A little CFTR goes a long way

CFTR-dependent sweat secretion from G551D and R117H-5T cystic fibrosis subjects taking ivacaftor

Jessica E. Char, Marlene H. Wolfe, Hyung Ju Cho, Il Ho Park, Jin Hyeok Jeong, Eric Frisbee, Colleen Dunn, Zoe Davies, Carlos Milla, Richard B. Moss, Ewart A.C. Thomas, Jeffrey J. Wine

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

To determine if oral dosing with the CFTR-potentiator ivacaftor (VX-770, Kalydeco) improves CFTR-dependent sweating in CF subjects carrying G551D or R117H-5T mutations, we optically measured sweat secretion from 32-143 individually identified glands in each of 8 CF subjects; 6 F508del/G551D, one G551D/R117H-5T, and one I507del/R117H-5T. Two subjects were tested only (-) ivacaftor, 3 only (+) ivacaftor and 3 (+/-) ivacaftor (1-5 tests per condition). The total number of gland measurements was 852 (-) ivacaftor and 906 (+) ivacaftor. A healthy control was tested 4 times (51 glands). For each gland we measured both CFTR-independent (M-sweat) and CFTR-dependent (C-sweat); C-sweat was stimulated with a badrenergic cocktail that elevated [cAMP]i while blocking muscarinic receptors. Absent ivacaftor, almost all CF glands produced M-sweat on all tests, but only 1/593 glands produced C-sweat (10 tests, 5 subjects). By contrast, 6/6 subjects (113/ 342 glands) produced C-sweat in the (+) ivacaftor condition, but with large inter-subject differences; 3-74% of glands responded with C/M sweat ratios 0.04%-2.57% of the average WT ratio of 0.265. Sweat volume losses cause proportionally larger underestimates of CFTR function at lower sweat rates. The losses were reduced by measuring C/M ratios in 12 glands from each subject that had the highest M-sweat rates. Remaining losses were estimated from single channel data and used to correct the C/M ratios, giving estimates of CFTR function (+) ivacaftor = 1.6%-7.7% of the WT average. These estimates are in accord with single channel data and transcript analysis, and suggest that significant clinical benefit can be produced by low levels of CFTR function.

Original languageEnglish
Article numbere88564
JournalPLoS One
Volume9
Issue number2
DOIs
Publication statusPublished - 2014 Feb 10
Externally publishedYes

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sweat
Sweat
cystic fibrosis
Cystic Fibrosis
secretion
ivacaftor
sweating
Sweating
testing
Muscarinic Receptors
mouth

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

A little CFTR goes a long way : CFTR-dependent sweat secretion from G551D and R117H-5T cystic fibrosis subjects taking ivacaftor. / Char, Jessica E.; Wolfe, Marlene H.; Cho, Hyung Ju; Park, Il Ho; Jeong, Jin Hyeok; Frisbee, Eric; Dunn, Colleen; Davies, Zoe; Milla, Carlos; Moss, Richard B.; Thomas, Ewart A.C.; Wine, Jeffrey J.

In: PLoS One, Vol. 9, No. 2, e88564, 10.02.2014.

Research output: Contribution to journalArticle

Char, JE, Wolfe, MH, Cho, HJ, Park, IH, Jeong, JH, Frisbee, E, Dunn, C, Davies, Z, Milla, C, Moss, RB, Thomas, EAC & Wine, JJ 2014, 'A little CFTR goes a long way: CFTR-dependent sweat secretion from G551D and R117H-5T cystic fibrosis subjects taking ivacaftor', PLoS One, vol. 9, no. 2, e88564. https://doi.org/10.1371/journal.pone.0088564
Char, Jessica E. ; Wolfe, Marlene H. ; Cho, Hyung Ju ; Park, Il Ho ; Jeong, Jin Hyeok ; Frisbee, Eric ; Dunn, Colleen ; Davies, Zoe ; Milla, Carlos ; Moss, Richard B. ; Thomas, Ewart A.C. ; Wine, Jeffrey J. / A little CFTR goes a long way : CFTR-dependent sweat secretion from G551D and R117H-5T cystic fibrosis subjects taking ivacaftor. In: PLoS One. 2014 ; Vol. 9, No. 2.
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abstract = "To determine if oral dosing with the CFTR-potentiator ivacaftor (VX-770, Kalydeco) improves CFTR-dependent sweating in CF subjects carrying G551D or R117H-5T mutations, we optically measured sweat secretion from 32-143 individually identified glands in each of 8 CF subjects; 6 F508del/G551D, one G551D/R117H-5T, and one I507del/R117H-5T. Two subjects were tested only (-) ivacaftor, 3 only (+) ivacaftor and 3 (+/-) ivacaftor (1-5 tests per condition). The total number of gland measurements was 852 (-) ivacaftor and 906 (+) ivacaftor. A healthy control was tested 4 times (51 glands). For each gland we measured both CFTR-independent (M-sweat) and CFTR-dependent (C-sweat); C-sweat was stimulated with a badrenergic cocktail that elevated [cAMP]i while blocking muscarinic receptors. Absent ivacaftor, almost all CF glands produced M-sweat on all tests, but only 1/593 glands produced C-sweat (10 tests, 5 subjects). By contrast, 6/6 subjects (113/ 342 glands) produced C-sweat in the (+) ivacaftor condition, but with large inter-subject differences; 3-74{\%} of glands responded with C/M sweat ratios 0.04{\%}-2.57{\%} of the average WT ratio of 0.265. Sweat volume losses cause proportionally larger underestimates of CFTR function at lower sweat rates. The losses were reduced by measuring C/M ratios in 12 glands from each subject that had the highest M-sweat rates. Remaining losses were estimated from single channel data and used to correct the C/M ratios, giving estimates of CFTR function (+) ivacaftor = 1.6{\%}-7.7{\%} of the WT average. These estimates are in accord with single channel data and transcript analysis, and suggest that significant clinical benefit can be produced by low levels of CFTR function.",
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