1
|
Konno S, Kudo H. Fundamental Study of a Wristwatch Sweat Lactic Acid Monitor. BIOSENSORS 2024; 14:187. [PMID: 38667180 PMCID: PMC11048019 DOI: 10.3390/bios14040187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
A lactic acid (LA) monitoring system aimed at sweat monitoring was fabricated and tested. The sweat LA monitoring system uses a continuous flow of phosphate buffer saline, instead of chambers or cells, for collecting and storing sweat fluid excreted at the skin surface. To facilitate the use of the sweat LA monitoring system by subjects when exercising, the fluid control system, including the sweat sampling device, was designed to be unaffected by body movements or muscle deformation. An advantage of our system is that the skin surface condition is constantly refreshed by continuous flow. A real sample test was carried out during stationary bike exercise, which showed that LA secretion increased by approximately 10 μg/cm2/min compared to the baseline levels before exercise. The LA levels recovered to baseline levels after exercise due to the effect of continuous flow. This indicates that the wristwatch sweat LA monitor has the potential to enable a detailed understanding of the LA distribution at the skin surface.
Collapse
Affiliation(s)
| | - Hiroyuki Kudo
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Tokyo 214-8571, Kanagawa, Japan
| |
Collapse
|
2
|
Zajac M, Jakiela S, Dolowy K. Understanding Bidirectional Water Transport across Bronchial Epithelial Cell Monolayers: A Microfluidic Approach. MEMBRANES 2023; 13:901. [PMID: 38132905 PMCID: PMC10744786 DOI: 10.3390/membranes13120901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/24/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
Deciphering the dynamics of water transport across bronchial epithelial cell monolayers is pivotal for unraveling respiratory physiology and pathology. In this study, we employ an advanced microfluidic system to explore bidirectional water transport across 16HBE14σ bronchial epithelial cells. Previous experiments unveiled electroneutral multiple ion transport, with chloride ions utilizing transcellular pathways and sodium ions navigating both paracellular and transcellular routes. Unexpectedly, under isoosmotic conditions, rapid bidirectional movement of Na+ and Cl- was observed, leading to the hypothesis of a substantial transport of isoosmotic solution (145 mM NaCl) across cell monolayers. To validate this conjecture, we introduce an innovative microfluidic device, offering a 500-fold sensitivity improvement in quantifying fluid flow. This system enables the direct measurement of minuscule fluid volumes traversing cell monolayers with unprecedented precision. Our results challenge conventional models, indicating a self-regulating mechanism governing water transport that involves the CFTR channel and anion exchangers. In healthy subjects, equilibrium is achieved at an apical potential of Δφap = -30 mV, while subjects with cystic fibrosis exhibit modulation by an anion exchanger, reaching equilibrium at [Cl] = 67 mM in the airway surface liquid. This nuanced electrochemical basis for bidirectional water transport in bronchial epithelia sheds light on physiological intricacies and introduces a novel perspective for understanding respiratory conditions.
Collapse
Affiliation(s)
- Miroslaw Zajac
- Department of Physics and Biophysics, Institute of Biology, Warsaw University of Life Sciences, 02-776 Warsaw, Poland;
| | | | - Krzysztof Dolowy
- Department of Physics and Biophysics, Institute of Biology, Warsaw University of Life Sciences, 02-776 Warsaw, Poland;
| |
Collapse
|
3
|
Zampoli M, Verstraete J, Nguyen-Khoa T, Sermet-Gaudelus I, Zar HJ, Gonska T, Morrow BM. β-adrenergic sweat test in children with inconclusive cystic fibrosis diagnosis: Do we need new reference ranges? Pediatr Pulmonol 2023; 58:187-196. [PMID: 36193559 PMCID: PMC10092537 DOI: 10.1002/ppul.26179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/18/2022] [Accepted: 10/02/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Investigating inconclusive cystic fibrosis (CF) diagnosis in children is difficult without advanced cystic fibrosis transmembrane conductance regulator (CFTR) function tests. This study investigated the utility of beta (β)-adrenergic sweat test to exclude CF in participants with inconclusive diagnosis (CF suspects) in South Africa. METHODS β-adrenergic sweat test and sweat chloride tests (SCT) were performed simultaneously in CF suspects and adult controls (healthy, CFTR heterozygotes and CF). Cholinergic and β-adrenergic induced sweat rate was measured by evaporimetry (transepithelial water loss [TEWL]: g H2 O/m2 /h) following intradermal injections. Next-generation sequencing of CFTR was performed in CF suspects. CF diagnosis was defined by genotype. RESULTS Thirty-seven controls (10 healthy, 14 CF, 13 CFTR heterozygotes) and 32 CF suspects (26 children; 6 adults) were enrolled. Six were excluded from formal analyses due to β-adrenergic sweat test failure. In adults, evaporimetry was superior to SCT for diagnosis of CF with β-adrenergic:cholinergic ratio TEWL ≤ 0.05 achieving 100% sensitivity and specificity. Twenty-two CF suspect children (age range: 3.4-15.6 years) completed β-adrenergic sweat testing of which none had CF confirmed by genotyping: β-adrenergic:cholinergic ratio > 0.05 successfully excluded CF in all but one child who was CFTR heterozygous. Median peak β-adrenergic TEWL and β-adrenergic:cholinergic ratio in CFTR negative and CFTR heterozygous children was significantly lower than adult controls. CONCLUSION β-adrenergic sweat test is more accurate than SCT for excluding CF in children with inconclusive diagnosis. Established reference ranges for β-adrenergic sweat test may not be suitable for children due to lower β-adrenergic sweat secretion compared to adults.
Collapse
Affiliation(s)
- Marco Zampoli
- Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa.,South African MRC Unit for Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Janine Verstraete
- Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Thao Nguyen-Khoa
- Laboratories of Biochemistry and Newborn screening, Necker-Enfants Malades Hospital Assistance Publique-Hôpitaux de Paris, Paris, France.,Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées. Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France.,Institut National de la Santé et de la Recherche Médicale U1151, Institut Necker Enfants Malades, Paris, France
| | - Isabelle Sermet-Gaudelus
- Centre de Référence Maladies Rares Mucoviscidose et Maladies apparentées. Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France.,Institut National de la Santé et de la Recherche Médicale U1151, Institut Necker Enfants Malades, Paris, France.,European Respiratory Network for Rare Diseases of the Lung
| | - Heather J Zar
- Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa.,South African MRC Unit for Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Tanja Gonska
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Toronto, and The Program of Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brenda M Morrow
- Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
4
|
Cystic fibrosis in low and middle-income countries (LMIC): A view from four different regions of the world. Paediatr Respir Rev 2021; 38:37-44. [PMID: 32826173 DOI: 10.1016/j.prrv.2020.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 01/23/2023]
Abstract
Cystic fibrosis (CF) has been shown to affect people all over the world. While life expectancy for people with CF has increased substantially, CF is still associated with death in infants and young children in many regions, particularly in low and middle-income countries (LMIC). These countries face significant challenges to promote CF diagnosis and improvements to CF care due to financial constraints and a significant burden of other diseases. In this review, we describe the status of CF diagnosis and care in different LMIC settings, from four different parts of the world (Brazil, South Africa, Israel and India). We highlight challenges and opportunities for CF practitioners in LMIC to improve CF care and outcomes. While early CF diagnosis is the key to optimising outcomes, newborn screening may not be feasible for countries with lower CF incidence and higher birth rates, such as India or South Africa. CF therapies and care in LMIC need to be adapted to available resources of these countries. Collaboration initiatives of the global CF community with LMIC may improve CF care in these countries. Most individuals with CF in LMIC are not benefiting from CFTR modulator treatments due to the prohibitive cost of these drugs.
