No description available.

Yes / Background: Chronic infections with Pseudomonas aeruginosa are a leading cause of morbidity in patients with cystic fibrosis (CF). The aim of tobramycin inhalation therapy in CF patients with chronic pulmonary infection is to deliver high amounts of drug directly to the site of infection. TOBI® is a tobramycin nebulizer solution (300 mg/5 ml) approved by FDA for maintenance therapy for patient with CF. The 20% tobramycin sulfate solution was reported as the optimal and maximal concentration. Methods: Nebulization of high strength tobramycin solution (20% tobramycin sulfate) (HSTS) has been assessed in this study by using different selected high performance nebulizer delivery systems: two different designs of jet nebulizers, and three new nebulizers based on vibrating mesh technology. The aerosol particle size distribution and output characteristics were measured for in vitro performance assessment of the nebulizer systems. The methodology was adapted from the current European standard, EN 13544-1:2001E. Results: The particle size distribution characteristic measurements showed that all tested nebulizers may be suitable for inhalation of HSTS. The mean (SD) of highest percentage of fine particles (<5 mm) was 77.64 (2.3) % for Sidestream®, at flow rate 16 L/min. The highest respirable inhaled mass was for Pari LC Plus® combined with PariBoyN® compressor, with mean (SD) 90.85 (8.6) mg. The mean (SD) of highest drug wastage percentage was 63.9 (3.9) % for Sidestream® jet nebulizer combined with compressed air cylinder at flow rate 16 L/min, while the lowest was 2.3 (0.26) % for NE-U22 Omron® (high frequency). Conclusions: The HSTS can be nebulized by all tested nebulisers but the high frequency NE-U22 Omron® and Aeroneb Go® are more efficient. When the HSTS compared to TOBI®, the respirable inhaled dose was increased to more than 73%.

Yes / Cystic fibrosis (CF) is an inherited multi-system disorder characterised by chronic airway infection with pathogens such as Pseudomonas aeruginosa. Acquisition of P. aeruginosa by patients with CF is usually from the environment, but recent studies have demonstrated patient to patient transmission of certain epidemic strains, possibly via an airborne route. This study was designed to examine the survival of P. aeruginosa within artificially generated aerosols. Survival was effected by the solution used for aerosol generation. Within the aerosols it was adversely affected by an increase in air temperature. Both epidemic and non-epidemic strains of P. aeruginosa were able to survive within the aerosols, but strains expressing a mucoid phenotype had a survival advantage. This would suggest that segregating individuals free of P. aeruginosa from those with chronic P. aeruginosa infection who are more likely to be infected with mucoid strains may help reduce the risk of cross-infection. Environmental factors also appear to influence bacterial survival. Warming and drying the air within clinical areas and avoidance of humidification devices may also be beneficial in reducing the risk of cross-infection.

