Physiology, The Rockefeller University, New York, NY 10021, USA.
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Abstract
CFTR chloride channels are encoded by the gene mutated in patients with cystic fibrosis. These channels belong to the superfamily of ABC transporter ATPases. ATP-driven conformational changes, which in other ABC proteins fuel uphill substrate transport across cellular membranes, in CFTR open and close a gate to allow transmembrane flow of anions down their electrochemical gradient. New structural and biochemical information from prokaryotic ABC proteins and functional information from CFTR channels has led to a unifying mechanism explaining those ATP-driven conformational changes.
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Affiliation(s)
- David C Gadsby
- Laboratory of Cardiac/Membrane Physiology, The Rockefeller University, New York, NY 10021, USA.
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Vergani P, Lockless SW, Nairn AC, Gadsby DC. CFTR channel opening by ATP-driven tight dimerization of its nucleotide-binding domains. Nature 2005; 433:876-80. [PMID: 15729345 PMCID: PMC2756053 DOI: 10.1038/nature03313] [Citation(s) in RCA: 336] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2004] [Accepted: 12/22/2004] [Indexed: 11/08/2022]
Abstract
ABC (ATP-binding cassette) proteins constitute a large family of membrane proteins that actively transport a broad range of substrates. Cystic fibrosis transmembrane conductance regulator (CFTR), the protein dysfunctional in cystic fibrosis, is unique among ABC proteins in that its transmembrane domains comprise an ion channel. Opening and closing of the pore have been linked to ATP binding and hydrolysis at CFTR's two nucleotide-binding domains, NBD1 and NBD2 (see, for example, refs 1, 2). Isolated NBDs of prokaryotic ABC proteins dimerize upon binding ATP, and hydrolysis of the ATP causes dimer dissociation. Here, using single-channel recording methods on intact CFTR molecules, we directly follow opening and closing of the channel gates, and relate these occurrences to ATP-mediated events in the NBDs. We find that energetic coupling between two CFTR residues, expected to lie on opposite sides of its predicted NBD1-NBD2 dimer interface, changes in concert with channel gating status. The two monitored side chains are independent of each other in closed channels but become coupled as the channels open. The results directly link ATP-driven tight dimerization of CFTR's cytoplasmic nucleotide-binding domains to opening of the ion channel in the transmembrane domains. This establishes a molecular mechanism, involving dynamic restructuring of the NBD dimer interface, that is probably common to all members of the ABC protein superfamily.
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Affiliation(s)
- Paola Vergani
- Laboratory of Cardiac/Membrane Physiology, The Rockefeller University, New York, New York 10021, USA.
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Basso C, Vergani P, Nairn AC, Gadsby DC. Prolonged nonhydrolytic interaction of nucleotide with CFTR's NH2-terminal nucleotide binding domain and its role in channel gating. J Gen Physiol 2003; 122:333-48. [PMID: 12939393 PMCID: PMC2234483 DOI: 10.1085/jgp.200308798] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CFTR, the protein defective in cystic fibrosis, functions as a Cl- channel regulated by cAMP-dependent protein kinase (PKA). CFTR is also an ATPase, comprising two nucleotide-binding domains (NBDs) thought to bind and hydrolyze ATP. In hydrolyzable nucleoside triphosphates, PKA-phosphorylated CFTR channels open into bursts, lasting on the order of a second, from closed (interburst) intervals of a second or more. To investigate nucleotide interactions underlying channel gating, we examined photolabeling by [alpha32P]8-N3ATP or [gamma32P]8-N3ATP of intact CFTR channels expressed in HEK293T cells or Xenopus oocytes. We also exploited split CFTR channels to distinguish photolabeling at NBD1 from that at NBD2. To examine simple binding of nucleotide in the absence of hydrolysis and gating reactions, we photolabeled after incubation at 0 degrees C with no washing. Nucleotide interactions under gating conditions were probed by photolabeling after incubation at 30 degrees C, with extensive washing, also at 30 degrees C. Phosphorylation of CFTR by PKA only slightly influenced photolabeling after either protocol. Strikingly, at 30 degrees C nucleotide remained tightly bound at NBD1 for many minutes, in the form of nonhydrolyzed nucleoside triphosphate. As nucleotide-dependent gating of CFTR channels occurred on the time scale of seconds under comparable conditions, this suggests that the nucleotide interactions, including hydrolysis, that time CFTR channel opening and closing occur predominantly at NBD2. Vanadate also appeared to act at NBD2, presumably interrupting its hydrolytic cycle, and markedly delayed termination of channel open bursts. Vanadate somewhat increased the magnitude, but did not alter the rate, of the slow loss of nucleotide tightly bound at NBD1. Kinetic analysis of channel gating in Mg8-N3ATP or MgATP reveals that the rate-limiting step for CFTR channel opening at saturating [nucleotide] follows nucleotide binding to both NBDs. We propose that ATP remains tightly bound or occluded at CFTR's NBD1 for long periods, that binding of ATP at NBD2 leads to channel opening wherupon its hydrolysis prompts channel closing, and that phosphorylation acts like an automobile clutch that engages the NBD events to drive gating of the transmembrane ion pore.
