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      Phenotyping ciliary dynamics and coordination in response to CFTR-modulators in Cystic Fibrosis respiratory epithelial cells

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          Abstract

          Personalized approaches for systematically assessing ciliary beat dynamics and for drug testing would improve the challenging task of diagnosing and treating respiratory disorders. In this pilot study, we show how multiscale differential dynamic microscopy (multi-DDM) can be used to characterize collective ciliary beating in a non-biased automated manner. We use multi-DDM to assess the efficacy of different CFTR-modulating drugs in human airway epithelial cells derived from subjects with cystic fibrosis (ΔF508/ΔF508 and ∆F508/-) based on ciliary beat frequency and coordination. Similar to clinical observations, drug efficacy is variable across donors, even within the same genotype. We show how our assay can quantitatively identify the most efficient drugs for restoring ciliary beating for each individual donor. Multi-DDM provides insight into ciliary beating responses following treatment with drugs, and has application in the broader context of respiratory disease and for drug screening.

          Abstract

          Personalized approaches to diagnosis and treatment monitoring could improve the management of cystic fibrosis patients. Here the authors show that multiscale differential dynamic microscopy can assess changes in cilia beating dynamics and coordination in patient-derived airway epithelial cells, in response to different CFTR-modulating drugs, in a patient-specific manner.

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          Most cited references20

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          Airway mucus function and dysfunction.

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            Cystic fibrosis genetics: from molecular understanding to clinical application.

            The availability of the human genome sequence and tools for interrogating individual genomes provide an unprecedented opportunity to apply genetics to medicine. Mendelian conditions, which are caused by dysfunction of a single gene, offer powerful examples that illustrate how genetics can provide insights into disease. Cystic fibrosis, one of the more common lethal autosomal recessive Mendelian disorders, is presented here as an example. Recent progress in elucidating disease mechanism and causes of phenotypic variation, as well as in the development of treatments, demonstrates that genetics continues to play an important part in cystic fibrosis research 25 years after the discovery of the disease-causing gene.
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              Characterizing responses to CFTR-modulating drugs using rectal organoids derived from subjects with cystic fibrosis.

              Identifying subjects with cystic fibrosis (CF) who may benefit from cystic fibrosis transmembrane conductance regulator (CFTR)-modulating drugs is time-consuming, costly, and especially challenging for individuals with rare uncharacterized CFTR mutations. We studied CFTR function and responses to two drugs-the prototypical CFTR potentiator VX-770 (ivacaftor/KALYDECO) and the CFTR corrector VX-809 (lumacaftor)-in organoid cultures derived from the rectal epithelia of subjects with CF, who expressed a broad range of CFTR mutations. We observed that CFTR residual function and responses to drug therapy depended on both the CFTR mutation and the genetic background of the subjects. In vitro drug responses in rectal organoids positively correlated with published outcome data from clinical trials with VX-809 and VX-770, allowing us to predict from preclinical data the potential for CF patients carrying rare CFTR mutations to respond to drug therapy. We demonstrated proof of principle by selecting two subjects expressing an uncharacterized rare CFTR genotype (G1249R/F508del) who showed clinical responses to treatment with ivacaftor and one subject (F508del/R347P) who showed a limited response to drug therapy both in vitro and in vivo. These data suggest that in vitro measurements of CFTR function in patient-derived rectal organoids may be useful for identifying subjects who would benefit from CFTR-correcting treatment, independent of their CFTR mutation.
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                Author and article information

                Contributors
                BratcherP@NJHealth.org
                pc245@cam.ac.uk
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                16 April 2019
                16 April 2019
                2019
                : 10
                : 1763
                Affiliations
                [1 ]ISNI 0000000121885934, GRID grid.5335.0, Biological and Soft Systems Sector, Cavendish Laboratory, , University of Cambridge, ; Cambridge, CB3 0HE UK
                [2 ]ISNI 0000000419368710, GRID grid.47100.32, Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, , Yale School of Medicine, ; New Haven, CT 06510 USA
                [3 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, Institute of Clinical Sciences, , Imperial College London, ; London, SW7 2AZ UK
                [4 ]ISNI 0000000122478951, GRID grid.14105.31, MRC London Institute of Medical Sciences, ; London, W12 0NN UK
                [5 ]ISNI 0000 0004 0396 0728, GRID grid.240341.0, Division of Cell Biology, Department of Pediatrics, , National Jewish Health, ; Denver, CO 80206 USA
                Author information
                http://orcid.org/0000-0003-2240-8632
                http://orcid.org/0000-0002-9193-8496
                Article
                9798
                10.1038/s41467-019-09798-3
                6467870
                30992452
                4e344641-b308-4f84-8046-f672a937c547
                © The Author(s) 2019

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 4 December 2017
                : 29 March 2019
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