ACTA SCIENTIFIC CLINICAL CASE REPORTS

Research Article Volume 4 Issue 12

New Integrated Approaches for Cystic Fibrosis

Amelia Morgillo1,2*

1Department of Biological Science, University of Sannio, Benevento
2Department of Medicine and Surgery, University of Siena – SI– Street Mario Bracci 16, Italy

*Corresponding Author: Amelia Morgillo, Department of Medicine and Surgery, University of Siena – SI– Street Mario Bracci 16, Italy.

Received: October 19, 2023; Published: November 02, 2023

Abstract

Introduction: Cystic fibrosis, while remaining a rare disease, is the most common autosomal recessive genetic form in the Caucasian population and is a chronic developmental multisystem disease for which until a few years ago there were only supportive therapies, which did not however modify the long-term outcome, inevitably characterized by chronic lung damage, nutritional imbalances and, in severe cases, delayed physical development in affected children and endocrine-metabolic disorders. Today, new drugs are available that act directly on the CFTR protein, which is responsible for clinical signs and symptoms. In this article we wanted to deepen the pharmacology of these new molecules and the trials concerning gene therapy and new pharmacological approaches.

Objective and Materials and Methods: A computerized search was carried out for the articles to be included through the use of international databases such as pubmed, scopus, researchgate, google scholar, by typing in keywords such as: gene therapy for cystic fibrosis and the names of the new drugs and integration with literature data. In addition, data from paper documents such as books and articles have been integrated. The articles relating to the new therapies just approved or in the process of being approved and the related studies were selected.

Results: Although it remains a non-curable disease to date, the therapeutic possibilities for cystic fibrosis are expanding considerably and to date four modulating drugs (correctors and enhancers) CTFR are already available in clinical practice. Furthermore, gene therapy-based methodologies are being developed to directly correct the causal genetic defect, even if they are not yet directly applicable in clinical practice. Although gene therapy in lung diseases has not yet been fully realized, recent efforts in molecular virology aimed at the development of vectors will undoubtedly lead to great benefits in the next decade in this area. From the point of view of safety and efficacy, the current most promising gene transfer systems to the lung for inherited genetic diseases are adeno-associated vectors.

Conclusion: Novel approaches for purifying large amounts of vectors have also made widespread clinical applications more viable. With the help of the appropriate animal model for a given disease and efficient vectors for gene transfer, the field of gene therapy is likely to see great progress in the next decade.