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Affiliation(s)
- Claudia Basso
- Laboratory of Cardiac/Membrane Physiology, The Rockefeller University, 1230 York Ave., New York, NY 10021, USA
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45
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Abstract
CFTR, the product of the gene mutated in cystic fibrosis, is an ATPase that functions as a Cl(-) channel in which bursts of openings separate relatively long interburst closed times (tauib). Channel gating is controlled by phosphorylation and MgATP, but the underlying molecular mechanisms remain controversial. To investigate them, we expressed CFTR channels in Xenopus oocytes and examined, in excised patches, how gating kinetics of phosphorylated channels were affected by changes in [MgATP], by alterations in the chemical structure of the activating nucleotide, and by mutations expected to impair nucleotide hydrolysis and/or diminish nucleotide binding affinity. The rate of opening to a burst (1/tauib) was a saturable function of [MgATP], but apparent affinity was reduced by mutations in either of CFTR's nucleotide binding domains (NBDs): K464A in NBD1, and K1250A or D1370N in NBD2. Burst duration of neither wild-type nor mutant channels was much influenced by [MgATP]. Poorly hydrolyzable nucleotide analogs, MgAMPPNP, MgAMPPCP, and MgATPgammaS, could open CFTR channels, but only to a maximal rate of opening approximately 20-fold lower than attained by MgATP acting on the same channels. NBD2 catalytic site mutations K1250A, D1370N, and E1371S were found to prolong open bursts. Corresponding NBD1 mutations did not affect timing of burst termination in normal, hydrolytic conditions. However, when hydrolysis at NBD2 was impaired, the NBD1 mutation K464A shortened the prolonged open bursts. In light of recent biochemical and structural data, the results suggest that: nucleotide binding to both NBDs precedes channel opening; at saturating nucleotide concentrations the rate of opening to a burst is influenced by the structure of the phosphate chain of the activating nucleotide; normal, rapid exit from bursts occurs after hydrolysis of the nucleotide at NBD2, without requiring a further nucleotide binding step; if hydrolysis at NBD2 is prevented, exit from bursts occurs through a slower pathway, the rate of which is modulated by the structure of the NBD1 catalytic site and its bound nucleotide. Based on these and other results, we propose a mechanism linking hydrolytic and gating cycles via ATP-driven dimerization of CFTR's NBDs.
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Affiliation(s)
- Paola Vergani
- Laboratory of Cardiac/Membrane Physiology, Rockefeller University, New York, NY 10021, USA
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Vergani P. [Chorioamnionitis and preterm labor]. Pediatr Med Chir 2002; 24:423-4. [PMID: 12610914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Affiliation(s)
- P Vergani
- Clinica Ostetrico-Ginecologica, Università degli Studi di Milano-Bicocca Ospedale San Gerardo, Monza
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Abstract
We evaluated the efficacy and safety of nimesulide (100 mg orally twice daily for > 48 hours) in a pilot series of five women (two with twin pregnancies) at 24(+6) weeks (range 21(+3) - 27(+2)) in preterm labour which was unresponsive to intravenous ritodrine. Nimesulide therapy was continued for eight days (5-16) and was associated with a prolongation of pregnancy of 27 days (6-69). Oligohydramnios occurred in all seven fetuses after three to nine days of therapy, and in the five pregnancies that continued after discontinuation of nimesulide, it resolved within four days (2-7). None of the babies manifested permanent renal damage.
