lecture 7 - cystic fibrosis Flashcards

1
Q

what is CFTR

A

an anion channel that controls the amount of epithelial secretions (e.g. airway surface liquid)

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2
Q

the most common mutation is

A

F508del - a loss of phenylalanine at position 508 in NBD1

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3
Q

class I - no protein

A

mutation = G542X (X represents a stop mutation)

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4
Q

class II - no traffic

A

mutation = F508del (protein is made but doesn’t process to membrane as protein is misfolded)

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5
Q

class III - no function

A

mutation = G551D (doesnt respond to normal queues that activates the channel e.g. phosphorylation) gating mutation

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6
Q

class IV - less function

A

mutation = R117H (cant conduct chloride and bicarbonate as well as the wild type)

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7
Q

class V - less protein

A

mutation = A455E (less protein produced so overall transport of chloride and bicarbonate is reduced)

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8
Q

class VI - less stable

A

mutation = rF508del (get retrieved from membrane earlier so shorter half life)

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9
Q

other factors affective disease

A
  • single nucleotide polymorphisms SNPs can alter the activity and function of other genes which can modify the disease severity
  • and air pollution can contribute to the severity of the lung disease
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10
Q

airway surface liquid is made up of

A

mucus layer and periciliary liquid layer (cilia in the salty solution)

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11
Q

proper hydration ensures efficient mucociliary clearance (MCC) which removes pathogens

A
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12
Q

in a healthy cell if theres too much fluid in ASL

A

ENaC is activated

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13
Q

in a healthy cell if there isnt enough fluid in the ASL

A

CFTR is activated

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14
Q

in CF there’s no chloride secretion but you still have sodium absorption

A

CFTR has a negative effect on ENaC so without CFTR, ENaC is overactive making dehydration of ASL even worse

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15
Q

in CF the pH of ASL is

A

more acidic as lack of CFTR reduces HCO3- secretion into ASL, this togethr with the proton ATPase which secretes H+ from airway cells causes more acidic ASL

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16
Q

consequences of more acidic pH

A
  1. increased ENaC activity - increased CAP (they cleave ENaC and increase its activity) function and decreased SPLUNC1 function
  2. decreased bacterial killing - reduced antimicrobial activity
  3. increased mucus viscosity - due to conformational changes in mucins making them more rigid
17
Q

lung disease

A

dysfunctional CFTR -> decreased Cl and HCO3 transport -> decreased ASL volume and pH -> increased ENaC function, increases mucus obstruction, decreased MCC, decreased antimicrobial activity -> increased bacterial and viral infections, increased inflammation -> destruction of lung

18
Q

treatments for CF

A

mucus clogging - physiotherapy and mucolytics
restore ASL - hypertonic saline (draws water from the body into airways improving hydration)

19
Q

SPLUNC1 reduced in acidic pH

A

SPLUNC1 binds to ENaC and takes ENaC in