We conclude that cigarette smoke decreases the expression of CFTR gene, protein, and function in vitro and that acquired CFTR deficiency occurs in the nasal respiratory epithelium of cigarette smokers. We suggest that acquired CFTR deficiency may contribute to the physiopathology of cigarette-induced diseases such as chronic bronchitis.

Epithelial mucous membranes are repeatedly exposed to oxidants and xenobiotics. CFTR plays a role in glutathione transepithelial flux and in defining the hydration and viscoelasticity of protective mucus. We therefore hypothesized that CFTR expression and function may be modulated by oxidant stress. A sublethal oxidant stress ( tert-butylhydroquinone, BHQ) in CFTR-expressing epithelial cells (T84) induced a significant increase in cellular glutathione that was associated with an increase in expression of the gene encoding the heavy subunit of the rate-limiting enzyme for glutathione synthesis, γ-glutamylcysteine synthetase (γ-GCShs). CFTR gene expression was markedly decreased according to a time course that mirrored the changes in γ-GCShs. Western blot analysis confirmed that the decrease in CFTR gene expression was associated with a decrease in CFTR protein. cAMP-dependent iodide efflux was also decreased by the oxidant stress. Nuclear run-on assays indicated that the oxidant stress had no effect on CFTR gene transcription, but the mRNA stability in the oxidant-stressed cells was markedly reduced. Furthermore, BHQ increased γ-GCShs mRNA while decreasing CFTR mRNA in Calu-3 cells, and taurine chloramine induced similar effects in T84 cells. We conclude that suppression of CFTR expression may represent an adaptive response of mucosal epithelium to an exogenous oxidant stress.

The infection of nonphagocytic host cells by Staphylococcus aureus and more particularly by small-colony variants (SCVs) may contribute to the persistence of this pathogen in the lungs of cystic fibrosis (CF) patients. The development of chronic infections is also thought to be facilitated by the proinflammatory status of CF airways induced by an activation of NF-B. The aim of this study was to compare the infection of non-CF and CF-like airway epithelial cells by S. aureus strains (normal and SCVs) and to determine the impact of the interaction between cystic fibrosis transmembrane conductance regulator (CFTR) and NF-B on the infection level of these cells by S. aureus. We developed an S. aureus infection model using polarized airway epithelial cells grown at the air-liquid interface and expressing short hairpin RNAs directed against CFTR to mimic the CF condition. A pair of genetically related CF coisolates with the normal and SCV phenotypes was characterized and used. Infection of both cell lines (non-CF and CF-like) was more productive with the SCV strain than with its normal counterpart. However, both normal and SCV strains infected more CF-like than non-CF cells. Accordingly, inhibition of CFTR function by CFTRinh-172 increased the S. aureus infection level. Experimental activation of NF-B also increased the level of infection of polarized pulmonary epithelial cells by S. aureus, an event that could be associated with that observed when CFTR function is inhibited or impaired. This study supports the hypothesis that the proinflammatory status of CF tissues facilitates the infection of pulmonary epithelial cells by S. aureus.

Airway secretions of patients with cystic fibrosis (CF) contain large amounts of alpha 1-antitrypsin (alpha 1-AT), yet elastase activity is also often detectable, suggesting that airway alpha 1-AT may not be functional in some CF patients. It is unknown whether in CF sputum alpha 1-AT is inactivated by oxidants, neutrophil metalloproteinases, bacterial elastase, or neutrophil elastase. To investigate the mechanism(s) by which alpha 1-AT may be inactivated in CF airway secretions, sputum samples were obtained from nine patients during respiratory physiotherapy. alpha 1-AT was measured by radial immunodiffusion. Sputum-alpha 1-AT was purified by antibody affinity chromatography. Electrophoresis of alpha 1-AT from seven patients with acute infectious exacerbations revealed two distinct components: a minor band corresponding to an elastase/alpha 1-AT complex and a major band typical of proteolysed alpha 1-AT (Mr = 48 kD). Each patient had large amounts of sputum elastase activity. In contrast, two patients without free sputum elastase activity had intact sputum alpha 1-AT; however, alpha 1-AT was partially truncated by porcine pancreatic elastase suggesting that the alpha 1-AT may have been partially oxidized. Adding alpha 1-AT purified from normal serum to alpha 1-AT-depleted sputum containing elastase activity resulted in a small alpha 1-AT/elastase complex with most alpha 1-AT being truncated. The serine proteinase inhibitor phenylmethylsulfonyl fluoride but not the metalloproteinase inhibitor EDTA prevented alpha 1-AT proteolysis, thus granulocyte elastase can mediate alpha 1-AT degradation in CF. Apparently, the large granulocyte elastase burden in some acutely ill patients with cystic fibrosis can proteolytically inactivate alpha 1-AT.

