Doctor of Philosophy / Biochemistry Interdepartmental Program / Antje Philine Wangemann / Mutations of SLC26A4 are the most common cause of the hearing loss associated with enlargement of the vestibular aqueduct. SLC26A4 encodes pendrin, an anion exchanger expressed in the cochlea, the vestibular labyrinth, and the endolymphatic sac of the inner ear. Slc26a4Δ/Δ mice, devoid of pendrin expression, develop an enlarged membranous labyrinth which leads to the failure to develop hearing, thereby recapitulating the human disease. Identifying the ionic composition of the endolymph and evaluating the importance of pendrin expression at various sites are initial steps towards developing strategies for preventing enlargement of the endolymph volume and subsequently restoring the inner ear functions. The major aims of the present study are 1) To determine the ionic composition of inner ear fluids during the developmental phase in which the enlargement of the endolymph volume occurs; 2) To test the hypothesis that pendrin expression in the endolymphatic sac is more important than its expression in the cochlea and the vestibular labyrinth. Here, we determined the Na+ and K⁺ concentrations in the cochlea and the endolymphatic sac with double-barreled ion-selective electrodes and generated a mouse model that restores pendrin expression in the endolymphatic sac while lacking expression in the cochlea and the vestibular labyrinth. High Na⁺ and low K⁺ concentrations were found in the cochlear endolymph during the embryonic stage. A rise of the K⁺ concentration along with a decline of the Na⁺ concentration occurred shortly before birth. The site-specific restoration of pendrin to the endolymphatic sac prevented enlargement and rescued hearing and balance. In conclusion, these data demonstrate that endolymph, in the phase of luminal enlargement during the embryonic development, is a Na⁺-rich fluid that is modified into a K⁺-rich fluid just before birth; restoration of pendrin in the endolymphatic sac is sufficient for developing normal inner ear function. Furthermore, these data suggest enlargement of endolymph volume caused by the loss of Slc26a4 is a consequence of disrupted Na⁺ absorption. Moreover, pharmacological strategies that correct fluid transport, as well as spatially and temporally limited restorations of pendrin, might restore normal inner ear functions in humans carrying mutations of SLC26A4.

Pendrin is an anion transporter that is expressed in several organs. In the thyroid gland, pendrin is localized at the apical pole of thyrocytes and it is responsible for the iodide efflux from thyrocytes into the colloid in the follicular lumen where iodide is organificated. The extrathyroidal expression was shown in the inner ear, kidney, placenta and mammary gland. Carriers of mutations in the pendrin gene (PDS, SLC26A4) display variable phenotypical features following the autosomal recessive manner of the inheritance: combined thyroid and hearing affection (Pendred syndrome - OMIM274600), nonsyndromic autosomal recessive neurosensory deafness (DFNB4 - OMIM600791) or isolated enlarged vestibular aqueduct (EVA - OMIM603545). The thyroid affection is usually manifested as euthyroid or hypothyroid goitre in the second decade of life. In a minority of patients, dyshormonogenesis is present at birth, and the disease is diagnosed in the frame of the nation-wide neonatal screening for congenital hypothyroidism.

Pendrina é um transportador de ânions inserido na membrana apical de células foliculares. Estudos subseqüentes demonstraram que a proteína pode mediar o efluxo apical do iodeto nos tirócitos. Sendo o iodo fundamental para a síntese de hormônios tiroidianos foi objetivo deste estudo avaliar o efeito da administração aguda de iodo na expressão do mRNA da proteína pendrina, em curtos períodos de tempo (30min à 24h).Ratos Wistar foram divididos em: controle e iodo, que receberam injeção de salina ou NaI, sendo decapitados após 30, 1 e 24h dessa administração.O RNA da tiróide foi extraído para a análise da expressão do mRNA da Pendrina por Real Time PCR e Northern Blot. Para o estudo in vitro utilizou-se a linhagem celular de tiróide de rato PCCl3, que foi tratada ou não com 10-3M de NaI. As células permaneceram sob tratamento por 30´, 1 e 24h, quando então o RNA foi extraído para análise da expressão por Real Time PCR.Houve aumento significativo do mRNA da Pendrina em todos os grupos, indicando que mecanismos foram desencadeados visando o efluxo do iodeto da célula. / Pendrin is a chloride/iodide exchange located at the apical membrane of thyrocytes. Mutations in its gene lead to a defect in iodide organification. This suggested that pendrin could function as an apical iodide transporter in this cells. Since iodine is essential for thyroid hormone synthesis, this study attempted to investigate that possibility by evaluating whether the acute iodide administration, from 30min up to 24h, could regulate the Pendrin mRNA expression. Rats received NaI or saline, and were sacrificed 30´, 1 and 24h later.Thyroid total RNA was extracted and Pendrin mRNA content was evaluated by Northern Blotting and Real-Time PCR. For in vitro study,PCCl3 rat thyroid cells were cultured and treated or no with 103M NaI. After 30´, 1 and 24h, the cells were harvested and total RNA was extracted. The mRNA content was evaluated by Real-Time PCR. The mRNA increased in all groups of study, indicating that excess of iodide leads to an activation of Pendrin gene transcription and as consequence increased efflux of this element.