Collapse
|
5
|
Lin PH, Chang WL, Sheu SC, Li BR. A Noninvasive Wearable Device for Real-Time Monitoring of Secretion Sweat Pressure by Digital Display. iScience 2020; 23:101658. [PMID: 33117969 PMCID: PMC7582050 DOI: 10.1016/j.isci.2020.101658] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/11/2020] [Accepted: 10/04/2020] [Indexed: 02/07/2023] Open
Abstract
Sweat-based wearable devices have attracted increasing attention by providing abundant physiological information and continuous measurement through noninvasive healthcare monitoring. Sweat pressure generated via sweat glands to the skin surface associated with osmotic effects may help to elucidate such parameters as physiological conditions and psychological factors. This study introduces a wearable device for measuring secretion sweat pressure through noninvasive, continuous monitoring. Secretion pressure is detected by a microfluidic chip that shows the resistance variance from a paired electrode pattern and transfers digital signals to a smartphone for real-time display. A human study demonstrates this measurement with different exercise activities, showing the pressure ranges from 1.3 to 2.5 kPa. This device is user-friendly and applicable to exercise training and personal health care. The convenience and easy-to-wear characteristics of this device may establish a foundation for future research investigating sweat physiology and personal health care.
Collapse
Affiliation(s)
- Pei-Heng Lin
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
- Department of Electrical and Computer Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Wei-Lun Chang
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Sian-Chen Sheu
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Bor-Ran Li
- Institute of Biomedical Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
- Department of Electrical and Computer Engineering, College of Electrical and Computer Engineering, National Chiao Tung University, Hsinchu, Taiwan
- Center for Emergent Functional Matter Science, National Chiao Tung University, Hsinchu, Taiwan
| |
Collapse
|
6
|
Kabir AL, Roy S, Habib RB, Anwar KS, Mollah MAH, Amin R, Mridha AA, Majumder JU, Hossain MD, Haque N, Ahmed S, Chisti MJ. Cystic Fibrosis Diagnosed Using Indigenously Wrapped Sweating Technique: First Large-Scale Study Reporting Socio-Demographic, Clinical, and Laboratory Features among the Children in Bangladesh A Lower Middle Income Country. Glob Pediatr Health 2020; 7:2333794X20967585. [PMID: 33195743 PMCID: PMC7607759 DOI: 10.1177/2333794x20967585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/21/2020] [Accepted: 09/29/2020] [Indexed: 11/23/2022] Open
Abstract
Due to lack of robust data on childhood cystic fibrosis (CF) in Bangladesh we sought to evaluate their clinico-epidemiology. A cross-sectional observation was conducted adopting CF-foundation consensus-panel-diagnostic criteria in 3 tertiary-care-hospitals in Bangladesh from 2000 to 2017. Clinically suspected 95 CF-cases were subjected to sweat-chloride testing using locally-developed a fast, cheap and effective indigenously body-wrapped sweating technique measured by US-Easy Lyte-automated microprocessor-controlled analyzer marking ≥60 mmol/L as positive. Mean-age of CF-cases at disease-onset was 16.9 ± 26.6 months that significantly differed with age-at-diagnosis (P < .02). Pulmonary syndromes included chronic wet cough in 100%, respiratory distress in 90.5%, digital-clubbing in 78%, mucopurulent-sputum in 74%-cases, and crepitation in 82%. Radio-imaging revealed bronchiectasis in 60%, hyperinflation/peribronchial-thickening in 22% and, pan-sinusitis in 89%-cases. While 37% had history-of malabsorption, high-fecal-fat revealed in 53%-cases. Malnutrition prevailed as severe-underweight in 87%-cases and all CF-cases (100%) had high sweat-chloride (mean = 118 ± 53.34 mmol/L). Thus, children with pulmonary features coupled with severe malnutrition and associated radio-imaging bronchiectasis should be screened for CF with a fast, cheap and effective sweat test in resource poor settings.
Collapse
Affiliation(s)
| | - Sudipta Roy
- Ad-din Women's Medical College Hospital, Dhaka, Bangladesh
| | | | | | | | - Ruhul Amin
- Institute of Child Health (BICH), Dhaka, Bangladesh
| | | | | | | | | | - Shakil Ahmed
- Shaheed Shuhrawardy Medical College, Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
7
|
Cystic Fibrosis: A Simple and Customized Strategy for Genetic Screening Able to Detect Over 90% of Identified Mutated Alleles in Brazilian Newborns. Mol Diagn Ther 2020; 24:315-325. [PMID: 32185651 DOI: 10.1007/s40291-020-00456-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The incorporation of molecular genetic testing into cystic fibrosis (CF) screening programs increases the specificity of the diagnostic strategy and has the potential to decrease the rate of false- positive results. In this sense, our objective was to develop a genotyping assay that could detect 25 pathogenic variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene with high sensitivity and that could be incorporated into the routine of newborn screening, complementing the current existing protocol used in our public health institution. METHODS A mini-sequencing assay was standardized using single-base extension in a previously genotyped control sample. This strategy was validated in a Brazilian cohort of CF patients by Sanger sequencing. RESULTS The inclusion of the 25 variants in the current newborn screening program increased the identification rates of two alleles from 33 to 52.43% in CF patients. This new approach was able to detect a total of 37 variants, which represents 93.01% of all mutated alleles described in the last CF Brazilian Register. CONCLUSIONS Mini-sequencing for the simultaneous detection of 25 CFTR gene variants improves the screening of Brazilian newborns and decreases the number of inconclusive cases. This method uses minimal hands-on time and is suited for rapid screening, which reduces sample processing costs.