The purpose of the current study was to examine the relationship between parent and child factors for mothers of children diagnosed with cystic fibrosis to predict mother's psychological distress. Mothers were surveyed to identify measurement models in areas of Child and Parental characteristics and a Full Causal Model of Maternal distress. Factors related to Child Characteristics include general parental stressors and cystic fibrosis specific parental stressors. Factors related to Parental Characteristics include the mother's sense of parental competence and self-esteem. Additional factors related to the Full Causal Model include social support, major and minor life events, and demographics. Results were analyzed using LISREL IV structural equation modeling. Measurement model analysis found a good fit for the Child Characteristics model (Chi Square = 6.85, df = 4, JD = .144, Goodness of Fit Indices = .972) and Parental Characteristics model (Chi Square = 5.89, df = 3, p = .117, Goodness of Fit Indices = .971), but not for the full causal model of maternal distress (Chi Square = 114.98, df = 66, E = .000, Goodness of Fit Indices = .853)

上皮間充質轉化（EMT），作為重要的生理和病理事件，廣泛的參與胚胎發育、組織纖維化病變及腫瘤轉移的過程。這一顯著的細胞表型變化包括上皮細胞失去緊密連接和極性，上皮細胞呈現纖維細胞形態以及增強的細胞移動性。囊性纖維變性跨膜電導調節器（CFTR）是一種廣泛表達於上皮細胞的氯離子和碳酸根離子通道。研究證實，CFTR 的蛋白轉運與上皮連接的形成和功能有關，同時 CFTR 的表達受到 EMT 誘導因子 HIF-1 和 TGF-β 的反向調節。另外，CFTR 的表達和功能被證實參與 EMT 相關信號分子 Wnt 和 NF-κB活性的調節。基於上述發現，本研究旨在闡述 CFTR 與 EMT 的相關性。 / CFTR 參與的腎上皮 EMT 以及後續的腎纖維化首先被關注。實驗表明，在腎上皮細胞（MDCK）中，小 RNA 介導的 CFTR 基因敲降或抑製劑引起的CFTR 通道功能缺陷均引起間充質細胞特徵的出現，包括纖維狀細胞形態、細胞連接分子 E-cadherin, ZO-1 和 Occludin 表達下調和間充質細胞標誌分子 Vimentin 和 N-cadherin 上調、上皮細胞跨膜電阻減低以及細胞遷徙能力的增強。有趣的是，在單側尿道結紮的腎纖維化模型中，CFTR 表達被顯著下調。同時，動物實驗證實一個最常見的 CFTR 分子突變（deltaF508 -/-）增加了單側尿道結紮導致的腎纖維化的程度。另外，在缺氧引起的 EMT 過程中CFTR 的表達顯著下調；同時，腎纖維化模型中，HIF-1 和 CFTR 的表達呈現負相關。結果提示，生理及病理的條件下，氧氣的調節可能作為 CFTR 下調及其後續事件的誘因。進一步實驗發現，CFTR 功能抑製或基因突變可以引起Wnt 的富集和 β-catenin 的細胞核轉移。基於以上的實驗結果，在腎纖維化的過程中，CFTR 參與了缺氧引起的 EMT 過程，並通過激活 Wnt/β-catenin 信號調節相關的下游因子。 / 第二部分集中探究了 CFTR 在癌細胞EMT 及腫瘤轉移中的作用及機制。實驗證實，在 TGF-β 誘導的腫瘤細胞 EMT 過程中，CFTR 表達被抑制。TGF-β 可能作為病理狀態下的調節因子，引起腫瘤細胞中 CFTR 表達下調及EMT。抑制 CFTR 通道功能或敲降其蛋白表達導致明顯的間充質細胞特徵，這一變化在不同來源的腫瘤細胞系中呈均一性。相對地，過表達 CFTR 引起細胞遷移和侵潤能力地顯著下降。在體實驗顯示，CFTR 表達與腫瘤的轉移能力呈現負相關。進一步機制研究證明，CFTR 通過調節多重的通路參與 EMT的過程。首先，uPA 的表達和活性受到 CFTR 的反向調節，並且這一調節作用是由激活的 NF-κB 介導的。其次，抑制 CFTR 通道功能引起 β-catenin 的細胞核轉移。 / 綜上所述，研究發現 CFTR 通過調節多重信號參與腎上皮及腫瘤細胞的 EMT。同時，研究顯示 CFTR 的表達和功能與腎纖維化及腫瘤轉移有關。此研究對相關疾病的診斷和預後具有潛在的提示作用。 / Epithelial-Mesenchymal Transition (EMT) is an intricate process by which epithelial cells lose their epithelial characteristics and acquire a mesenchymal-like phenotype. It is essential for numerous physiological and pathological processes, such as embryonic development, tissue fibrosis and cancer metastasis. The dramatic phenotype changes of EMT include loss of tight junctions and polarity, acquisition of a fibroblastic morphology and increased motility. The cystic fibrosis transmembrane regulator (CFTR) is known as an anion channel and extensively expressed in a variety of epithelial cells. Interestingly, the apical membrane expression of CFTR is reported to be required for the normal organization and function of epithelial junctions. Moreover, EMT inducers, such as HIF-1 and TGF-β, are known to suppress the expression of CFTR in epithelial cells. In addition, CFTR has been reported to be associated with expression and/or activity of Wnt and NF- κB, key factors known to be involved in EMT. Thus, we hypothesized that CFTR might play an important role in EMT. / In the first part of the study, the involvement of CFTR in EMT of kidney epithelial cells and renal fibrosis was investigated. Our experiments revealed that suppression of CFTR by either inhibitor or knockdown induced EMT in Madin- Darby canine kidney epithelial cells (MDCK). This was accompanied by the appearance of fibroblastic morphology, with reduced expression of epithelial junction proteins E-cadherin, ZO-1 and occludin and