[HTML][HTML] Acidic pH increases airway surface liquid viscosity in cystic fibrosis

XX Tang, LS Ostedgaard, MJ Hoegger… - The Journal of …, 2016 - Am Soc Clin Investig
XX Tang, LS Ostedgaard, MJ Hoegger, TO Moninger, PH Karp, JD McMenimen…
The Journal of clinical investigation, 2016Am Soc Clin Investig
Cystic fibrosis (CF) disrupts respiratory host defenses, allowing bacterial infection,
inflammation, and mucus accumulation to progressively destroy the lungs. Our previous
studies revealed that mucus with abnormal behavior impaired mucociliary transport in
newborn CF piglets prior to the onset of secondary manifestations. To further investigate
mucus abnormalities, here we studied airway surface liquid (ASL) collected from newborn
piglets and ASL on cultured airway epithelia. Fluorescence recovery after photobleaching …
Cystic fibrosis (CF) disrupts respiratory host defenses, allowing bacterial infection, inflammation, and mucus accumulation to progressively destroy the lungs. Our previous studies revealed that mucus with abnormal behavior impaired mucociliary transport in newborn CF piglets prior to the onset of secondary manifestations. To further investigate mucus abnormalities, here we studied airway surface liquid (ASL) collected from newborn piglets and ASL on cultured airway epithelia. Fluorescence recovery after photobleaching revealed that the viscosity of CF ASL was increased relative to that of non-CF ASL. CF ASL had a reduced pH, which was necessary and sufficient for genotype-dependent viscosity differences. The increased viscosity of CF ASL was not explained by pH-independent changes in HCO3 concentration, altered glycosylation, additional pH-induced disulfide bond formation, increased percentage of nonvolatile material, or increased sulfation. Treating acidic ASL with hypertonic saline or heparin largely reversed the increased viscosity, suggesting that acidic pH influences mucin electrostatic interactions. These findings link loss of cystic fibrosis transmembrane conductance regulator–dependent alkalinization to abnormal CF ASL. In addition, we found that increasing Ca2+ concentrations elevated ASL viscosity, in part, independently of pH. The results suggest that increasing pH, reducing Ca2+ concentration, and/or altering electrostatic interactions in ASL might benefit early CF.
The Journal of Clinical Investigation