Collapse
|
8
|
Awatade NT, Wong SL, Hewson CK, Fawcett LK, Kicic A, Jaffe A, Waters SA. Human Primary Epithelial Cell Models: Promising Tools in the Era of Cystic Fibrosis Personalized Medicine. Front Pharmacol 2018; 9:1429. [PMID: 30581387 PMCID: PMC6293199 DOI: 10.3389/fphar.2018.01429] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/19/2018] [Indexed: 12/29/2022] Open
Abstract
Cystic fibrosis (CF) is an inherited disorder where individual disease etiology and response to therapeutic intervention is impacted by CF transmembrane regulator (CFTR) mutations and other genetic modifiers. CFTR regulates multiple mechanisms in a diverse range of epithelial tissues. In this Review, we consolidate the latest updates in the development of primary epithelial cellular model systems relevant for CF. We discuss conventional two-dimensional (2-D) airway epithelial cell cultures, the backbone of in vitro cellular models to date, as well as improved expansion protocols to overcome finite supply of the cellular source. We highlight a range of strategies for establishment of three dimensional (3-D) airway and intestinal organoid models and evaluate the limitations and potential improvements in each system, focusing on their application in CF. The in vitro CFTR functional assays in patient-derived organoids allow for preclinical pharmacotherapy screening to identify responsive patients. It is likely that organoids will be an invaluable preclinical tool to unravel disease mechanisms, design novel treatments, and enable clinicians to provide personalized management for patients with CF.
Collapse
Affiliation(s)
- Nikhil T. Awatade
- Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Molecular and Integrative Cystic Fibrosis Research Centre (miCF_RC), School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Sharon L. Wong
- Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Molecular and Integrative Cystic Fibrosis Research Centre (miCF_RC), School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Chris K. Hewson
- Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Molecular and Integrative Cystic Fibrosis Research Centre (miCF_RC), School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Laura K. Fawcett
- Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Molecular and Integrative Cystic Fibrosis Research Centre (miCF_RC), School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Anthony Kicic
- Centre for Child Health Research, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia
- Occupation and Environment, School of Public Health, Curtin University, Bentley, WA, Australia
- Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, WA, Australia
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, WA, Australia
- Centre for Cell Therapy and Regenerative Medicine, School of Medicine and Pharmacology, The University of Western Australia, Nedlands, WA, Australia
| | - Adam Jaffe
- Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Molecular and Integrative Cystic Fibrosis Research Centre (miCF_RC), School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Shafagh A. Waters
- Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- Molecular and Integrative Cystic Fibrosis Research Centre (miCF_RC), School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
9
|
Gomez CCS, Marson FAL, Servidoni MF, Ribeiro AF, Ribeiro MÂGO, Gama VAL, Costa ET, Ribeiro JD, Vieira Junior FU. Evaluation of continuous constant current and continuous pulsed current in sweat induction for cystic fibrosis diagnosis. BMC Pulm Med 2018; 18:153. [PMID: 30217179 PMCID: PMC6137935 DOI: 10.1186/s12890-018-0696-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
Background The sweat test (ST) is the gold standard for the diagnosis of cystic fibrosis (CF). However, little is known about sweat induction using different types of currents and waves. In this context, our objective was to develop a device to induce sweat and compare the use of continuous constant current (CCC) and continuous pulsed current (CPC) in individuals with CF and healthy controls. Methods A prospective cross-sectional study with experimental intervention. The variables of gender, ethnicity, age, and body mass index (BMI) were considered. The method of Gibson and Cooke was used, and the following markers were evaluated: sweat weight, electrical impedance, sufficient sweat amount, and CF diagnosis. Triangular (TPC) or sinusoidal (SPC) pulsed current was applied to the right arm, and CCC was applied to the left arm. Results The study analyzed 260 individuals, 141/213 (54.2%) were female participants, 135/260 (51.9%) were Caucasians. The distribution of individuals by concentration of chloride at the ST was: (CF) 26/260 (10%); (borderlines) 109/260 (41.9%); (healthy) 97/260 (37.3%); (insufficient weight in sweat) 28/260 (10.8%). No association was observed between the sufficient sweat amount to perform the ST when we compared the currents. However, the SPC showed a higher amount of sweat weight. Using Bland and Altman plot considering the agreement between the sweat chloride values achieved from CPC [SPC and TPC] and CCC, there was no proportional bias and mean values are unrelated and only explain less than 8% of the variation. Moreover, TPC presented higher electrical impedance when compared with SPC and CCC. SPC presented lower electrical impedance and higher sweat weight than CCC. Male participants presented lower electrical impedance and higher sweat weight with CCC and TPC, and higher sweat weight with SPC. Conclusions The evaluated currents are safe and able to induce and produce sweat in sufficient quantities for the ST. SPC presented lower electrical impedance when compared with other currents. The use of SPC is recommended to induce sweat in patients with sweat problems. Finally, ethnicity, gender, age and BMI did not influence sweat induction at the ST, and no side effect was observed in our study. Electronic supplementary material The online version of this article (10.1186/s12890-018-0696-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Carla Cristina Souza Gomez
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil. .,Center for Research in Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil.
| | - Fernando Augusto Lima Marson
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil. .,Center for Research in Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil. .,Department of Medical Genetics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil.
| | - Maria Fátima Servidoni
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil.,Center for Research in Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil.,Gastrocentro - Endoscopy Unit, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-872, Brazil
| | - Antônio Fernando Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil.,Center for Research in Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil
| | - Maria Ângela Gonçalves Oliveira Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil.,Center for Research in Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil
| | - Veruska Acioli Lopes Gama