accumulated expression of the mensenchymal markers vimentin and N-cadherin, as well as reduced transepithelial resistance (TER) and enhanced migratory ability. Interestingly, the expression of CFTR was found significantly down-regulated in unilateral urethral obstruction (UUO) kidney. In addition, CFTR mutant (deltaF508 -/-), the most common mutation found in CF patients, increased the risk of renal fibrosis in UUO model. Our results showed that the expression of CFTR down-regulated in hypoxia induced-EMT in MDCK, and the expression of hypoxia-sensitive transcription factor, HIF-1, is inversely correlated with CFTR in UUO kidney. Accumulation of Wnt and translocation of β-catenin were also observed in CFTR inhibitors-treated MDCK and deltaF508 -/- UUO mice. Taken together, these findings suggest that CFTR may be involved in mediating hypoxia-induced EMT by influencing the Wnt/β-catenin signaling contributing to renal fibrosis. / In the second part of the study, the role of CFTR in EMT during cancer metastasis and the underlying mechanisms were investigated. Recent studies have demonstrated that cancer cells may reinstitute properties of developmental EMT including enhanced migration and invasion. On the other hand, the reverse process, known as mesenchymal-to-epithelial transition (MET), has been implicated in forming a secondary metastatic tumor. Using various tissue-derived cancer cell lines including human colorectal cancer cell line LIM1863, human lung carcinoma cell line A549, and human breast cancer cell lines MCF7 and MDA-MB-231, we report that induction of EMT by TGF-β sharply reduces CFTR expression in various tissue derived cancer cell lines, while overexpression of CFTR can reverse the TGF-β- induced EMT phenyotype. Interfering with CFTR function either by its specific inhibitor or lentiviral miRNA-mediated knockdown mimicks TGF-β-induced EMT and enhances cell migration and invasion. Ectopic overexpression of CFTR in a highly metastatic cancer cell lines downregulates EMT markers and suppresses cell invasion and migration in vitro, as well as the ability of the cells to metastasize to the lung in vivo. The EMT-suppressing effect of CFTR is found to be associated with its ability to alter NF-κB targeting urokinase-type plasminogen activator (uPA) and the nuclear translocation of β-catenin. Taken together, the present study has demonstrated a previously undefined role of CFTR as an EMT suppressor in cancer. / In summary, our findings have demonstrated a regulatory role of CFTR in EMT in both normal kidney epithelial cell line and various cancer cell lines. We conclude that CFTR plays important roles in renal fibrosis and cancer progression/metastasis by modulating EMT process through multiple pathways. The insights afforded by these studies will provide critical new information about the function of CFTR as a suppressor of EMT, which may have potential application in diagnosis and prognosis of fibrosis and cancer. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Zhang, Jieting. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 136-150). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese. / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Epithelial-Mesenchymal Transition --- p.1 / Chapter 1.1.1 --- Concept and features of EMT --- p.2 / Chapter 1.1.2 --- Roles of EMT in development and diseases --- p.10 / Chapter 1.1.3 --- The Regulators of EMT --- p.13 / Chapter 1.2 --- Structure and function of CFTR --- p.18 / Chapter 1.2.1 --- General structure and channel functions of CFTR --- p.18 / Chapter 1.2.2 --- Gene mutations and CF --- p.18 / Chapter 1.3 --- Potential role of CFTR in EMT --- p.20 / Chapter 1.3.1 --- CFTR in formation of cell-cell junction and membrane polarity --- p.20 / Chapter 1.3.2 --- CFTR and EMT inducers --- p.21 / Chapter 1.3.3 --- CFTR and EMT related pathways and factors --- p.22 / Chapter 1.4 --- Hypothesis and aim of the study --- p.22 / Chapter