Pendrina é um transportador de iodo na tiróide, codificada pelo gene PDS.Sabendo-se que o iodo é fundamental para a síntese de T3 e T4 foi objetivo avaliar o efeito do iodo na expressão gênica, atividade e promotor da pendrina. Foram utilizados ratos Wistar, que receberam injeção de salina ou 2mg de NaI. Após 30, 1, 24 e 48h as tiróides foram removidas para análise do mRNA e proteína, por PCR em Tempo Real e Western Blot. Ainda, utilizou-se celulas PCCl3, que foram tratadas ou não com 10-3M de NaI. Após 30, 1, 24 e 48h o RNA/proteína foram isolados.Determinou-se o efluxo pela medição do125I presente no meio de cultura. Para analisar a atividade do promotor, ele foi inserido no vetor pGL3-básico.Nossos resultados mostram que houve aumento do mRNA da pendrina em resposta ao iodo em todos os tempos estudados, porém não houve aumento da atividade promotora.A expressão da proteína pendrina, bem como taxa do efluxo de iodeto, aumentou nos tempos mais longos de tratamento.Esses dados apontam um importante papel de pendrina para o fenômeno de autoregulação da tiróide. / Pendrin is an iodide transporter in thyroid, encoded by the PDS gene. Since iodide is essential for the synthesis of T3 and T4, this study aimed to evaluate the iodine effect on pendrin gene expression and on the activity of its promoter. Male rats received an injection of saline or 2mg of NaI. After 30, 1, 24 and 48h the thyroids were removed for mRNA and protein analysis by Real Time PCR and Western Blot. Moreover, PCCl3 cells were treated or not with 10-3M NaI. After 30, 1, 24 and 48h the RNA/protein were isolated. The efflux was determined by measure of 125I in the culture medium. For the promoter analysis, it was inserted in pGL3-basic plasmid. The results indicated that the pendrin mRNA amount increased after iodide treatment. However, the promoter activity was unchanged. The protein expression and iodide efflux increased only after 24h of treatment. These data suggest an important role of pendrin for the autoregulation of the thyroid.

Pendrina é um transportador de iodo na tiróide, codificada pelo gene PDS.Sabendo-se que o iodo é fundamental para a síntese de T3 e T4 foi objetivo avaliar o efeito do iodo na expressão gênica, atividade e promotor da pendrina. Foram utilizados ratos Wistar, que receberam injeção de salina ou 2mg de NaI. Após 30, 1, 24 e 48h as tiróides foram removidas para análise do mRNA e proteína, por PCR em Tempo Real e Western Blot. Ainda, utilizou-se celulas PCCl3, que foram tratadas ou não com 10-3M de NaI. Após 30, 1, 24 e 48h o RNA/proteína foram isolados.Determinou-se o efluxo pela medição do125I presente no meio de cultura. Para analisar a atividade do promotor, ele foi inserido no vetor pGL3-básico.Nossos resultados mostram que houve aumento do mRNA da pendrina em resposta ao iodo em todos os tempos estudados, porém não houve aumento da atividade promotora.A expressão da proteína pendrina, bem como taxa do efluxo de iodeto, aumentou nos tempos mais longos de tratamento.Esses dados apontam um importante papel de pendrina para o fenômeno de autoregulação da tiróide. / Pendrin is an iodide transporter in thyroid, encoded by the PDS gene. Since iodide is essential for the synthesis of T3 and T4, this study aimed to evaluate the iodine effect on pendrin gene expression and on the activity of its promoter. Male rats received an injection of saline or 2mg of NaI. After 30, 1, 24 and 48h the thyroids were removed for mRNA and protein analysis by Real Time PCR and Western Blot. Moreover, PCCl3 cells were treated or not with 10-3M NaI. After 30, 1, 24 and 48h the RNA/protein were isolated. The efflux was determined by measure of 125I in the culture medium. For the promoter analysis, it was inserted in pGL3-basic plasmid. The results indicated that the pendrin mRNA amount increased after iodide treatment. However, the promoter activity was unchanged. The protein expression and iodide efflux increased only after 24h of treatment. These data suggest an important role of pendrin for the autoregulation of the thyroid.