- Center for Biomedical Engineering, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-970, Brazil.,Department of Biomedical Engineering, Faculty of Electrical and Computer Engineering, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-881, Brazil.,Federal Institute of Education, Science and Technology of Sao Paulo, Campus Campinas, km 143.5, Campinas, São Paulo, 13069-901, Brazil
| | - Eduardo Tavares Costa
- Center for Biomedical Engineering, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-970, Brazil.,Department of Biomedical Engineering, Faculty of Electrical and Computer Engineering, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-881, Brazil
| | - José Dirceu Ribeiro
- Department of Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil.,Center for Research in Pediatrics, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-887, Brazil
| | - Francisco Ubaldo Vieira Junior
- Center for Biomedical Engineering, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-970, Brazil.,Department of Biomedical Engineering, Faculty of Electrical and Computer Engineering, University of Campinas, Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo, 13083-881, Brazil.,Federal Institute of Education, Science and Technology of Sao Paulo, Campus Campinas, km 143.5, Campinas, São Paulo, 13069-901, Brazil
| |
Collapse
|
10
|
Salvatore M, Floridia G, Amato A, Censi F, Carta C, de Stefano MC, Ferrari G, Tosto F, Capoluongo E, Caruso U, Castaldo G, Cirilli N, Corbetta C, Padoan R, Raia V, Taruscio D. The Italian pilot external quality assessment program for cystic fibrosis sweat test. Clin Biochem 2016; 49:601-5. [DOI: 10.1016/j.clinbiochem.2015.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/17/2015] [Accepted: 12/07/2015] [Indexed: 11/26/2022]
|
11
|
Sad IR, Higa LYS, Leal T, Martins RDS, de Almeida AC, Ramos EG, de Cabello GMK, Peixoto MVM. Repeatability and Diagnostic Value of Nasal Potential Difference in a Genetically Admixed Population. J Clin Med Res 2015; 8:15-24. [PMID: 26668678 PMCID: PMC4676341 DOI: 10.14740/jocmr2312w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The genetic diversity of the Brazilian population results from three ethnic groups admixture: Europeans, Africans and Amerindians, thus increasing the difficulty of performing cystic fibrosis (CF) diagnosis. The nasal potential difference (NPD) evaluates the cystic fibrosis transmembrane conductance regulator (CFTR) and epithelial sodium channel (ENaC) activity. Despite being a useful CF diagnostic test and a biomarker of CFTR-modulator drugs, it is also highly operator dependent. Therefore, it may be difficult to get accurate results and to interpret them. Wilschanski and Sermet scores were proposed to address these issues. This study aimed to evaluate repeatability and diagnostic value of NPD parameters and Wilschanski and Sermet scores in a CF center in Rio de Janeiro. METHODS NPD was performed in 78 subjects. Maximal PD, amiloride response, total chloride response, and Wilschanski and Sermet scores were explored as means (confidence interval, CI). One-way ANOVA was used to compare mean differences and Scheffe test was used to pair-wise comparisons. Repeatability was evaluated by scatter and Bland-Altman plots. The Ethics Committee of the CF Center has approved the study protocol. Parents and adult participants signed an informed consent form. RESULTS Forty-eight healthy-volunteers, 19 non-CF and 11 CF patients were enrolled in this study. Significant differences were found when comparing CF patients' NPD parameters to the other two groups (P = 0.000). Moreover, no significant differences were found when parameters from non-CF patients were compared with those from healthy volunteers (P > 0.05). The means of NPD parameters and diagnostic scores of each group were in concordance with disease/non-disease conditions. The repeatability data - Wilschanski and Sermet and NPD - allow NPD to be performed in this Brazilian CF Center. CONCLUSIONS The present study gathered consistent data for Bland-Altman plots. The results of Wilschanski and Sermet diagnostic scores suggest that they were concordant with CF/non-CF conditions. More NPD tests should be performed in the Rio de Janeiro CF dynamic cohort to contribute to international NPD validation studies and to provide NPD as a biomarker in Brazil.
Collapse
Affiliation(s)
- Izabela Rocha Sad
- Pediatric Pulmonology, Pediatric Department, Fernandes Figueira National Institute of Woman, Child and Adolescent Health, Oswaldo Cruz Foundation/FIOCRUZ, Rio de Janeiro, Brazil
| | - Laurinda Yoko Shinzato Higa
- Pediatric Pulmonology, Pediatric Department, Fernandes Figueira National Institute of Woman, Child and Adolescent Health, Oswaldo Cruz Foundation/FIOCRUZ, Rio de Janeiro, Brazil
| | - Teresinha Leal
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Experimentale et Clinique (IREC) Universite Catholique de Louvain, Brussels, Belgium
| | - Raisa da Silva Martins
- Pediatric Pulmonology, Pediatric Department, Fernandes Figueira National Institute of Woman, Child and Adolescent Health, Oswaldo Cruz Foundation/FIOCRUZ, Rio de Janeiro, Brazil
| | - Ana Claudia de Almeida
- Laboratory of Quantitative Methods, Fernandes Figueira National Institute of Woman, Child and Adolescent Health, Oswaldo Cruz Foundation/FIOCRUZ, Rio de Janeiro, Brazil
| | - Eloane Goncalves Ramos
- Clinical Research Unit, Fernandes Figueira National Institute of Woman, Child and Adolescent Health, Oswaldo Cruz Foundation/FIOCRUZ, Rio de Janeiro, Brazil
| | - Giselda Maria Kalil de Cabello
- Laboratory of Human Genetics, Oswaldo Cruz Institute, Oswaldo Cruz Foundation/FIOCRUZ, Pavilhao Leonidas Deane, sala 611, Rio de Janeiro, Brazil
| | - Maria Virginia Marques Peixoto
- Laboratory of Quantitative Methods, Fernandes Figueira National Institute of Woman, Child and Adolescent Health, Oswaldo Cruz Foundation/FIOCRUZ, Rio de Janeiro, Brazil
| |
Collapse
|
12
|
Matzeu G, Fay C, Vaillant A, Coyle S, Diamond D. A Wearable Device for Monitoring Sweat Rates via Image Analysis. IEEE Trans Biomed Eng 2015; 63:1672-80. [PMID: 26394409 DOI: 10.1109/tbme.2015.2477676] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A feasibility study on a new technique capable of monitoring localized sweat rate is explored in this paper. Wearable devices commonly used in clinical practice for sweat sampling (i.e., Macroducts) were positioned on the body of an athlete whose sweat rate was then monitored during cycling sessions. The position at which the sweat fills the Macroduct was indicated by a contrasting marker and captured via a series of time-stamped photos or a video recording of the device during an exercise period. Given that the time of each captured image/frame is known (either through time stamp on photos or the constant frame rate of the video capture), it was, therefore, possible to estimate the sweat flow rate through a simple calibration model. The importance of gathering such valuable information is described, together with the results from a number of exercise trials to investigate the viability of this approach.