Chapter 2 --- CFTR involves in hypoxia induced EMT in renal fibrosis --- p.24 / Chapter 2.1 --- Abstract --- p.24 / Chapter 2.2 --- Introduction --- p.25 / Chapter 2.3 --- Results --- p.30 / Chapter 2.3.1 --- Knockdown of CFTR induces EMT in MDCK --- p.30 / Chapter 2.3.2 --- Inhibition of CFTR channel function induces EMT in MDCK --- p.30 / Chapter 2.3.3 --- CFTR is downregulated during the process of renal fibrosis --- p.36 / Chapter 2.3.4 --- CFTR defect increases the risk of renal fibrosis --- p.39 / Chapter 2.3.5 --- Hypoxia/HIF-1α rather than TGF-β as the inducer of CFTR repression during EMT and renal fibrosis --- p.44 / Chapter 2.3.6 --- CFTR as a negative regulator of Wnt/β-catenin signaling in renal epithelium --- p.51 / Chapter 2.4 --- Discussion --- p.57 / Chapter 2.5 --- Conclusion --- p.61 / Chapter 2.6 --- Materials and Methods --- p.61 / Chapter 2.6.1 --- Cell culture and treatments --- p.61 / Chapter 2.6.2 --- Plasmids and transient transfection --- p.62 / Chapter 2.6.3 --- Western blot analysis --- p.62 / Chapter 2.6.4 --- Measurement of trans epithelial electric resistance --- p.64 / Chapter 2.6.5 --- Wound-healing migration assay --- p.64 / Chapter 2.6.6 --- Animals and Obstructive model --- p.64 / Chapter 2.6.7 --- HE and Masson's trichrome stain --- p.65 / Chapter 2.6.8 --- Immunofluorescent and immunohistochemistry staining --- p.65 / Chapter 2.6.9 --- Statistical analysis --- p.66 / Chapter Chapter 3 --- CFTR down-regulation mediates EMT during cancer metastasis --- p.67 / Chapter 3.1 --- Abstract --- p.67 / Chapter 3.2 --- Introduction --- p.67 / Chapter 3.3 --- Results --- p.73 / Chapter 3.3.1 --- Repression of CFTR during TGF-β induced EMT in cancer cells --- p.73 / Chapter 3.3.2 --- Hypoxia does not have significant effect on CFTR expression --- p.78 / Chapter 3.3.3 --- Repression of CFTR channel function induces EMT in cancer cells --- p.81 / Chapter 3.3.4 --- Knockdown/overexpression of CFTR induces/inhibits EMT and malignant phenotypes --- p.84 / Chapter 3.3.5 --- CFTR inhibits lung metastasis in vivo --- p.94 / Chapter 3.3.6 --- Anti-metastatic effect of CFTR involves NF-κB targeting uPA --- p.104 / Chapter 3.3.7 --- Correlation between CFTR and β-catenin --- p.112 / Chapter 3.4 --- Discussion --- p.116 / Chapter 3.5 --- Conclusion --- p.122 / Chapter 3.6 --- Materials and methods --- p.122 / Chapter 3.6.1 --- Cell culture and treatments --- p.122 / Chapter 3.6.2 --- Lentiviral production and transduction --- p.123 / Chapter 3.6.3 --- Plasmids and stable transfection --- p.124 / Chapter 3.6.4 --- RT-PCR analysis --- p.124 / Chapter 3.6.5 --- Western blot analysis --- p.126 / Chapter 3.6.6 --- Immunofluorescence staining --- p.126 / Chapter 3.6.7 --- Cell growth assay --- p.127 / Chapter 3.6.8 --- Migration assay --- p.127 / Chapter 3.6.9 --- Invasion assay --- p.128 / Chapter 3.6.10 --- In vivo tumor growth assay --- p.128 / Chapter 3.6.11 --- In vivo metastasis assay --- p.128 / Chapter 3.6.12 --- Human EMT PCR array --- p.129 / Chapter 3.6.13 --- uPA activity assay --- p.129 / Chapter 3.6.14 --- Statistical analysis --- p.129 / Chapter Chapter 4 --- General discussion --- p.130 / Chapter 4.1 --- Normal function of CFTR in epithelial polarity and barrier function --- p.130 / Chapter 4.2 --- Down-regulation of CFTR is associated with EMT-related diseases --- p.131 / Chapter 4.3 --- CFTR functions as a central mediator of different EMT signals --- p.132 / Chapter 4.4 --- Future directions --- p.134 / Chapter 4.5 --- Conclusion --- p.135 / References --- p.136 / Declaration --- p.151