Pendrina é um transportador de ânions inserido na membrana apical de células foliculares. Estudos subseqüentes demonstraram que a proteína pode mediar o efluxo apical do iodeto nos tirócitos. Sendo o iodo fundamental para a síntese de hormônios tiroidianos foi objetivo deste estudo avaliar o efeito da administração aguda de iodo na expressão do mRNA da proteína pendrina, em curtos períodos de tempo (30min à 24h).Ratos Wistar foram divididos em: controle e iodo, que receberam injeção de salina ou NaI, sendo decapitados após 30, 1 e 24h dessa administração.O RNA da tiróide foi extraído para a análise da expressão do mRNA da Pendrina por Real Time PCR e Northern Blot. Para o estudo in vitro utilizou-se a linhagem celular de tiróide de rato PCCl3, que foi tratada ou não com 10-3M de NaI. As células permaneceram sob tratamento por 30´, 1 e 24h, quando então o RNA foi extraído para análise da expressão por Real Time PCR.Houve aumento significativo do mRNA da Pendrina em todos os grupos, indicando que mecanismos foram desencadeados visando o efluxo do iodeto da célula. / Pendrin is a chloride/iodide exchange located at the apical membrane of thyrocytes. Mutations in its gene lead to a defect in iodide organification. This suggested that pendrin could function as an apical iodide transporter in this cells. Since iodine is essential for thyroid hormone synthesis, this study attempted to investigate that possibility by evaluating whether the acute iodide administration, from 30min up to 24h, could regulate the Pendrin mRNA expression. Rats received NaI or saline, and were sacrificed 30´, 1 and 24h later.Thyroid total RNA was extracted and Pendrin mRNA content was evaluated by Northern Blotting and Real-Time PCR. For in vitro study,PCCl3 rat thyroid cells were cultured and treated or no with 103M NaI. After 30´, 1 and 24h, the cells were harvested and total RNA was extracted. The mRNA content was evaluated by Real-Time PCR. The mRNA increased in all groups of study, indicating that excess of iodide leads to an activation of Pendrin gene transcription and as consequence increased efflux of this element.

La mucoviscidose est la maladie génétique autosomique récessive létale la plus fréquente dans la population caucasienne. Le gène muté code pour la protéine CFTR (Cystic Fibrosis Transmembrane conductance Regulator). CFTR est un canal anionique localisé dans la membrane apicale des épithélia. Il permet notamment le transport d’ions chlorure (Cl-) et bicarbonates (HCO3-). La délétion de la phénylalanine en position 508 (F508del) de CFTR est la mutation la plus fréquente et entraîne un défaut d’adressage de CFTR à la membrane plasmique. L’atteinte respiratoire réalise une bronchopathie obstructive surinfectée qui détermine le pronostic vital de la maladie. Deux mécanismes délétères présents dès la période néonatale vont notamment contribuer à la destruction du tissu pulmonaire : une inflammation exacerbée et auto-entretenue, et une colonisation bactérienne chronique du mucus notamment à Pseudomonas aerugonisa et Staphylococcus aureus. Les mécanismes à l’origine de l'initiation de ce double processus demeurent inconnus. De plus en plus d'arguments plaident pour l'implication des ions HCO3-, donc du pH, dans l'initiation de l'atteinte pulmonaire de la mucoviscidose. En effet, le défaut de CFTR entraîne une diminution de leur sécrétion dans le liquide de surface bronchique (ou Airway Surface Liquid : ASL), ce qui conduit à un pH local anormalement bas. Les ions HCO3- jouent un rôle important dans la physiopathologie bronchique pulmonaire. En effet, ils régulent la rhéologie du mucus et sont impliqués dans l’activité des peptides antimicrobiens, principaux facteurs de la bactéricidie locale et dont l'activité est pH dépendante. Cela a été démontré dans un modèle porcin de mucoviscidose. Ainsi une altération du transport de HCO3- pourrait contribuer à l'hyperviscosité des sécrétions muqueuses, initier la colonisation bactérienne en diminuant le pouvoir bactéricide du liquide de surface respiratoire. Cette hypothèse est la base de mon projet visant à étudier le rôle du transport transépithélial des ions bicarbonates dans la bactéricidie au sein de l’épithélium respiratoire dans la mucoviscidose. La mesure du pH de l’ASL a nécessité la conception d’une enceinte à atmosphère contrôlée. Cet outil a permis la mise en évidence d’une acidité de l’ASL F508del en comparaison du Wild Type (WT), due à un défaut de sécrétion des ions