Collapse
|
13
|
Gomez CCS, Servidoni MDF, Marson FADL, Canavezi PJC, Vinagre AM, Costa ET, Ribeiro AF, Ribeiro MAGDO, Toro AADC, Pavan CR, Rondon MVSDS, Lorena SLS, Vieria FU, Ribeiro JD. Pulsed direct and constant direct currents in the pilocarpine iontophoresis sweat chloride test. BMC Pulm Med 2014; 14:198. [PMID: 25495771 PMCID: PMC4290820 DOI: 10.1186/1471-2466-14-198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 11/27/2014] [Indexed: 11/17/2022] Open
Abstract
Background The classic sweat test (CST) is the golden standard for cystic fibrosis (CF) diagnosis. Then, our aim was compare the production and volume of sweat, and side effects caused by pulsed direct current (PDC) and constant direct current (CDC). To determine the optimal stimulation time (ST) for the sweat collection. To verify the PDC as CF diagnosis option. Methods Prospective study with cross-sectional experimental intervention. Experiment 1 (right arm): PDC and CDC. ST at 10 min and sweat collected at 30 min. Currents of 0.5; 0.75; 1.0 and 1.5 mA and frequencies of 0, 200, 1,000 and 5,000 Hz applied. Experiment 2 (left arm): current of 1.0 mA, ST at 5 and 10 min and sweat collected at 15 and 30 min with frequencies of 0; 200; 1,000 and 5,000 Hz applied Experiments 1 and 2 were performed with current density (CD) from 0.07 to 0.21 mA/cm2. Experiment 3: PDC was used in typical CF patients with two CFTR mutations screened and or with CF diagnosis by rectal biopsy and patients with atypical CF. Results 48 subjects (79.16% female) with average of 29.54 ± 8.87 years old were enrolled. There was no statistical difference between the interaction of frequency and current in the sweat weight (p = 0.7488). Individually, positive association was achieved between weight sweat and stimulation frequency (p = 0.0088); and current (p = 0.0025). The sweat production was higher for 10 min of stimulation (p = 0.0023). The sweat collection was better for 30 min (p = 0.0019). The skin impedance was not influenced by ST and sweat collection (p > 0.05). The current frequency was inversely associated with the skin impedance (p < 0.0001). The skin temperature measured before stimulation was higher than after (p < 0.0001). In Experiment 3 (29 subjects) the PDC showed better kappa index compared to CDC (0.9218 versus 0.5205, respectively). Conclusions The performance of the CST with CDC and PDC with CD of 0.14 to 0.21 mA/cm2 showed efficacy in steps of stimulation and collection of sweat, without side effects. The optimal stimulation time and sweat collection were, respectively, 10 and 30 min. Electronic supplementary material The online version of this article (doi:10.1186/1471-2466-14-198) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Carla Cristina Souza Gomez
- Departament of Pediatrics, Faculty of Medical Sciences, State University of Campinas, 13083-887 Campinas, SP, Brazil.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Doorn J, Storteboom TTR, Mulder AM, de Jong WHA, Rottier BL, Kema IP. Ion chromatography for the precise analysis of chloride and sodium in sweat for the diagnosis of cystic fibrosis. Ann Clin Biochem 2014; 52:421-7. [PMID: 25128544 DOI: 10.1177/0004563214549642] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Measurement of chloride in sweat is an essential part of the diagnostic algorithm for cystic fibrosis. The lack in sensitivity and reproducibility of current methods led us to develop an ion chromatography/high-performance liquid chromatography (IC/HPLC) method, suitable for the analysis of both chloride and sodium in small volumes of sweat. METHODS Precision, linearity and limit of detection of an in-house developed IC/HPLC method were established. Method comparison between the newly developed IC/HPLC method and the traditional Chlorocounter was performed, and trueness was determined using Passing Bablok method comparison with external quality assurance material (Royal College of Pathologists of Australasia). RESULTS Precision and linearity fulfill criteria as established by UK guidelines are comparable with inductively coupled plasma-mass spectrometry methods. Passing Bablok analysis demonstrated excellent correlation between IC/HPLC measurements and external quality assessment target values, for both chloride and sodium. With a limit of quantitation of 0.95 mmol/L, our method is suitable for the analysis of small amounts of sweat and can thus be used in combination with the Macroduct collection system. CONCLUSIONS Although a chromatographic application results in a somewhat more expensive test compared to a Chlorocounter test, more accurate measurements are achieved. In addition, simultaneous measurements of sodium concentrations will result in better detection of false positives, less test repeating and thus faster and more accurate and effective diagnosis. The described IC/HPLC method, therefore, provides a precise, relatively cheap and easy-to-handle application for the analysis of both chloride and sodium in sweat.
Collapse
Affiliation(s)
- J Doorn
- Department of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - T T R Storteboom
- Department of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - A M Mulder
- Department of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - W H A de Jong
- Department of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - B L Rottier
- Department of Pediatric Pulmonology and Allergy, Beatrix Children's Hospital/University Medical Centre Groningen, GRIAC Research Institute, Groningen, The Netherlands
| | - I P Kema
- Department of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
15
|
The Italian National Centre for Rare Diseases: where research and public health translate into action. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2014; 12 Suppl 3:s591-605. [PMID: 24922300 DOI: 10.2450/2014.0040-14s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
16
|
Williams SN, Nussbaum E, Chin TW, Do PCM, Singh KE, Randhawa I. Diagnosis of cystic fibrosis in the kindred of an infant with CFTR-related metabolic syndrome: importance of follow-up that includes monitoring sweat chloride concentrations over time. Pediatr Pulmonol 2014; 49:E103-8. [PMID: 24535988 DOI: 10.1002/ppul.22918] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 09/16/2013] [Indexed: 11/06/2022]
Abstract
Newly implemented newborn screening (NBS) programs in California have resulted in a large subset of patients in whom at least two cystic fibrosis transmembrane conductance regulator (CFTR) mutations are identified, but subsequent sweat chloride analysis reveals normal or indeterminate values. These patients are diagnosed with CFTR-Related Metabolic Syndrome (CRMS). However, the natural progression and management of these patients are not clearly understood and frequently after the age of 1-year these patients are lost to follow-up with Cystic Fibrosis (CF) Centers. We present the first case of an infant who was referred to Miller Children's Hospital for a NBS positive for CF and subsequent discovery of identical mutations in six of his seven older brothers. Several siblings had positive sweat chloride results on repeat testing after the age of 3 years. We suggest the need for continued follow-up of CRMS in a CF center with diagnostic evaluation including repeat sweat chloride testing, beyond the currently recommended period.
Collapse
Affiliation(s)
- Sophia N Williams
- Pediatric Pulmonology/Allergy/Immunology, Miller Children's Hospital, Long Beach, University of California, Irvine
| | | | | | | | | | | |
Collapse
|
17
|
Stock C, Ludwig FT, Hanley PJ, Schwab A. Roles of ion transport in control of cell motility. Compr Physiol 2013; 3:59-119. [PMID: 23720281 DOI: 10.1002/cphy.c110056] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cell motility is an essential feature of life. It is essential for reproduction, propagation, embryonic development, and healing processes such as wound closure and a successful immune defense. If out of control, cell motility can become life-threatening as, for example, in metastasis or autoimmune diseases. Regardless of whether ciliary/flagellar or amoeboid movement, controlled motility always requires a concerted action of ion channels and transporters, cytoskeletal elements, and signaling cascades. Ion transport across the plasma membrane contributes to cell motility by affecting the membrane potential and voltage-sensitive ion channels, by inducing local volume changes with the help of aquaporins and by modulating cytosolic Ca(2+) and H(+) concentrations. Voltage-sensitive ion channels serve as voltage detectors in electric fields thus enabling galvanotaxis; local swelling facilitates the outgrowth of protrusions at the leading edge while local shrinkage accompanies the retraction of the cell rear; the cytosolic Ca(2+) concentration exerts its main effect on cytoskeletal dynamics via motor proteins such as myosin or dynein; and both, the intracellular and the extracellular H(+) concentration modulate cell migration and adhesion by tuning the activity of enzymes and signaling molecules in the cytosol as well as the activation state of adhesion molecules at the cell surface. In addition to the actual process of ion transport, both, channels and transporters contribute to cell migration by being part of focal adhesion complexes and/or physically interacting with components of the cytoskeleton. The present article provides an overview of how the numerous ion-transport mechanisms contribute to the various modes of cell motility.
