Prevention of toxin-induced intestinal ion and fluid secretion by a small-molecule CFTR inhibitor

JR Thiagarajah, T Broadbent, E Hsieh, AS Verkman - Gastroenterology, 2004 - Elsevier
JR Thiagarajah, T Broadbent, E Hsieh, AS Verkman
Gastroenterology, 2004Elsevier
Background & Aims: The cystic fibrosis transmembrane conductance regulator (CFTR)
provides an important apical route for Cl− secretion across intestinal epithelia. A
thiazolidinone-type CFTR blocker (CFTRinh-172) reduced cholera toxin-induced fluid
accumulation in mouse intestinal loops. Here, we characterize the efficacy and
pharmacodynamics of CFTRinh-172 in blocking cAMP and cGMP induced Cl−/fluid
secretion in rodent and human intestine. Methods & Results: CFTRinh-172 inhibited cAMP …
Background & Aims
The cystic fibrosis transmembrane conductance regulator (CFTR) provides an important apical route for Cl secretion across intestinal epithelia. A thiazolidinone-type CFTR blocker (CFTRinh-172) reduced cholera toxin-induced fluid accumulation in mouse intestinal loops. Here, we characterize the efficacy and pharmacodynamics of CFTRinh-172 in blocking cAMP and cGMP induced Cl/fluid secretion in rodent and human intestine.
Methods & Results
CFTRinh-172 inhibited cAMP and cGMP agonist induced short-circuit current by >95% in T84 colonic epithelial cells (KI ∼ 3 μmol/L) and in mouse and human intestinal sheets (KI ∼ 9 μmol/L). A single intraperitoneal injection of CFTRinh-172 (200 μg) blocked intestinal fluid secretion in a rat closed-loop model by >90% for cholera toxin and >70% for STa Escherichia coli toxin. In mice, CFTRinh-172 (20 μg) inhibited cholera toxin-induced intestinal fluid secretion by 90% (persistence t1/2 ∼10 hours, KI ∼ 5 μg) and STa toxin by 75% (KI ∼ 10 μg). Tissue distribution and pharmacokinetic studies indicated intestinal CFTRinh-172 accumulation facilitated by enterohepatic circulation. An oral CFTRinh-172 preparation reduced fluid secretion by >90% in a mouse open-loop cholera model.
Conclusions
A small molecule CFTR blocker markedly reduced intestinal ion and fluid secretion caused by cAMP/cGMP-dependent bacterial enterotoxins. CFTR inhibition may thus reduce fluid secretion in infectious secretory diarrheas.
Elsevier