Further studies were conducted to define an indispensable role of uterine bicarbonate secretion at pre-implantation for the success of blastocyst implantation. The in vitro implantation experiments showed that only when cultured in bicarbonate-containing medium, the blastocysts exhibited normal rate of attachment and outgrowth level. The forskolin-induced endometrial bicarbonate secretion measured by the Isc on pregnant day 4 was almost abolished by CA inhibitor acetazolamide. The efflux of intracellular bicarbonate, measured by intracellular pH-sensitive dye, was blocked by CFTR inhibitor, NPPB, and SLC26a6 inhibitor, DIDS, indicating their involvement in mediating uterine bicarbonate secretion. / In conclusion, the present findings have demonstrated an important role of CFTR in formation of optimal uterine fluid, in terms of both volume and composition, which is crucial for various reproductive events occurring in the uterus. Deviation from the normal uterine fluid composition and volume due to defects in CFTR function or abnormal regulation under pathological conditions, such as CF and genital bacteria infection, probably leads to infertility. The information obtained may provide insight into regulatory mechanism underlying fertility and infertility, as well as the rationale for development of treatment methods for female infertility and new strategies for female contraception. (Abstract shortened by UMI.) / The last part of the study was to demonstrate possible cause of infertility by disturbance of uterine fluid dynamic due to abnormal expression of CFTR using a model of uterine Chlamydia (C.) trachomatis infection, the most common infection-related sterility with the underlying cause unexplained. Uterine C. trachomatis infection induced up-regulated expression of CFTR with enhanced electrolyte and fluid transport as demonstrated by the increase in the cAMP-dependent Isc and uterine wet weight with obvious fluid accumulation in the lumen at diestrus stage, during which the endometrium normally undergoes a series of changes preparing for blastocyst implantation with minimum CFTR expression and uterine fluid volume. The abnormal uterine fluid accumulation upon uterine C. trachomatis infection significantly reduced implantation rate in uterine C. trachomatis infection mouse model. / The present study was aimed to elucidate the cellular and molecular mechanisms underlying the CFTR-related reproductive events in physiological and pathological conditions by using a variety of techniques, including RT-PCR, Western blot, intracellular and extracellular pH measurements, and the short-circuit current (Isc) measurement, in conjunction with mouse primary culture of endometrial cells and blastocyst, as well as several animal models including CF mouse, mouse uterine infectious model and overyectomized (OVX) mouse, etc. / We first examined dynamic changes in uterine bicarbonate secretion, as indicated by bicarbonate-dependent forskolin-induced Isc and epithelial surface pH measurement, and the expression profile of candidate genes and proteins known to be involved in bicarbonate secretion throughout the estrous cycle in mouse uterus. The results showed that the maximum mRNA and protein levels of CFTR, SLC26a6, carbonic anhydrase (CA)2 and CA12 were observed at proestrus stage and/or estrus stages. Luminal surface pH measured by 5-N-hexadecanoyl-aminofluorescein (HAF) showed that the basal endometrial epithelial surface pH at estrus stage was significantly higher than that in diestrus, which could be reduced significantly by CFTR inhibitor DPC, SLC26a6 inhibitor 4',4'-Diisothiocyanostilbene-2',2' Disulfonic Acid (DIDS) and CA suppressor acetazolamide. In the ovariectimized (OVX) mice and primary culture of endometrial cells, estrogen could induce up-regulation of CFTR, SLC26a6, CA2 and CA12 expression with corresponding increase in the bicarbonate-dependent Isc, suggesting a novel role of estrogen in regulating uterine bicarbonate secretion. / He, Qiong. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3247. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 163-176). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Thesis (Ph.D.)--University of Alabama at Birmingham, 2008. / Title from PDF title page (viewed on Feb. 10, 2010). Includes bibliographical references.