Collapse
Affiliation(s)
- Christian Stock
- Institute of Physiology II, University of Münster, Münster, Germany.
| | | | | | | |
Collapse
|
18
|
Screening for cystic fibrosis: what every NP should know. Nurse Pract 2013; 38:24-32; quiz 32-3. [PMID: 23917504 DOI: 10.1097/01.npr.0000433073.84279.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In a chronic childhood disease such as cystic fibrosis, it is important for nurse practitioners to be knowledgeable about the disease process, methods of mutation identification, and diagnostic criteria. Multiple studies have shown improved prognosis for patients diagnosed early.
Collapse
|
19
|
Langfelder-Schwind E, Karczeski B, Strecker MN, Redman J, Sugarman EA, Zaleski C, Brown T, Keiles S, Powers A, Ghate S, Darrah R. Molecular testing for cystic fibrosis carrier status practice guidelines: recommendations of the National Society of Genetic Counselors. J Genet Couns 2013; 23:5-15. [PMID: 24014130 DOI: 10.1007/s10897-013-9636-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 07/29/2013] [Indexed: 12/12/2022]
Abstract
PURPOSE To provide practice recommendations for genetic counselors whose clients are considering cystic fibrosis (CF) carrier testing or seeking information regarding CF molecular test results. The goals of these recommendations are to: 1) Provide updated information about the natural history, diagnosis, and treatment of CF and related conditions. 2) Supplement genetic counselors' knowledge and understanding of the available carrier screening and diagnostic testing options. 3) Describe the current state of genotype/phenotype correlations for CFTR mutations and an approach to interpreting both novel and previously described variants. 4) Provide a framework for genetic counselors to assist clients' decision-making regarding CF carrier testing, prenatal diagnosis, and pregnancy management. Disclaimer The practice guidelines of the National Society of Genetic Counselors (NSGC) are developed by members of the NSGC to assist genetic counselors and other health care providers in making decisions about appropriate management of genetic concerns; including access to and/or delivery of services. Each practice guideline focuses on a clinical or practice-based issue, and is the result of a review and analysis of current professional literature believed to be reliable. As such, information and recommendations within the NSGC practice guidelines reflect the current scientific and clinical knowledge at the time of publication, are only current as of their publication date, and are subject to change without notice as advances emerge.In addition, variations in practice, which take into account the needs of the individual patient and the resources and limitations unique to the institution or type of practice, may warrant approaches, treatments and/or procedures that differ from the recommendations outlined in this guideline. Therefore, these recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. Genetic counseling practice guidelines are never intended to displace a health care provider's best medical judgment based on the clinical circumstances of a particular patient or patient population.Practice guidelines are published by NSGC for educational and informational purposes only, and NSGC does not "approve" or "endorse" any specific methods, practices, or sources of information.
Collapse
|
20
|
Servidoni MF, Sousa M, Vinagre AM, Cardoso SR, Ribeiro MA, Meirelles LR, de Carvalho RB, Kunzelmann K, Ribeiro AF, Ribeiro JD, Amaral MD. Rectal forceps biopsy procedure in cystic fibrosis: technical aspects and patients perspective for clinical trials feasibility. BMC Gastroenterol 2013; 13:91. [PMID: 23688510 PMCID: PMC3679995 DOI: 10.1186/1471-230x-13-91] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Accepted: 05/16/2013] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Measurements of CFTR function in rectal biopsies ex vivo have been used for diagnosis and prognosis of Cystic Fibrosis (CF) disease. Here, we aimed to evaluate this procedure regarding: i) viability of the rectal specimens obtained by biopsy forceps for ex vivo bioelectrical and biochemical laboratory analyses; and ii) overall assessment (comfort, invasiveness, pain, sedation requirement, etc.) of the rectal forceps biopsy procedure from the patients perspective to assess its feasibility as an outcome measure in clinical trials. METHODS We compared three bowel preparation solutions (NaCl 0.9%, glycerol 12%, mannitol), and two biopsy forceps (standard and jumbo) in 580 rectal specimens from 132 individuals (CF and non-CF). Assessment of the overall rectal biopsy procedure (obtained by biopsy forceps) by patients was carried out by telephone surveys to 75 individuals who underwent the sigmoidoscopy procedure. RESULTS Integrity and friability of the tissue specimens correlate with their transepithelial resistance (r = -0.438 and -0.305, respectively) and are influenced by the bowel preparation solution and biopsy forceps used, being NaCl and jumbo forceps the most compatible methods with the electrophysiological analysis. The great majority of the individuals (76%) did not report major discomfort due to the short procedure time (max 15 min) and considered it relatively painless (79%). Importantly, most (88%) accept repeating it at least for one more time and 53% for more than 4 times. CONCLUSIONS Obtaining rectal biopsies with a flexible endoscope and jumbo forceps after bowel preparation with NaCl solution is a safe procedure that can be adopted for both adults and children of any age, yielding viable specimens for CFTR bioelectrical/biochemical analyses. The procedure is well tolerated by patients, demonstrating its feasibility as an outcome measure in clinical trials.
Collapse
Affiliation(s)
- Maria F Servidoni
- Gastrocentro - Endoscopy Unit - State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
- Post-graduate Course, Pediatrics Department, State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
| | - Marisa Sousa
- University of Lisboa - Faculty of Sciences, BioFIG - Centre for Biodiversity, Functional and Integrative Genomics, Campo Grande, 1749-016, Lisbon, Portugal
- Department of Genetics, National Institute of Health – Av. Padre Cruz, 1649-016, Lisbon, Portugal
| | - Adriana M Vinagre
- Faculty of Medical Sciences - State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
| | - Silvia R Cardoso
- Post-graduate Course, Pediatrics Department, State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
- Endoscopy Unit – University Hospital of Campinas, Campinas, Brazil
| | - Maria A Ribeiro
- CIPED - Research Center in Pediatrics - State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
| | - Luciana R Meirelles
- Pathological Anatomy Department, University Hospital of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
| | - Rita B de Carvalho
- Pathological Anatomy Department, University Hospital of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
| | - Karl Kunzelmann
- Institut für Physiologie - Universität Regensburg, Universitat Strasse 31, D-93053, Regensburg, Germany
| | - Antônio F Ribeiro
- Post-graduate Course, Pediatrics Department, State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
- Faculty of Medical Sciences - State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
- CIPED - Research Center in Pediatrics - State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
| | - José D Ribeiro
- Post-graduate Course, Pediatrics Department, State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
- Faculty of Medical Sciences - State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
- CIPED - Research Center in Pediatrics - State University of Campinas (Unicamp) - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP 13083-872, Brazil
| | - Margarida D Amaral
- University of Lisboa - Faculty of Sciences, BioFIG - Centre for Biodiversity, Functional and Integrative Genomics, Campo Grande, 1749-016, Lisbon, Portugal
- Department of Genetics, National Institute of Health – Av. Padre Cruz, 1649-016, Lisbon, Portugal
- Edifício C8, Departamento de Química e Bioquímica, Faculdade de Ciências da Universidade de Lisboa, Campo Grande, 1749-016, Lisbon, Portugal
| |
Collapse
|
21
|
Tran V, Zhang X, Cao L, Li H, Lee B, So M, Sun Y, Chen W, Zhao M. Synchronization modulation increases transepithelial potentials in MDCK monolayers through Na/K pumps. PLoS One 2013; 8:e61509. [PMID: 23585907 PMCID: PMC3621860 DOI: 10.1371/journal.pone.0061509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 03/09/2013] [Indexed: 01/13/2023] Open
Abstract
Transepithelial potential (TEP) is the voltage across a polarized epithelium. In epithelia that have active transport functions, the force for transmembrane flux of an ion is dictated by the electrochemical gradient in which TEP plays an essential role. In epithelial injury, disruption of the epithelial barrier collapses the TEP at the wound edge, resulting in the establishment of an endogenous wound electric field (∼100 mV/mm) that is directed towards the center of the wound. This endogenous electric field is implicated to enhance wound healing by guiding cell migration. We thus seek techniques to enhance the TEP, which may increase the wound electric fields and enhance wound healing. We report a novel technique, termed synchronization modulation (SM) using a train of electric pulses to synchronize the Na/K pump activity, and then modulating the pumping cycles to increase the efficiency of the Na/K pumps. Kidney epithelial monolayers (MDCK cells) maintain a stable TEP and transepithelial resistance (TER). SM significantly increased TEP over four fold. Either ouabain or digoxin, which block Na/K pump, abolished SM-induced TEP increases. In addition to the pump activity, basolateral distribution of Na/K pumps is essential for an increase in TEP. Our study for the first time developed an electrical approach to significantly increase the TEP. This technique targeting the Na/K pump may be used to modulate TEP, and may have implication in wound healing and in diseases where TEP needs to be modulated.