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Affiliation(s)
- A Locatelli
- Department of Obstetrics and Gynaecology, San Gerardo's Institute of Biomedical Sciences, University of Milano-Bicocca, Monza, Italy
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Locatelli A, Vergani P, Di Pirro G, Doria V, Biffi A, Ghidini A. Role of amnioinfusion in the management of premature rupture of the membranes at <26 weeks' gestation. Am J Obstet Gynecol 2000; 183:878-82. [PMID: 11035330 DOI: 10.1067/mob.2000.108873] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE We sought to evaluate whether serial amnioinfusions for persistent oligohydramnios can affect the perinatal and long-term outcomes in extreme cases of preterm premature rupture of membranes. STUDY DESIGN All singleton pregnancies with preterm premature rupture of membranes at <26 weeks' gestation and lasting >4 days between January 1991 and June 1998 were included. Amniotic fluid volume was assessed as the maximum cord-free pocket with serial ultrasonographic examinations. Consenting women with persistent (>4 days) oligohydramnios (amniotic fluid </=2 cm) received serial transabdominal amnioinfusions to maintain an amniotic fluid pocket >2 cm. The pregnancy, neonatal, and long-term neurologic outcomes of the cases that spontaneously maintained a median amniotic fluid pocket >2 cm (amnioinfusion-not-necessary group) were compared with those of women with oligohydramnios who underwent amnioinfusion but continued to have a median amniotic fluid pocket after preterm premature rupture of membranes </=2 cm (persistent oligohydramnios group) and with those of women in whom oligohydramnios was alleviated by the procedure for at least 48 hours (successful amnioinfusion group). Statistical analysis included the Wilcoxon rank-sum test and the Fisher exact test, with a 2-tailed P <.05 considered significant. RESULTS Among the 49 women included in the study, 13 (26.5%) did not have oligohydramnios, the neonatal survival rate was 92%, and normal fetal lung development and neurologic outcome were achieved in all survivors. The remaining 36 women had oligohydramnios, and all underwent serial amnioinfusions, which successfully restored a median amniotic fluid pocket >2 cm for >/=48 hours in 11 (30%) patients. This successful amnioinfusion group was comparable with the persistent oligohydramnios group (n = 25) in gestational age at first amnioinfusion (median, 20.2 weeks; range, 16-25.6 weeks; vs median, 20.3 weeks; range, 16.5-24.2 weeks; P =.4), number of amnioinfusions (median, 3; range, 1-9; vs median, 3; range, 1-5; P =.4), and interval between amnioinfusions (median, 6 days; range, 4-14 days; vs median, 8 days; range, 6-43 days; P =. 1). However, patients in the persistent oligohydramnios group had a significantly shorter interval to delivery, lower neonatal survival (20%), and higher rates of pulmonary hypoplasia (62%) and abnormal neurologic outcomes (60%) than the patients in the groups in which amnioinfusion was not necessary or was successful (all P </=.01). CONCLUSION Pregnancies with preterm premature rupture of membranes-related oligohydramnios at <26 weeks' gestation in which serial amnioinfusions successfully alleviate oligohydramnios have a perinatal outcome that is significantly better than the outcome in those with persistent oligohydramnios and is comparable with gestations with preterm premature rupture of membranes in which oligohydramnios never develops.
