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Cystic fibrosis transmembrane conductance regulator dysfunction in platelets drives lung hyperinflammation
Guadalupe Ortiz-Muñoz, … , Alan S. Verkman, Mark R. Looney
Guadalupe Ortiz-Muñoz, … , Alan S. Verkman, Mark R. Looney
Published January 21, 2020
Citation Information: J Clin Invest. 2020;130(4):2041-2053. https://doi.org/10.1172/JCI129635.
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Research Article Inflammation Pulmonology

Cystic fibrosis transmembrane conductance regulator dysfunction in platelets drives lung hyperinflammation

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Abstract

Cystic fibrosis (CF) lung disease is characterized by an inflammatory response that can lead to terminal respiratory failure. The cystic fibrosis transmembrane conductance regulator (CFTR) is mutated in CF, and we hypothesized that dysfunctional CFTR in platelets, which are key participants in immune responses, is a central determinant of CF inflammation. We found that deletion of CFTR in platelets produced exaggerated acute lung inflammation and platelet activation after intratracheal LPS or Pseudomonas aeruginosa challenge. CFTR loss of function in mouse or human platelets resulted in agonist-induced hyperactivation and increased calcium entry into platelets. Inhibition of the transient receptor potential cation channel 6 (TRPC6) reduced platelet activation and calcium flux, and reduced lung injury in CF mice after intratracheal LPS or Pseudomonas aeruginosa challenge. CF subjects receiving CFTR modulator therapy showed partial restoration of CFTR function in platelets, which may be a convenient approach to monitoring biological responses to CFTR modulators. We conclude that CFTR dysfunction in platelets produces aberrant TRPC6-dependent platelet activation, which is a major driver of CF lung inflammation and impaired bacterial clearance. Platelets and TRPC6 are what we believe to be novel therapeutic targets in the treatment of CF lung disease.

Authors

Guadalupe Ortiz-Muñoz, Michelle A. Yu, Emma Lefrançais, Beñat Mallavia, Colin Valet, Jennifer J. Tian, Serena Ranucci, Kristin M. Wang, Zhe Liu, Nicholas Kwaan, Diana Dawson, Mary Ellen Kleinhenz, Fadi T. Khasawneh, Peter M. Haggie, Alan S. Verkman, Mark R. Looney

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Figure 2

Lung injury and leukocyte-platelet aggregates in mice with conditional CFTR deletion after intratracheal LPS or PAO1.

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Lung injury and leukocyte-platelet aggregates in mice with conditional C...
(A) BAL WBCs, (B) neutrophils, (C) total protein in CFfl/fl, CF-LysM, CF-MRP8, and CF-PF4 mice at 48 hours after intratracheal LPS. NPAs in BAL (D) and blood (E), and MPAs in blood (F) at 24 hours after intratracheal LPS. Data are mean ± SEM of 4 to 9 animals per group. Data were analyzed by 1-way ANOVA. (G–N) Lung injury and leukocyte-platelet aggregates in CFfl/fl and CF-PF4 mice after intratracheal PAO1. (G) BAL WBC, (H) neutrophils, (I) total protein, (J) NPAs, (K) CD62P, (L) blood NPAs, (M) blood MPAs, and (N) lung colonies in CF-PF4 and CFfl/fl mice after challenge with PAO1. Standard lung injury measurements were performed at 48 hours, and NPAs and MPAs at 24 hours after intratracheal PAO1. Data are mean ± SEM of 5 to 8 animals per group. Data were analyzed by Student’s t test. *P ≤ 0.05; **P ≤ 0.01; ***P ≤ 0.001; ****P ≤ 0.0001.

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