Keywords: CF; CFTR; Viral Vector; Gene Therapy and ATMP

References

  1. Accurso FJ., et al. “Effect of VX-770 in persons with cystic fibrosis and the G551D-CFTR mutation”. The New England Journal of Medicine 363 (2010): 1991-2003.
  2. Akabas MH., et al. “Acetylcholine receptor channel structure probed in cysteine-substitution mutants”. Science (1992).
  3. Al-Awqati Q. “Alternative treatment for secretory diarrhea revealed in a new class of CFTR inhibitors”. Journal of Clinical Investigation 110 (2002): 1599-1601.
  4. Aleksandrov AA., et al. “Nucleoside triphosphate pentose ring impact on CFTR gating and hydrolysis”. FEBS Letter 518 (2002a): 183-188.
  5. Aleksandrov L., et al. “The First Nucleotide Binding Domain of Cystic Fibrosis Transmembrane Conductance Regulator Is a Site of Stable Nucleotide Interaction, whereas the Second Is a Site of Rapid Turnover”. Journal of Biological Chemistry 277 (2002b): 15419-15425.
  6. Alexander C., et al. “Cystic fibrosis transmembrane conductance regulator: using differential reactivity toward channel-permeant and channel- impermeant thiol-reactive probes to test a molecular model for the pore”. Biochemistry 48 (2009): 10078-10088.
  7. Aller SG., et al. “Structure of P-glycoprotein reveals a molecular basis for poly-specific drug binding”. Science 323 (2009): 1718-1722.
  8. Amaral MD and K Kunzelmann. “Molecular targeting of CFTR as a therapeutic approach to cystic fibrosis”. Trends in Pharmacological Sciences 28 (2007): 334-341.
  9. Anderson MP and MJ Welsh. “Regulation by ATP and ADP of CFTR chloride channels that contain mutant nucleotide-binding domains”. Science 257 (1992): 1701-1704.
  10. Anderson MP., et al. “Nucleoside triphosphates are required to open the CFTR chloride channel”. Cell 67 (1991): 775-784.
  11. Angelow S and AS Yu. “Structure-function studies of claudin extracellular do mains by cysteine-scanning mutagenesis”. Journal of Biological Chemistry 284 (2009): 29205-29217.
  12. Astiley L Cooney., et al. “Cystie Fibrosis Gene Therapy: Looking Back, Looking Forward”. Genes (Basel) (2018).
  13. AtWell S., et al. “Structures of a minimal human CFTR first nucleotide-binding domain as a monomer, head-totail homodimer, and pathogenic mutant”. Protein Engineering Design and Selection 23 (2010): 375-384.
  14. Aubin CN and P Linsdell. “Positive charges at the intracellular mouth of the pore regulate anion conduction in the FIR chloride channel”. The Journal of General Physiology 128 (2006): 535-545.
  15. Bai Y., et al. “Dual roles of the sixth transmembrane segment of the CFTR chloride channel in gating and permeation”. The Journal of General Physiology 136 (2010): 293-309.
  16. Bai Y., et al. “Structural basis for the channel function of a degraded ABC transporter, CFIR (ABCCT)”. The Journal of General Physiology 138 (2011): 495-507.
  17. Baker JM., et al. “CFTR regulatory region interacts with NBD1predominantly via multiple transient helices”. Nature Structural and Molecular Biology 14 (2007): 738-745.
  18. Baroni D., et al. “Direct interaction of a CFTR potentiator and a CFR corrector with phospholipid bilayers”. European Biophysics Journal 43 (2014): 341-346.
  19. Barreto-Ojeda E., et al. “Coarse grained molecular dynamics simulations reveal lipid access pathways in P-glycoprotein”. The Journal of General Physiology (2018).
  20. Barrett KE and SJ Keely. “Chloride secretion by the intestinal epithelium: molecular basis and regulatory aspects”. Annual Review of Physiology 62 (2000): 535-572.
  21. Basso C., et al. “Prolonged nonhydrolytic interaction of nucleotide with CFTR's NH2-terminal nucleotide binding domain and its role in channel gating”. The Journal of General Physiology 122 (2003): 333-348.
  22. Beck EJ., et al. “Conformational changes in a pore-lining helix coupled to cystic fibrosis transmembrane conductance regulator channel gating”. Journal of Biological Chemistry 283 (2008): 4957-4966.
  23. Bozoky Z., et al. “Regulatory R region of the CFTR chloride channel is a dynamic integrator of phospho- dependent intra- and intermolecular interactions”. Proceedings of the National Academy of Sciences of the United States of America 110 (2013): E4427-E4436.
  24. Bridges RJ., et al. “Capitalizing on corrector mechanistic differences to achieve synergy in F508del-CFTR expression”. Pediatric Pulmonology 45 (2010).
  25. Cai Z., et al. “Inhibition of heterologously expressed cystic fibrosi transmembrane conductance regulator Cl channels by non- sulphonylurea hypoglycaemic agents”. British Journal of Pharmacology 128 (1999): 108-118.