In recent studies, we have documented that the biologic activity of quartz can be substantially reduced by surface chemistry modification with aluminum lactate treatment of the particles. In the present study, we evaluated the efficacy of aluminum lactate inhalation to reduce the biologic activity of experimental silicosis in the sheep tracheal lobe model. Four groups of 10 sheep were exposed once to either 100 ml phosphate-buffered saline (PBS) followed by aerosol inhalation of 10 ml PBS at monthly intervals (PBS-PBS group), to 100 ml PBS followed by inhalation of 100 mg aluminum lactate in 10 ml PBS (PBS-Al group), to 100 mg of quartz in 100 ml PBS followed by inhalation of 10 ml PBS (Si-PBS group), or to 100 mg of quartz in 100 ml PBS followed by inhalation of 100 mg aluminum lactate in 10 ml PBS (Si-Al group). Bronchoalveolar lavage (BAL) was repeated at monthly intervals for 6 months from before exposure (Month 0), and all sheep were autopsied at Month 6. All aerosol inhalations were carried out 24 h after BAL starting at Month 1 and monthly thereafter. In the PBS-PBS group and PBS-Al group, all BAL analyses remained at control levels and lung histology remained normal. In the Si-PBS group, BAL analyses documented significant sustained 3- to 10-fold increases in macrophages, lymphocytes, neutrophils, immunoglobulins, lactate dehydrogenase, glycosaminoglycans, lecithin, and phosphatidylglycerol, with histopathologic changes of nodular silicosis (pathologic score, 2.9 +/- 0.9) and mean retention of quartz at 2.83 +/- 0.98 micrograms/mg lung tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Plasma biomarkers and cystic brosis lung disease AbstractPurpose: e purpose of this study was to determine whether plasma biomarkers re ect changes in lung function and respiratory exacerbations associated with CF lung disease.Methods: Plasma human leukocyte elastase/alpha1 antitrypsin complex (pHLE complex) values were measured in 28 adult CF patients and 47 healthy volunteers and correlated with forced expiratory volume (FEV1) and forced vital capacity (FVC). pHLE complexes were studied during respiratory exacerbations and a er antibiotic therapy. Plasma cytokines and sialic acid were also measured.Results: pHLE complexes were increased in CF patients (p < 0.01), were inversely correlated with FEV1 (r = 0.71) and FVC (r = 0.67) and returned to normal levels a er intravenous antibiotics (p < 0.001). Plasma cytokines did not correlate with lung function. Total sialic acid increased during CF respiratory exacerbations and decreased a er antibiotic therapy.Conclusion: Plasma sialic acid and pHLE complexes re ect clinically meaningful changes in CF lung disease. In contrast, plasma cytokine levels did not correlate with lung function.

The purposes of this study were (1) to investigate the chronology of events in cellular and biochemical changes thought to be important in the development of silicosis, (2) to relate these to changes in lung function and radiograph, and (3) to evaluate the relation of quartz exposure and retention to individual response leading to early silicosis. Thirty-six sheep were exposed by repeated intratracheal infusion at 10-day intervals to 100 mg Minusil-5 in 100 ml saline (Si group), and 10 sheep were exposed at the same intervals to 100 ml saline (control). All sheep were investigated at 3-month intervals by chest radiograph, lung function, and lung lavage. At month 9, chest radiograph score of parenchymal opacities was significantly increased at 2.8 +/- 0.6 versus 0.4 +/- 0.4 in the Si group (p less than .05), establishing early radiologic silicosis. Lung function was significantly altered with reduction in lung compliance, vital capacity, and diffusion capacity (p less than .05). Lung lavage cellularity revealed significant increase in total cells (X 2.5), macrophages (X3), and neutrophils (X3). Albumin in BAL remained at the control level. Fibronectin production was significantly increased, as was the fibroblast growth activity, without significant change in procollagen 3 at this early stage of disease. Total phospholipids were significantly elevated in the Si-exposed sheep, and the profile demonstrated an increase in all the phospholipid components. Spontaneous release of hydrogen peroxide by alveolar cells was not increased, but in the presence of phorbol myristate acetate (PMA) higher levels of peroxide were found in the quartz-exposed sheep (p less than .05). The cellular and biochemical alterations of lung lavage preceded other changes. At month 12, there were good correlations (r greater than .49, p less than .001) between parameters evaluating related phenomena but poor correlations between measurements evaluating different aspects of the disorder. To investigate the heterogeneity in the individual response of sheep to the same exposure (susceptibility), individual quartz retention levels at month 12 were measured and found to correlate well with individual parameters of disease activity. We concluded that in early silicosis of sheep, cellular and biochemical changes in lung lavage preceded derangements of pulmonary function and radiographic abnormalities. Thereafter, parameters of lung lavage, lung function, and radiograph were significantly interrelated, but for a given exposure the degree of quartz retention appeared to determine the intensity of the silicotic process.

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