HCO3- dans l’ASL, lui-même induit par une inhibition fonctionnelle du transporteur Cl-/HCO3- SLC26A4 ou pendrine majoritairement et du canal CFTR minoritairement. L’évaluation de la bactéricidie de l’ASL après infection au Staphylococcus aureus révèle une déficience de bactéricidie chez les cellules épithéliales F508del, reliée à l’activité anormale de la pendrine. L’investigation des capacités d’adhésion et d’invasion du Staphylococcus aureus dans nos modèles montre que le défaut de bactéricidie épithélial observé se restreint à l’ASL et incite à poursuivre les recherches sur le rôle du pH de l’ASL dans l’activité de ses peptides antimicrobiens, principale ligne de défense de l’immunité innée respiratoire. Notre travail de restauration du pH de l’ASL avant infection de l’épithélium respiratoire démontre d’ores et déjà l’impact significatif du pH de l’ASL dans la modulation de sa bactéricidie, où la restauration du pH est corrélée à une amélioration de la bactéricidie. Ce travail met en lumière le rôle crucial du pH de l’ASL dans l’appréhension de la physiopathologie de la maladie et sensibilise à de nouvelles voies thérapeutiques, basées sur une restauration du pH de l’ASL et/ou l’utilisation de peptides antimicrobiens pH-indépendant. / Cystic fibrosis (CF) is a lethal autosomal recessive disorder caused by mutations in the CF Transmembrane Conductance Regulator (CFTR) gene encoding for a cAMP-activated anionic channel, secreting mainly chloride (Cl-) and bicarbonate (HCO3-) at the apical surface of the epithelia. Most patients are homozygous for the p.PHe508del mutation (F508del). The main cause of morbidity and mortality is obstructive lung disease characterized by exacerbated inflammation and bacterial infection of the airway surface liquid (ASL), a thin layer coating the luminal face of the airway epithelium. ASL bacterial colonization begins from the first hours of life with evidence of Staphylococcus aureus in airway secretions pointing to impaired local defense. However, the defect responsible for this defective bacterial clearance is not clearly understood. It was proposed to be related to decreased mucociliary clearance and abnormal inflammatory responses, but recent studies also show the contribution of ASL in the reduced antimicrobial capacity of ASL in CF airways. An abnormally low ASL pH impairs mucin hydration and solubilization, resulting in hyperviscous mucus, which impedes muco-ciliary clearance. It also reduces the activity of antimicrobial peptides by modulating their native charges and the bactericidal activity of antibiotics. This was supported by studies in newborn CF pigs, which highlighted an abnormally low ASL pH, in association with a defective short-term S. aureus antimicrobial activity. Restoring normal pH in the ASL of CF pigs improved ability to eradicate the bacteria, showing that reduced ASL pH is central to disease pathogenesis. However, there is still controversy about the value of ASL pH in humans. Very recently, a study in young CF children, based on in vivo measurements, showed similar ASL pH values in children with CF to that in children without CF. The mechanisms underlying the ASL pH homeostasis and in particular the balance between HCO3- and proton (H+) secretion are still not known. Shah et al highlighted the role of persistent H+ secretion by ATP12A concomitant to a CFTR-mediated reduced bicarbonate transport, but recent work overexpressing ATP12A in respiratory cells failed to find any pH modification in physiological conditions. Most importantly, there is no clear understanding of the initial host response, when S. aureus bacteria land on the pristine surface of a newborn airway, with a prolonged time of contact and continuous reseeding from infected mucus plugs. This is however crucial to clarify pathogenesis of this early steps to counteract pro-infectious vicious circle and define optimal therapeutic strategy in newborns. We focused on human airways and hypothesized that S. aureus clearance during the first hours of infection was impaired in human airway CF ASL because of lowered ASL pH. To test this hypothesis, we designed bacterial infection experiments within human airway epithelium to mirror the onset of initial S. aureus infection. We then studied the relationship between local bacterial clearance and ASL pH regulation in WT and F508del homozygous human bronchial epithelial cells, with special emphasis on physiologically relevant HCO3- and H+ transporters.