  26. Cai Z., et al. “Differential sensitivity of the cystic fibrosis (CF)-associated mutants G551D and G1349D to potentiators of the cystic fibrosis transmembrane conductance regulator (CFTR) C1- channel”. Journal of Biological Chemistry 281 (2006): 1970-1977.
  27. Cai ZW., et al. “Targeting F508del-CFTR to develop rational new therapies for cystic fibrosis”. Acta Pharmacologica Sinica 32 (2011): 693-701.
  28. , et al. “Impact of the F508del mutation on ovine CFTR, a CI- channel with enhanced conductance and ATP. dependent gating”. Journal of Physiology 593 (2015): 2427-2446.
  29. Chaves LA and DiC Gadsby. “Cysteine accessibility probes liming and Putent of NBD separation along the dimer interface in galing CPTR channels”. Genetic Physiology 145 (2015): 261-283.
  30. Chen TY and TC Hwang. “CLC-0 and CPTR: chloride channels evolved from transporters”. Physiology Review 88 (2008): 351-387.
  31. Chen J., et al. “A tweezers-like motion of the ATP-binding cassette dimer in an ABC transport cycle”. Molecular Cell 12 (2003): 651-661.
  32. Chin S., et al. “Attenuation of Phosphorylation-dependent Activation of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) by Disease-causing Mutations at the Transmission Interface”. Journal of Biological Chemistry 292 (2017): 1988-1999.
  33. Corradi V., et al. “Cystic Fibrosis Transmembrane Conductance Regulator (CFTR): CLO SED AND OPEN STA TE CHA NNEL MOD ELS”. Journal of Biological Chemistry 290 (2015): 22891-22906.
  34. Cotten JF and MJ Welsh. “Covalent modification of the nucleotide binding domains of cystic fibrosis transmembrane conductance regulator”. Journal of Biological Chemistry 273 (1998): 31873-31879.
  35. Cotten JF and MJ Welsh. “Cystic fibrosis-associated mutations at arginine 347 alter the pore architecture of CFTR. Evidence for disruption of a salt bridge”. Journal of Biological Chemistry 274 (1999): 5429-5435.
  36. Csanády L and B Töröcsik. “Catalyst-like modulation of transition states for CFTR channel opening and closing: New stimulation strategy exploits nonequilibrium gating”. The Journal of General Physiology 143 (2014a): 269-287.
  37. Coanady L., et al. “Preferential phosphorylation of R-domain serine 768 dampens activation of CPTR channels by PKA”. The Journal of General Physiology 125 (2005): 171.
  38. Csanády L., et al. “Strict coupling between CFTR's catalytic cycle and gating of its CI- ion pore revealed by distributions of open channel burst durations”. Proceedings of the National Academy of Sciences of the United States of America 107 (2010): 1241-1246.
  39. Cystic Fibrosis Trust, Gene Therapy and Gene Editing Cui G., et al. “Mutations at arginine 352 alter the pore architecture of CFTR”. The Journal of Membrane Biology 222 (2008): 91-106.
  40. Cui G., et al. “Differential contribution of TM6 and TM12 to the pore of CFTR identified by three sulfonylurea- based blockers”. Pflugers Arch 463 (2012): 405-418.
  41. Cui G., et al. “Three charged amino acids in extracellular loop 1 are involved in maintaining the outer pore architecture of CFTR”. The Journal of General Physiology 144 (2014): 159-179.
  42. Cui L., et al. “Domain interdependence the biosynthetic assembly of CFTR”. Journal of Molecular Biology 365 (2007): 981-994.
  43. Dalton J., et al. “New model of cystic fibrosis transmembrane conductance regulator proposes active channel-like conformation” (2012).
  44. Das J., et al. “Transmembrane helical interactions in the CFTR channel pore” (2017).
  45. Doyle DA., et al. “The structure of the potassium molecular basis of K+ conduction and selectivity”. Science 280 (1998): 69-77.
  46. Du K and GL Lukacs. “Cooperative assembly and misfolding of CFTR domains in vivo”. Molecular Biology of the Cell 20 (2009): 1903-1915.
  47. Du K., et al. “The DeltaF508 cystic fibrosis mutation impairs domain-domain interactions and arrests post-translational folding of CFTR”. Nature Structural and Molecular Biology (2005).
  48. Dyson HJ and PE Wright. “Intrinsically unstructured proteins and their functions”. Nature Reviews Molecular Cell Biology 6 (2005): 197-208.

Citation

Citation: Amelia Morgillo. “New Integrated Approaches for Cystic Fibrosis".Acta Scientific Clinical Case Reports 4.12 (2023): 05-17.

Copyright

Copyright: © 2023 Amelia Morgillo. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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