Novel Anti-inflammatory Approaches for Cystic Fibrosis Lung Disease: Identification of Molecular Targets and Design of Innovative Therapies

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Mini Review
11 March 2021
Update on Calcium Signaling in Cystic Fibrosis Lung Disease
Alessandro Rimessi
2 more and 
Paolo Pinton
Principal defects in Ca2+ signaling associated with defective CFTR channel. Schematic representation of intracellular Ca2+ signaling in airway cells. The cellular Ca2+ homeostasis is regulated by systems of Ca2+-entry and Ca2+-efflux located in plasma membrane and organelles. In the inset are reported the principal molecular systems involved in the abnormal intracellular Ca2+ signaling associated with defective CFTR channel, where the their dysfunction contributes to physiopathology of CF lung disease: I) increased PLC activity, due to GPCR-dependent overstimulation; II) increased TRP-dependent Ca2+-entry, due to enhanced functional activity and/or expression; III) increased Orai insertion with consequent augments in Ca2+-influx; IV) increased SERCA activity; V) increased MCU activity; and VI) reduced Ca2+-efflux, due to altered PMCA activity. ATP, adenosine triphosphate; Ca2+, calcium; CFTR, cystic fibrosis transmembrane conductance regulator; Cl-, chloride; DAG, diacylglycerol; ER, endoplasmic reticulum; GPCR, G protein coupled receptor; GPD, guanosine diphosphate; GRP75, glucose-related protein 75; IP3, inositol 1,4,5-triphosphate; IP3Rs; inositol trisphosphate receptors; MCU, mitochondrial calcium uniporter; NCX, sodium-calcium exchanger; Orai, calcium release activated calcium channel; PLC, phospholipase C; PM, plasma membrane; PMCA, PM-resident Ca2+-ATPase; SERCA, ER-resident Ca2+-ATPase; STIM1; stromal interaction molecule 1; TRPC, transient receptor potential (TRP) channels; VDAC1, voltage-dependent anion-selective channel 1.

Cystic fibrosis (CF) is an autosomal recessive disorder characterized by mutations in the cystic fibrosis transmembrane conductance regulator gene, which causes multifunctional defects that preferentially affect the airways. Abnormal viscosity of mucus secretions, persistent pathogen infections, hyperinflammation, and lung tissue damage compose the classical pathological manifestation referred to as CF lung disease. Among the multifunctional defects associated with defective CFTR, increasing evidence supports the relevant role of perturbed calcium (Ca2+) signaling in the pathophysiology of CF lung disease. The Ca2+ ion is a critical player in cell functioning and survival. Its intracellular homeostasis is maintained by a fine balance between channels, transporters, and exchangers, mediating the influx and efflux of the ion across the plasma membrane and the intracellular organelles. An abnormal Ca2+ profile has been observed in CF cells, including airway epithelial and immune cells, with heavy repercussions on cell function, viability, and susceptibility to pathogens, contributing to proinflammatory overstimulation, organelle dysfunction, oxidative stress, and excessive cytokines release in CF lung. This review discusses the role of Ca2+ signaling in CF and how its dysregulation in airway epithelial and immune cells contributes to hyperinflammation in the CF lung. Finally, we provide an outlook on the therapeutic options that target the Ca2+ signaling to treat the CF lung disease.

6,765 views
25 citations
Schematic representation of mitochondrial stress response pathways in healthy and in CF. In healthy condition, compensatory mitochondrial stress responses are transiently triggered to restore the mitochondrial homeostasis during P. aeruginosa infection. Damaged mitochondrial portions are removed by mitophagy, where the PINK1-Parkin signaling pathway promotes ubiquitination of OMM proteins while the mitophagic receptors, optineurin (OPN) and NDP52, act as adaptors to recruit autophagosomal membranes to mitochondria, interacting with LC3. In CF, defective mitophagy leads to dysfunctional mitochondria accumulation with consequent release of mitochondrial DAMPs, which contribute to hyper-inflammatory responses in CF airway cells during the persistent P. aeruginosa infection. The mammalian UPRmt is regulated by the transcription factors ATF5, which in healthy condition is imported into mitochondria to be degraded. In CF, the persistent mitochondrial stress in airway cells induces abnormal UPRmt activation with consequent nuclear translocation of ATF5, which supports the regulation of innate immunity response during pathogen infection. At front of the mitochondrial Ca2+-overload, a higher susceptibility to irreversible damages in response to pathogen infection occur in CF airway cells, contributing to promote organelle dysfunction and cell death. In CF, the exacerbation of inflammatory environment is due also by mtDAMPs release and by accumulation of phagocyte cells that intervene to scavenge the dying cells and pathogens. PTEN induced kinase 1 (PINK-1); Microtubule-associated proteins 1A/1B light chain 3B (LC3); Nuclear domain 10 protein 52 (NDP52); Optineurin (OPN); Translocase of the outer membrane (TOM); Translocase of the inner membrane (TIM); Activating Transcription Factor 5 (ATF5); Lon protease homolog 1 (LON-1); heat shock protein 60 (HSP60); heat shock protein 10 (HSP10); Caseinolytic Mitochondrial Matrix Peptidase Proteolytic Subunit (CLPP); mitochondrial deoxyribonucleic acid (mtDNA); cytochrome c (cyt c); B-cell lymphoma 2 protein (Bcl2); BCL2 Associated X protein (BAX); Bcl-2 homologous antagonist/killer protein (BAK); reactive oxygen species (ROS); calcium (Ca2+); Pseudomonas aeruginosa (P. aeruginosa); apoptotic protease activating factor-1 (APAF-1). This figure has been created with “BioRender.com”.
Mini Review
30 September 2020
Mitochondrial Stress Responses and “Mito-Inflammation” in Cystic Fibrosis
Simone Patergnani
2 more and 
Alessandro Rimessi

Cystic fibrosis (CF) is a genetic disease associated to mutations in the cystic fibrosis transmembrane conductance regulator gene, which results in the alteration of biological fluid and electrolyte homeostasis. The characteristic pathological manifestation is represented by exaggerated proinflammatory response in lung of CF patients, driven by recurrent infections and worsen by hypersecretion of proinflammatory mediators and progressive tissue destruction. Treating inflammation remains a priority in CF. However, current anti-inflammatory treatments, including non-steroidal agents, are poorly effective and present dramatic side effects in CF patients. Different studies suggest an intimate relationship between mitochondria and CF lung disease, supporting the hypothesis that a decline in mitochondrial function endorses the development of the hyperinflammatory phenotype observed in CF lung. This allowed the implementation of a new concept: the “mito-inflammation,” a compartmentalization of inflammatory process, related to the role of mitochondria in engage and sustain the inflammatory responses, resulting a druggable target to counteract the amplification of inflammatory signals in CF. Here, we will offer an overview of the contribution of mitochondria in the pathogenesis of CF lung disease, delving into mitochondrial quality control responses, which concur significantly to exacerbation of CF lung inflammatory responses. Finally, we will discuss the new therapeutic avenues that aim to target the mito-inflammation, an alternative therapeutic advantage for mitochondrial quality control that improves CF patient’s inflammatory state.

5,997 views
22 citations
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35 citations
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Frontiers in Chemical Biology

Advances of Metal-based Compounds for Therapeutic Applications
Edited by May Lee Low, Nurul Huda Abd Karim, Wenyi Li, Helene C Bertrand
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26 February 2024
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Frontiers in Chemical Biology

Advances of Metal-based Compounds for Therapeutic Applications
Edited by May Lee Low, Nurul Huda Abd Karim, Wenyi Li, Helene C Bertrand
Deadline
26 February 2024
Submit a paper