Abstract

Cystic fibrosis (CF) is a genetic disease with many airway pathological features, including aberrant epithelial sodium channel (ENaC) function, persistent Pseudomonas aeruginosa (PA) infection and neutrophil-dominant inflammation. PA infection in CF airways is difficult to treat due to antibiotic resistance and other factors. Recently, α1-antitrypsin (A1AT) have been shown to be effective to reduce CF airway PA infection. However, there is a dearth of studies about the mechanisms underlying A1AT’s therapeutic effects. The goal of our study is to provide an animal model of A1AT therapy in CF lungs. ENaC transgenic mice with PA infection were used as a CF-like model. Mice were intratracheally treated with PA or saline (control) in a fibrin plug. Two hours after PA infection, aerosolized A1AT were delivered to mouse lungs once daily. At day 1 and day 3 post PA infection, lung inflammation, PA load as well as host defence protein short palate, lung, and nasal epithelium clone 1 (SPLUNC1) were measured. At day 1 post PA infection when A1AT was delivered once to ENaC transgenic mouse lungs, A1AT did not reduce lung inflammation (e.g., neutrophils) and PA load. However, at day 3 post PA infection when ENaC transgenic mice received three repeated A1AT treatments, a significant decrease in airspace inflammation and PA load was observed. Although A1AT prevented the loss of SPLUNC1 in bronchoalveolar lavage fluid of PA-infected wild-type mice, it did not restore SPLUNC1 levels in ENaC transgenic mice. Our current study has provided a valid and quick A1AT therapeutic model in CF-like lungs that may serve as a platform for future mechanistic studies about how A1AT exerts beneficial effects in human CF patients.

Highlights

  • Cystic fibrosis (CF), which is caused by mutation in CF transmembrane conductance regulator (CFTR) [1, 2], affects about 30,000 people in the US

  • We focused on the therapeutic effect of A1AT in Pseudomonas aeruginosa (PA)-infected ENaC transgenic (Tg) mice

  • In contrast to the data on day 1, A1AT treatment in ENaC Tg mice infected with PA for 3 days resulted in significant reduction of PA load in the lung and bronchoalveolar lavage (BAL) fluid, as well as leukocytes including neutrophils and KC in BAL fluid (Fig 3)

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Summary

Introduction

Cystic fibrosis (CF), which is caused by mutation in CF transmembrane conductance regulator (CFTR) [1, 2], affects about 30,000 people in the US. Α1-Antitrypsin Treatment in ENaC Transgenic Mice concentrations within the airway all work to make PA infection in CF difficult to treat [3, 4]. In our previous study of non-CF mice [6], we demonstrated that A1AT promotes lung bacterial clearance by preventing NE-mediated degradation of short palate, lung, and nasal epithelium clone 1 (SPLUNC1), an airway epithelial cell host defence protein. It is unclear whether or not A1AT reduces bacterial infection in the CF lung, and if so, whether A1AT could increase or maintain SPLUNC1 levels in the lung

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