Abstract

Under physiological conditions, a finely tuned system of cellular adaptation allows the intestinal mucosa to maintain the gut barrier function while avoiding excessive immune responses to non-self-antigens from dietary origin or from commensal microbes. This homeostatic function is compromised in cystic fibrosis (CF) due to loss-of-function mutations in the CF transmembrane conductance regulator (CFTR). Recently, we reported that mice bearing defective CFTR are abnormally susceptible to a celiac disease-like enteropathy, in thus far that oral challenge with the gluten derivative gliadin elicits an inflammatory response. However, the mechanisms through which CFTR malfunction drives such an exaggerated response to dietary protein remains elusive. Here we demonstrate that the proteostasis regulator/transglutaminase 2 (TGM2) inhibitor cysteamine restores reduced Beclin 1 (BECN1) protein levels in mice bearing cysteamine-rescuable F508del-CFTR mutant, either in homozygosis or in compound heterozygosis with a null allele, but not in knock-out CFTR mice. When cysteamine restored BECN1 expression, autophagy was increased and gliadin-induced inflammation was reduced. The beneficial effects of cysteamine on F508del-CFTR mice were lost when these mice were backcrossed into a Becn1 haploinsufficient/autophagy-deficient background. Conversely, the transfection-enforced expression of BECN1 in human intestinal epithelial Caco-2 cells mitigated the pro-inflammatory cellular stress response elicited by the gliadin-derived P31–43 peptide. In conclusion, our data provide the proof-of-concept that autophagy stimulation may mitigate the intestinal malfunction of CF patients.

Highlights

  • Cystic fibrosis (CF) is the most frequent monogenic lethal disease affecting more than 85,000 subjects worldwide[1,2,3,4]

  • Given the pivotal role of Beclin 1 (BECN1) and autophagy in orchestrating proteostasis in CF epithelia, we investigated whether the increased responsiveness to gliadin in CF mice may be due to defective autophagy and whether re-establishing BECN1 levels and autophagy by means of cysteamine would protect the CF intestine against the detrimental effects of gliadin

  • To investigate whether rescuing CFTR function by means of cysteamine would abrogate the pathogenic response to gliadin, we orally administered cysteamine for 5 consecutive days (60 μg/kg in 100 μl saline/day) to knock-in mice harboring the most common loss-of-function F508del-CFTR mutation (Cftrtm1EUR, F508del, FVB/129, CftrF508del/F508del), CFTR knock-out mice (B6.129P2-KOCftrtm1UNC, Cftr−/−), knock-in mice harbouring one F508del-CFTR allele in combination with one null-CFTR allele (CftrF508del/−) or their wild-type (WT) littermates (FVB/129 or B6.129P2)

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Summary

Introduction

Cystic fibrosis (CF) is the most frequent monogenic lethal disease affecting more than 85,000 subjects worldwide[1,2,3,4]. CF is caused by loss-of-function mutations in the gene coding for the cystic fibrosis transmembrane conductance regulator (CFTR)[5,6], a protein with 1480 amino. CF is best known for its respiratory phenotype, as the abnormal anion transport results in increased mucin polymer cross-links and mucus viscosity[12,13,14], leading to accumulation of thick, sticky mucus in the lung. These events cause chronic inflammation, persistent and untreatable bacterial colonization and recurrent chest infections, mostly by Pseudomonas aeruginosa, Staphylococcus aureus, and Burkholderia cepacia[15]. CF patients often show serum antibodies against dietary antigens[18,20]

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