Collapse
Affiliation(s)
- Vu Tran
- Institute for Regenerative Cures, Departments of Dermatology and Ophthalmology, University of California Davis, Davis, California, United States of America
| | - Xiaodong Zhang
- Institute for Regenerative Cures, Departments of Dermatology and Ophthalmology, University of California Davis, Davis, California, United States of America
| | - Lin Cao
- Institute for Regenerative Cures, Departments of Dermatology and Ophthalmology, University of California Davis, Davis, California, United States of America
| | - Hanqing Li
- Institute for Regenerative Cures, Departments of Dermatology and Ophthalmology, University of California Davis, Davis, California, United States of America
| | - Benjamin Lee
- Institute for Regenerative Cures, Departments of Dermatology and Ophthalmology, University of California Davis, Davis, California, United States of America
| | - Michelle So
- Institute for Regenerative Cures, Departments of Dermatology and Ophthalmology, University of California Davis, Davis, California, United States of America
| | - Yaohui Sun
- Institute for Regenerative Cures, Departments of Dermatology and Ophthalmology, University of California Davis, Davis, California, United States of America
| | - Wei Chen
- Cellular and Molecular Biophysics, Department of Physics, University of South Florida, Tampa, Florida, United States of America
| | - Min Zhao
- Institute for Regenerative Cures, Departments of Dermatology and Ophthalmology, University of California Davis, Davis, California, United States of America
- Center for Neurosciences, University of California Davis, Davis, California, United States of America
| |
Collapse
|
22
|
Sousa M, Servidoni MF, Vinagre AM, Ramalho AS, Bonadia LC, Felício V, Ribeiro MA, Uliyakina I, Marson FA, Kmit A, Cardoso SR, Ribeiro JD, Bertuzzo CS, Sousa L, Kunzelmann K, Ribeiro AF, Amaral MD. Measurements of CFTR-mediated Cl- secretion in human rectal biopsies constitute a robust biomarker for Cystic Fibrosis diagnosis and prognosis. PLoS One 2012; 7:e47708. [PMID: 23082198 PMCID: PMC3474728 DOI: 10.1371/journal.pone.0047708] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Accepted: 09/14/2012] [Indexed: 01/14/2023] Open
Abstract
Background Cystic Fibrosis (CF) is caused by ∼1,900 mutations in the CF transmembrane conductance regulator (CFTR) gene encoding for a cAMP-regulated chloride (Cl−) channel expressed in several epithelia. Clinical features are dominated by respiratory symptoms, but there is variable organ involvement thus causing diagnostic dilemmas, especially for non-classic cases. Methodology/Principal Findings To further establish measurement of CFTR function as a sensitive and robust biomarker for diagnosis and prognosis of CF, we herein assessed cholinergic and cAMP-CFTR-mediated Cl− secretion in 524 freshly excised rectal biopsies from 118 individuals, including patients with confirmed CF clinical diagnosis (n = 51), individuals with clinical CF suspicion (n = 49) and age-matched non-CF controls (n = 18). Conclusive measurements were obtained for 96% of cases. Patients with “Classic CF”, presenting earlier onset of symptoms, pancreatic insufficiency, severe lung disease and low Shwachman-Kulczycki scores were found to lack CFTR-mediated Cl− secretion (<5%). Individuals with milder CF disease presented residual CFTR-mediated Cl− secretion (10–57%) and non-CF controls show CFTR-mediated Cl− secretion ≥30–35% and data evidenced good correlations with various clinical parameters. Finally, comparison of these values with those in “CF suspicion” individuals allowed to confirm CF in 16/49 individuals (33%) and exclude it in 28/49 (57%). Statistical discriminant analyses showed that colonic measurements of CFTR-mediated Cl− secretion are the best discriminator among Classic/Non-Classic CF and non-CF groups. Conclusions/Significance Determination of CFTR-mediated Cl− secretion in rectal biopsies is demonstrated here to be a sensitive, reproducible and robust predictive biomarker for the diagnosis and prognosis of CF. The method also has very high potential for (pre-)clinical trials of CFTR-modulator therapies.
