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Guanylate cyclase 2C agonism corrects CFTR mutants
Kavisha Arora, Yunjie Huang, Kyushik Mun, Sunitha Yarlagadda, Nambirajan Sundaram, Marco M. Kessler, Gerhard Hannig, Caroline B. Kurtz, Inmaculada Silos-Santiago, Michael Helmrath, Joseph J. Palermo, John P. Clancy, Kris A. Steinbrecher, Anjaparavanda P. Naren
Kavisha Arora, Yunjie Huang, Kyushik Mun, Sunitha Yarlagadda, Nambirajan Sundaram, Marco M. Kessler, Gerhard Hannig, Caroline B. Kurtz, Inmaculada Silos-Santiago, Michael Helmrath, Joseph J. Palermo, John P. Clancy, Kris A. Steinbrecher, Anjaparavanda P. Naren
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Research Article Gastroenterology

Guanylate cyclase 2C agonism corrects CFTR mutants

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Abstract

Cystic fibrosis (CF) is a genetic disorder in which epithelium-generated fluid flow from the lung, intestine, and pancreas is impaired due to mutations disrupting CF transmembrane conductance regulator (CFTR) channel function. CF manifestations of the pancreas and lung are present in the vast majority of CF patients, and 15% of CF infants are born with obstructed gut or meconium ileus. However, constipation is a significantly underreported outcome of CF disease, affecting 47% of the CF patients, and management becomes critical in the wake of increasing life span of CF patients. In this study, we unraveled a potentially novel molecular role of a membrane-bound cyclic guanosine monophosphate–synthesizing (cGMP-synthesizing) intestinal enzyme, guanylate cyclase 2C (GCC) that could be targeted to ameliorate CF-associated intestinal fluid deficit. We demonstrated that GCC agonism results in functional rescue of murine F508del/F508del and R117H/R117H Cftr and CFTR mutants in CF patient–derived intestinal spheres. GCC coexpression and activation facilitated processing and ER exit of F508del CFTR and presented a potentially novel rescue modality in the intestine, similar to the CF corrector VX-809. Our findings identify GCC as a biological CFTR corrector and potentiator in the intestine.

Authors

Kavisha Arora, Yunjie Huang, Kyushik Mun, Sunitha Yarlagadda, Nambirajan Sundaram, Marco M. Kessler, Gerhard Hannig, Caroline B. Kurtz, Inmaculada Silos-Santiago, Michael Helmrath, Joseph J. Palermo, John P. Clancy, Kris A. Steinbrecher, Anjaparavanda P. Naren

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Figure 2

Long-term exposure to STc corrects and rescues F508del CFTR mutants.

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Long-term exposure to STc corrects and rescues F508del CFTR mutants.
(A)...
(A) Western blot data to study the amount of FLAG F508del CFTR B and C with and without recombinant expression of GCC or treatment with GCC agonist STc (500 nM, 24 h) in HEK 293 cells. A set of F508del CFTR–expressing cells was subjected to temperature rescue (TR). CFTR was immunoprecipitated using resin-conjugated with 24-1 anti-CFTR antibody and probed using anti–FLAG M2-HRP. This experiment was independently repeated 5 times and generated similar result. SE, short-exposure; LE, long exposure; IN, input. (B) Representative confocal images of YFP-tagged F508del CFTR expressed in HEK 293 cells under the following conditions: empty vector (pCDNA3), HA-GCC coexpression, and VX-809 treatment (2 μM, 24 h). YFP WT CFTR was expressed in the cells separately to mark intensive localization of a fold-normal CFTR protein at the plasma membrane (PM, indicated by white arrows). (C) Dequenching of SPQ fluorescence to study chloride transport activity of CFTR in HEK 293 cells upon stimulation with forskolin (10 μM) expressing no CFTR, WT-CFTR, F508del CFTR + pCDNA3 treated with STc (500 nM, 24 h), F508del CFTR + GCC treated with STc (500 nM, 24 h), and F508del CFTR treated with VX-809 (2 µM, 24 h). SPQ signal was quenched using NaI at the end of the experiment. Error bars represent ± SEM calculated from n = 6 wells from 3 independent experiments. P value by 1-way ANOVA with Bonferroni’s adjustment for multiple groups.

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