Ineffective mucociliary clearance (MCC) is a common pathophysiologic process that underlies airway inflammation and infection. Decreased transepithelial Cl- transport secondary to an acquired Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) deficiency may contribute to respiratory epithelial dysfunction by abrogating MCC and increasing mucus viscosity. The central hypothesis of the current proposal is that persistent mucosal inflammation and infection in chronic rhinosinusitis (CRS) results from acquired (partial) CFTR deficiency, creating a localized environment that impairs MCC. This hypothesis will be tested with three Specific Aims.
Specific Aim 1 will investigate CFTR deficiency in a well-characterized in vitro culture model of sinonasal epithelium. Our Preliminary Data indicate that lipopolysaccharide not only promotes inflammation, but leads to CFTR repression in sinonasal epithelium. CFTR transcription, maturational processing (protein biochemistry), and channel potentiation (patch clamp analysis) will be used to determine the mechanism underlying this observation.
Specific Aim 2 will test the hypothesis that Cl- secretagogues can offset acquired defects in CFTR-mediated ion transport. Compounds of this class, including VX-770, UCCF-152, and bioflavonoids have received considerable recent attention in both the scientific and lay press for their emerging role in cystic fibrosis (CF) therapeutics. We will investigate whether Cl- secretagogues 1) overcome acquired CFTR defects and 2) stimulate MCC (measured by ciliary beat frequency).
Specific Aim 3 will determine the extent of acquired CFTR deficiency in human CRS ex vivo and in vivo. Transepithelial ion transport will be quantified in sinus mucosal explants in the Ussing chamber and in vivo, using a well established nasal potential difference assay. The proposal will therefore develop an innovative approach to better understand the pathogenic mechanisms of CRS, a disease understudied in the past, and develop an entirely novel treatment strategy for sinus and nasal airway disease predicated on activation of fluid and electrolyte secretion with leading edge Cl- secretagogues.

Public Health Relevance

Chronic rhinosinusitis (CRS) affects nearly 16% of the US population each year, has an enormous economic impact resulting in billions of dollars in healthcare expenditures, and causes significant decrements in patient quality of life in terms of nasal airway specific morbidity, as well as general health and vitality. Because treatment options for CRS are usually limited to antimicrobials and anti-inflammatories, the research presented in this proposal provides a means to understand the pathogenic mechanism underlying CRS, and a new therapeutic strategy for restoring and/or increasing CFTR activity in sinus and nasal epithelium.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Clinical Investigator Award (CIA) (K08)
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Special Emphasis Panel (ZHL1-CSR-U (O1))
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Tigno, Xenia
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University of Alabama Birmingham
Schools of Medicine
United States
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Dean, Nichole; Ranganath, Neel K; Jones, Brandon et al. (2014) Porcine nasal epithelial cultures for studies of cystic fibrosis sinusitis. Int Forum Allergy Rhinol 4:565-70
Zhang, Shaoyan; Ranganath, Neel K; Skinner, Daniel et al. (2014) Marked repression of CFTR mRNA in the transgenic Cftr(tm1kth) mouse model. J Cyst Fibros 13:351-2
Lazrak, Ahmed; Jurkuvenaite, Asta; Ness, Emily C et al. (2014) Inter-?-inhibitor blocks epithelial sodium channel activation and decreases nasal potential differences in ?F508 mice. Am J Respir Cell Mol Biol 50:953-62
Illing, Elisa A; Woodworth, Bradford A (2014) Management of the upper airway in cystic fibrosis. Curr Opin Pulm Med 20:623-31
Zhang, Shaoyan; Skinner, Daniel; Hicks, Stephen Bradley et al. (2014) Sinupret activates CFTR and TMEM16A-dependent transepithelial chloride transport and improves indicators of mucociliary clearance. PLoS One 9:e104090
Chaaban, Mohamad R; Walsh, Erika M; Woodworth, Bradford A (2013) Epidemiology and differential diagnosis of nasal polyps. Am J Rhinol Allergy 27:473-8
Conger, Bryant T; Zhang, Shaoyan; Skinner, Daniel et al. (2013) Comparison of cystic fibrosis transmembrane conductance regulator (CFTR) and ciliary beat frequency activation by the CFTR Modulators Genistein, VRT-532, and UCCF-152 in primary sinonasal epithelial cultures. JAMA Otolaryngol Head Neck Surg 139:822-7
Chaaban, Mohamad R; Kejner, Alexandra; Rowe, Steven M et al. (2013) Cystic fibrosis chronic rhinosinusitis: a comprehensive review. Am J Rhinol Allergy 27:387-95
Solomon, George M; Frederick, Carla; Zhang, Shaoyan et al. (2013) IP-10 is a potential biomarker of cystic fibrosis acute pulmonary exacerbations. PLoS One 8:e72398
Zhang, Shaoyan; Blount, Angela C; McNicholas, Carmel M et al. (2013) Resveratrol enhances airway surface liquid depth in sinonasal epithelium by increasing cystic fibrosis transmembrane conductance regulator open probability. PLoS One 8:e81589

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