Collapse
Affiliation(s)
- Marisa Sousa
- BioFIG - Centre for Biodiversity, Functional and Integrative Genomics; Faculty of Sciences, University of Lisboa, Lisboa, Portugal
- Department of Genetics - National Institute of Health, Lisboa, Portugal
| | - Maria F. Servidoni
- Gastrocentro - Endoscopy Unit - State University of Campinas, Campinas, Brazil
- Pediatrics Department - State University of Campinas, Campinas, Brazil
| | - Adriana M. Vinagre
- Faculty of Medical Sciences - State University of Campinas, Campinas, Brazil
| | - Anabela S. Ramalho
- BioFIG - Centre for Biodiversity, Functional and Integrative Genomics; Faculty of Sciences, University of Lisboa, Lisboa, Portugal
- Department of Genetics - National Institute of Health, Lisboa, Portugal
| | - Luciana C. Bonadia
- Faculty of Medical Sciences - State University of Campinas, Campinas, Brazil
| | - Verónica Felício
- BioFIG - Centre for Biodiversity, Functional and Integrative Genomics; Faculty of Sciences, University of Lisboa, Lisboa, Portugal
| | - Maria A. Ribeiro
- CIPED - Research Center in Pediatrics - State University of Campinas, Campinas, Brazil
| | - Inna Uliyakina
- BioFIG - Centre for Biodiversity, Functional and Integrative Genomics; Faculty of Sciences, University of Lisboa, Lisboa, Portugal
- Department of Genetics - National Institute of Health, Lisboa, Portugal
| | - Fernando A. Marson
- Faculty of Medical Sciences - State University of Campinas, Campinas, Brazil
| | - Arthur Kmit
- Faculty of Medical Sciences - State University of Campinas, Campinas, Brazil
| | - Silvia R. Cardoso
- Pediatrics Department - State University of Campinas, Campinas, Brazil
- Endoscopy Unit – University Hospital of Campinas, Campinas, Brazil
| | - José D. Ribeiro
- Pediatrics Department - State University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences - State University of Campinas, Campinas, Brazil
- CIPED - Research Center in Pediatrics - State University of Campinas, Campinas, Brazil
| | - Carmen S. Bertuzzo
- Faculty of Medical Sciences - State University of Campinas, Campinas, Brazil
| | - Lisete Sousa
- CEAUL - Center of Statistics and Applications of the University of Lisboa; Department of Statistics and Operation Research, Faculty of Sciences, University of Lisboa, Lisboa, Portugal
| | - Karl Kunzelmann
- Institut für Physiologie – University of Regensburg, Regensburg, Germany
| | - Antônio F. Ribeiro
- Pediatrics Department - State University of Campinas, Campinas, Brazil
- Faculty of Medical Sciences - State University of Campinas, Campinas, Brazil
- CIPED - Research Center in Pediatrics - State University of Campinas, Campinas, Brazil
| | - Margarida D. Amaral
- BioFIG - Centre for Biodiversity, Functional and Integrative Genomics; Faculty of Sciences, University of Lisboa, Lisboa, Portugal
- Department of Genetics - National Institute of Health, Lisboa, Portugal
- * E-mail:
| |
Collapse
|
23
|
de Courcey F, Zholos AV, Atherton-Watson H, Williams MTS, Canning P, Danahay HL, Elborn JS, Ennis M. Development of primary human nasal epithelial cell cultures for the study of cystic fibrosis pathophysiology. Am J Physiol Cell Physiol 2012; 303:C1173-9. [PMID: 23015550 DOI: 10.1152/ajpcell.00384.2011] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Cultured primary epithelial cells are used to examine inflammation in cystic fibrosis (CF). We describe a new human model system using cultured nasal brushings. Nasal brushings were obtained from 16 F508del homozygous patients and 11 healthy controls. Cells were resuspended in airway epithelial growth medium and seeded onto collagen-coated flasks and membranes for use in patch-clamp, ion transport, and mediator release assays. Viable cultures were obtained with a 75% success rate from subjects with CF and 100% from control subjects. Amiloride-sensitive epithelial Na channel current of similar size was present in both cell types while forskolin-activated CF transmembrane conductance regulator current was lacking in CF cells. In Ussing chambers, cells from CF patients responded to UTP but not to forskolin. Spontaneous and cytomix-stimulated IL-8 release was similar (stimulated 29,448 ± 9,025 pg/ml; control 16,336 ± 3,308 pg/ml CF; means ± SE). Thus nasal epithelial cells from patients with CF can be grown from nasal brushings and used in electrophysiological and mediator release studies in CF research.
Collapse
Affiliation(s)
- F de Courcey
- Centre for Infection and Immunity, Queen’s University Belfast, Health Sciences Building, Belfast, UK
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Ashlock MA, Olson ER. Therapeutics Development for Cystic Fibrosis: A Successful Model for a Multisystem Genetic Disease. Annu Rev Med 2011; 62:107-25. [DOI: 10.1146/annurev-med-061509-131034] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Melissa A. Ashlock
- Former affiliation: Cystic Fibrosis Foundation Therapeutics, Inc., Bethesda, Maryland 20814;
| | - Eric R. Olson
- Vertex Pharmaceuticals Incorporated, Cambridge, Massachusetts 02139;
| |
Collapse
|
25
|
Bilateral sweat tests with two different methods as a part of cystic fibrosis newborn screening (CF NBS) protocol and additional quality control. Folia Histochem Cytobiol 2010; 48:358-65. [DOI: 10.2478/v10042-010-0044-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
26
|
Sermet-Gaudelus I, Girodon E, Sands D, Stremmler N, Vavrova V, Deneuville E, Reix P, Bui S, Huet F, Lebourgeois M, Munck A, Iron A, Skalicka V, Bienvenu T, Roussel D, Lenoir G, Bellon G, Sarles J, Macek M, Roussey M, Fajac I, Edelman A. Clinical Phenotype and Genotype of Children with Borderline Sweat Test and Abnormal Nasal Epithelial Chloride Transport. Am J Respir Crit Care Med 2010; 182:929-36. [DOI: 10.1164/rccm.201003-0382oc] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
27
|
Spadafora D, Hawkins EC, Murphy KE, Clark LA, Ballard ST. Naturally occurring mutations in the canine CFTR gene. Physiol Genomics 2010; 42:480-5. [PMID: 20571109 DOI: 10.1152/physiolgenomics.00092.2010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Naturally occurring cystic fibrosis (CF)-causing mutations in the CFTR gene have not been identified in any nonhuman animal species. Since domestic dogs are known to develop medical conditions associated with atypical CF in humans (e.g., bronchiectasis and pancreatitis), we hypothesized that dogs with these disorders likely have a higher expression rate of CFTR mutations than the at-large population. Temporal temperature-gradient gel electrophoresis (TTGE) was used to screen canine CFTR in 400 animals: 203 dogs diagnosed with pancreatitis, 23 dogs diagnosed with bronchiectasis, and 174 dogs admitted to clinics for any illness (at-large dogs). Twenty-eight dogs were identified with one of four CFTR missense mutations. P1281T and P1464H mutations occur in relatively unconserved residues. R1456W is analogous to the human R1453W mutation, which has approximately 20% of normal CFTR function and is associated with pancreatitis and panbronchiolitis. R812W disrupts a highly conserved protein kinase A recognition site within the regulatory domain. We conclude that naturally occurring CFTR mutations are relatively common in domestic dogs and can be detected with TTGE. No substantive differences in mutation frequency were observed between the at-large, pancreatitis, and bronchiectasis dogs.
Collapse
Affiliation(s)
- Domenico Spadafora
- Department of Physiology, College of Medicine, University of South Alabama, Mobile, Alabama 36688, USA
| | | | | | | | | |
Collapse
|