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Affiliation(s)
- A Locatelli
- Divisione di Ostetricia e Ginecologia, Istituto di Scienze Biomediche San Gerardo, Università di Milano-Bicocca, Monza, Italy
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Vergani P, Patanè L, Doria P, Borroni C, Cappellini A, Pezzullo JC, Ghidini A. Risk factors for neonatal intraventricular haemorrhage in spontaneous prematurity at 32 weeks gestation or less. Placenta 2000; 21:402-7. [PMID: 10833376 DOI: 10.1053/plac.1999.0499] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In this study we aimed to establish which clinical and histopathological factors are associated with early-onset neonatal intraventricular haemorrhage (IVH) in non-iatrogenic preterm delivery before 32 weeks of gestation. We retrospectively reviewed all singleton pregnancies delivered before 32 weeks of gestation after spontaneous onset of preterm labour or preterm membrane rupture during the period January 1993 to June 1997. Clinical and histopathological data in cases with IVH diagnosed at neonatal cranial ultrasound within 72 h of birth (n = 17) were compared with those of neonates not experiencing this complication (non-IVH) (n = 54). Histological lesions analysed were those of acute inflammation and those on a uteroplacental vascular basis. Statistical methods included the Wilcoxon rank sum test, Fisher's exact test, and logistic regression analysis. A P<0.05 was considered significant.IVH and non-IVH groups were not significantly different in birthweight, gestational age at delivery, cord pH at birth, rates of 5-min Apgar score below 7, caesarean delivery, diagnosis of clinical chorioamnionitis or antenatal administration of steroids. Respiratory distress syndrome was more frequently diagnosed in the IVH than non-IVH group (64 per cent versus 33 per cent, P=0.02). Placental acute inflammatory or uteroplacental vascular lesions were present in 100 per cent of IVH neonates versus 22 per cent of non-IVH cases (P<0.001). Logistic regression analysis demonstrated that only respiratory distress syndrome (P = 0.04) and histological evidence of acute placental inflammation (P = 0.02) were significantly and independently associated with IVH. Histopathological evidence of acute inflammatory placental lesions is the best predictor of occurrence of neonatal IVH.
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Affiliation(s)
- P Vergani
- Department of Obstetrics and Gynecology, Istituto di Scienze Biomediche San Gerardo, Monza, Italy.
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Ghidini A, Strobelt N, Locatelli A, Mariani E, Piccoli MG, Vergani P. Isolated fetal choroid plexus cysts: role of ultrasonography in establishment of the risk of trisomy 18. Am J Obstet Gynecol 2000; 182:972-7. [PMID: 10764483 DOI: 10.1016/s0002-9378(00)70356-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The significance of isolated choroid plexus cysts found by ultrasonographic scan during the second trimester as a marker for trisomy 18 is still debated. We analyzed our data and reviewed the series published in the English-language literature to calculate the likelihood ratio of trisomy 18 in the presence of isolated choroid plexus cysts; that is, the factor by which the individual risk of trisomy 18 is increased in the presence of isolated choroid plexus cysts. STUDY DESIGN Likelihood ratios were calculated as ratio of the sensitivity to the false-positive rate. Sensitivity was defined as the rate of isolated choroid plexus cysts detected at midgestation among fetuses with trisomy 18. False-positive rate was defined as the rate of choroid plexus cysts detected at midgestation in the population without trisomy 18. The sensitivities of all published series reporting rates of choroid plexus cysts at the time of the first ultrasonographic examination between 14 and 24 weeks' gestation in populations with trisomy 18 and in low-risk populations were included in the analysis. To these we added all cases of trisomy 18 diagnosed at our institution during the period January 1, 1988, through June 30, 1998, in which prenatal ultrasonographic examination was performed between 14 and 24 weeks' gestation. RESULTS The prevalence of second-trimester ultrasonographic detection of isolated choroid plexus cysts among fetuses with trisomy 18 was 6.7% (13/194), whereas that in the population without trisomy 18 was 0.9% (752/79,583). The likelihood ratio associated with isolated choroid plexus cysts was therefore 7.09 (95% confidence interval, 3.97-12.18). CONCLUSION The presence of isolated second-trimester choroid plexus cysts increases the base risk of trisomy 18 by a factor of 7.09. This likelihood ratio can be multiplied by the risk calculated according to maternal age to obtain the individual risk of trisomy 18 and thus permit more accurate counseling of the patient.
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Affiliation(s)
- A Ghidini
- Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC 20007, USA
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