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Niclosamide repurposed for the treatment of inflammatory airway disease
Inês Cabrita, … , Rainer Schreiber, Karl Kunzelmann
Inês Cabrita, … , Rainer Schreiber, Karl Kunzelmann
Published August 8, 2019
Citation Information: JCI Insight. 2019;4(15):e128414. https://doi.org/10.1172/jci.insight.128414.
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Research Article Cell biology

Niclosamide repurposed for the treatment of inflammatory airway disease

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Abstract

Inflammatory airway diseases, such as asthma, cystic fibrosis (CF), and chronic obstructive pulmonary disease (COPD), are characterized by mucus hypersecretion and airway plugging. In both CF and asthma, enhanced expression of the Ca2+-activated Cl– channel TMEM16A is detected in mucus-producing club/goblet cells and airway smooth muscle. TMEM16A contributes to mucus hypersecretion and bronchoconstriction, which are both inhibited by blockers of TMEM16A, such as niflumic acid. Here we demonstrate that the FDA-approved drug niclosamide, a potent inhibitor of TMEM16A identified by high-throughput screening, is an inhibitor of both TMEM16A and TMEM16F. In asthmatic mice, niclosamide reduced mucus production and secretion, as well as bronchoconstriction, and showed additional antiinflammatory effects. Using transgenic asthmatic mice, we found evidence that TMEM16A and TMEM16F are required for normal mucus production/secretion, which may be due to their effects on intracellular Ca2+ signaling. TMEM16A and TMEM16F support exocytic release of mucus and inflammatory mediators, both of which are blocked by niclosamide. Thus, inhibition of mucus and cytokine release, bronchorelaxation, and reported antibacterial effects make niclosamide a potentially suitable drug for the treatment of inflammatory airway diseases, such as CF, asthma, and COPD.

Authors

Inês Cabrita, Roberta Benedetto, Rainer Schreiber, Karl Kunzelmann

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Figure 1

The TMEM16 inhibitor niflumic acid attenuates inflammatory airway disease.

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The TMEM16 inhibitor niflumic acid attenuates inflammatory airway diseas...
(A and B) OVA sensitization induced goblet cell metaplasia as indicated by Alcian blue positivity. Exposure to carbachol (CCH, 25 mg/mL, nebulizer) induced release of mucus and airway contraction (n = 3 mice/8–20 airway sections). Scale bars: 20 μm. Preexposure to the TMEM16A inhibitor niflumic acid (NFA; 0.5 mg/kg/d, intratracheal application for 3 days) strongly attenuated mucus production and CCH-induced airway contraction (A–C). (C) Cross section of airways indicating airway relaxation by NFA (3 mice/8–13 airway sections). (D–F) Whole-cell currents obtained in patch-clamp experiments with HEK293 cells expressing TMEM16A or TMEM16F. Currents were activated by 1 μM ionomycin and inhibited by NFA (20 μM) (n = 5–6 cells). Scale bars: 20 μm. Data are reported as mean ± SEM. #Significant increase compared with control (P < 0.05; unpaired t test); §significant inhibition (P < 0.05; unpaired t test); *significant activation (P < 0.05; paired t test). IIono, current induced by ionomycin; pA/pF, picoAmper per picoFarad.

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