Airway Responses to Inhaled Ouabain in Subjects With and Without Asthma

Agrawal, K. P.; Reed, Charles E.; Hyatt, Robert E.; Imber, W.E.; Krell, Willane S.

doi:10.1016/s0025-6196(12)64816-2

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…Several groups have studied the in vivo effect of cardiac glycosides, including ouabain, in inhaled form, on bronchial reactivity in asthma (Agrawal et al, 1986; Knox et al, 1988; Hulks and Patel, 1989). Indeed in the 1980s, a study conducted in England and Wales showed a correlation between asthma mortality and dietary salt intake (Burney, 1987) and it was thought that inhibiting Na + /K + -ATPase would increase the intracellular concentration of Na + , inhibiting Na + -Ca 2+ exchange, and thereby increasing contractility of smooth muscle cells.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed in the 1980s, a study conducted in England and Wales showed a correlation between asthma mortality and dietary salt intake (Burney, 1987) and it was thought that inhibiting Na + /K + -ATPase would increase the intracellular concentration of Na + , inhibiting Na + -Ca 2+ exchange, and thereby increasing contractility of smooth muscle cells. In one study, Agrawal et al (1986) showed that a low dose of ouabain-induced bronchodilatation in 6 out of 10 asthmatic subjects, whereas higher doses induced bronchoconstriction. However, two more studies reported no effect of inhaled ouabain on FEV 1 or bronchial reactivity to histamine in asthmatic patients (Knox et al, 1988; Hulks and Patel, 1989).…”

Section: Discussionmentioning

confidence: 99%

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Esomeprazole Increases Airway Surface Liquid pH in Primary Cystic Fibrosis Epithelial Cells

et al. 2018

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Respiratory failure, driven by airways mucus obstruction, chronic inflammation and bacterial infections, is the main cause of mortality and morbidity in people with cystic fibrosis (CF) due to defects in the Cl- and HCO3− transport activity of the CF Transmembrane conductance Regulator (CFTR). Most recent pre-clinical and clinical studies have focused on restoring CFTR function by enhancing its trafficking or transport activity and show promising results. However, there are a significant number of patients that will not benefit from these CFTR-targeted therapies and it is therefore important to identify new non-CFTR targets that will restore lung function, by-passing CFTR dysfunction. The H+/K+-ATPase, ATP12A, has recently been identified as a potential novel target for CF therapies, since its acute inhibition by ouabain was shown to help restore mucus viscosity, mucociliary transport, and antimicrobial activity using in vitro CF airway models, and this effect was linked to an increase in the pH of the airway surface liquid (ASL). Here, we have evaluated the potential therapeutic use of ouabain by investigating the effect of chronically treating fully differentiated CF primary human airway epithelial cells (hAECs) with ouabain, under thin film conditions, resembling the in vivo situation. Our results show that although chronic treatment increased ASL pH, this correlated with a deleterious effect on epithelial integrity as assessed by LDH release, transepithelial electrical resistance, fluorescein flux, and ion transport. Since ATP12A shares approximately 65% identity with the gastric H+/K+-ATPase (ATP4A), we investigated the potential of using clinically approved ATP4A proton pump inhibitors (PPIs) for their ability to restore ASL pH in CF hAECs. We show that, despite not expressing ATP4A transcripts, acute exposure to the PPI esomeprezole, produced changes in intracellular pH that were consistent with the inhibition of H+ secretion, but this response was independent of ATP12A. More importantly, chronic exposure of CF hAECs to esomeprazole alkalinized the ASL without disrupting the epithelial barrier integrity, but this increase in ASL pH was consistent with a decrease in mRNA expression of ATP12A. We conclude that PPIs may offer a new approach to restore ASL pH in CF airways, which is independent of CFTR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Esomeprazole Increases Airway Surface Liquid pH in Primary Cystic Fibrosis Epithelial Cells

et al. 2018

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“…Inhibiting this transporter can ultimately lead to death of the cell. Despite this, a number of studies have aerosolized ouabain, in vivo, in human subjects (193)(194)(195)(196). The rationale of these studies was to mildly inhibit the Na + /K + ATPase and reduce airway hyperreactivity in asthma.…”

Section: Future Directionsmentioning

confidence: 99%