Exercise has become a vital component of the therapy regimen prescribed to cystic fibrosis (CF) patients due to its systemic benefits, such as increased sputum expectoration, attenuation of the expected 2-3% annual decline in pulmonary function, and extended life expectancy. However, exercise still is not viewed as being as beneficial as pharmacological treatments by many CF patients and can be intimidating. My aims in this study were two-fold; first, to determine the ideal exercise intensity for individuals with CF; and second, to determine if exercise at this ideal intensity could provide improvements in ion regulation in the lungs, which was measured using exhaled breath condensate (EBC) collection and nasal potential difference (NPD), that were comparable to one of their standard pharmacological therapies, albuterol. I hypothesized that with moderate intensity exercise, Na⁺ absorption would decrease from baseline due to Na⁺ channel inhibition, rather than increase or remain unchanged, as was expected with albuterol, and cause an even greater increase Cl- secretion compared to albuterol due to activation of both CF-dependent and independent Cl- efflux with exercise. CF (n=14) and healthy (n=16) subjects completed three visits, a baseline screening and two treatment visits. I collected EBC at baseline, 30- and 60-minutes post-albuterol administration on one visit, and at baseline and during three separate 15 min exercise bouts at low, moderate and high intensity on the other visit. Following the EBC collection, NPD was performed at 30- and 80-minutes post albuterol or following moderate and high intensity exercise. We also measured spirometry and diffusing capacity of the lungs for nitric oxide (DLNO) during each visit at the various time points. In CF subjects, moderate intensity exercise resulted in greater improvements in DLNO (39 ± 29vs.15 ± 22% change from baseline, exercise vs. albuterol respectively), similar levels of bronchodilation compared to 60-minutes post-albuterol administration, no change in Na⁺ absorption, and a four-fold increase in Cl- secretion. Our results suggest that moderate intensity exercise is the best dose for CF patients, and can provide comparable changes as its pharmacological counterpart albuterol, when compared over a short term duration.

Mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator protein (CFTR) cause cystic fibrosis (CF), the most common life-shortening genetic disease among Caucasians. Although general features of the structure of CFTR have been predicted from homology models, the conformational changes that result in channel opening and closing have yet to be resolved. We created new closed- and open-state homology models of CFTR, and performed targeted molecular dynamics simulations of the conformational transitions in a channel opening event. The simulations predict a conformational wave that starts at the nucleotide binding domains and ends with the formation of an open conduction pathway. Experimentally confirmed changes in side-chain interactions are observed in all major domains of the protein. We also identified unique-to-CFTR substitutions that may have led to channel activity in CFTR. Molecular modeling and simulations are used to compare the effects of these substitutions against a canonical ABC transporter, and suggest that gain of channel function in CFTR may have risen from loss of ATPase function at its NBDs. The models and simulation add to our understanding of the mechanism of ATP-dependent gating in this disease-relevant ion channel.

Thesis (Ph.D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed on June 24, 2009). Includes bibliographical references.