Gastroenterology

Gastroenterology

Volume 126, Issue 2, February 2004, Pages 511-519
Gastroenterology

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

https://doi.org/10.1053/j.gastro.2003.11.005Get rights and content

Abstract

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.

Section snippets

Cell lines, animals, human tissues, and compounds

T84 and Caco-2 cells were obtained from the UCSF cell culture facility. T84 cells were cultured in a 1:1 mixture of DMEM and Hams F12 supplemented with 5% fetal calf serum, 100 U/mL penicillin, and 100 μg/mL streptomycin and plated on Snapwell inserts (Corning Costar) for growth in a humidified (5% O2/95% CO2) atmosphere at 37°C. Cells were used at 10–14 days after plating. Caco-2 cells were cultured in DMEM containing 10% fetal calf serum, 1% nonessential amino acids, 100 U/mL penicillin, and

Results

We reported previously that a single intraperitoneal injection of CFTRinh-172 in mice inhibited cholera toxin-stimulated fluid secretion in a closed intestinal loop model.14 These initial observations were extended by measurement of the dose-response relationship and the apparent half-time for persistence of the CFTRinh-172 inhibitory effect.

First, the kinetics of intestinal loop fluid absorption and secretion were determined to characterize the mouse model. To study absorption, loop fluid

Discussion

The purpose of this study was to evaluate the potential antidiarrheal properties of a small-molecule CFTR inhibitor identified recently by high-throughput screening of a collection of diverse, drug-like compounds and optimization of thiazolidinone analogs.14 The best CFTR blocker, CFTRinh-172, inhibited CFTR Cl conductance reversibly at submicromolar concentrations without inhibiting/activating a series of other channels and transporters, including the ABC (ATP binding cassette) transporters

References (34)

  • M. Claeson et al.

    Global progress in the control of diarrheal diseases

    Pediatr Infect Dis

    (1990)
  • C. Bern et al.

    The magnitude of the global problem of diarrhoeal diseasea ten-year update

    Bull WHO

    (1992)
  • R.I. Glass et al.

    Estimates of morbidity and mortality rates for diarrheal diseases in American children

    J Pediatr

    (1991)
  • J.F. Lew et al.

    Diarrheal deaths in the United States, 1979 through 1987. A special problem for the elderly

    JAMA

    (1991)
  • J.F. Desjeux et al.

    Oral rehydration solution in the year 2000pathophysiology, efficacy and effectiveness

    Baillieres Clin Gastroenterol

    (1997)
  • E.C. Oldfield et al.

    The role of antibiotics in the treatment of infectious diarrhea

    Gastroenterol Clin North Am

    (2001)
  • C.L. Sears et al.

    Enteric bacterial toxinsmechanisms of action and linkage to intestinal secretion

    Microbiol Rev

    (1996)
  • C.L. Gyles

    Escherichia coli cytotoxins and enterotoxins

    Can J Microbiol

    (1992)
  • K.E. Barrett et al.

    Chloride secretion by the intestinal epitheliummolecular basis and regulatory aspects

    Annu Rev Physiol

    (2000)
  • S.E. Gabriel et al.

    Cystic fibrosis heterozygote resistance to cholera toxin in the cystic fibrosis mouse model

    Science

    (1994)
  • A.C. Chao et al.

    Activation of intestinal CFTR Cl channel by heat-stable enterotoxin and guanylin via cAMP-dependent protein kinase

    EMBO J

    (1994)
  • K. Kunzelmann et al.

    Electrolyte transport in the mammalian colonmechanisms and implications for disease

    Physiol Rev

    (2002)
  • E.K. O’Donnell et al.

    Inhibition of enterotoxin-induced porcine colonic secretion by diarylsulfonylureas in vitro

    Am J Physiol

    (2000)
  • T. Ma et al.

    Thiazolidinone CFTR inhibitor identified by high-throughput screening blocks cholera-toxin induced intestinal fluid secretion

    J Clin Invest

    (2002)
  • J. Thiagarajah et al.

    Antidiarrheal properties and pharmacology of a small molecule CFTR inhibitor

    Ped Pulmonol

    (2003)
  • S.L. Gorbach et al.

    Acute undifferentiated human diarrhea in the tropics. I. Alterations in intestinal microflora

    J Clin Invest

    (1971)
  • H. Oi et al.

    Identification in traditional herbal medications and confirmation by synthesis of factors that inhibit cholera toxin-induced fluid accumulation

    Proc Natl Acad Sci U S A

    (2002)
  • Cited by (0)

    Supported by a drug discovery grant from the Cystic Fibrosis Foundation; grants HL60288, HL73856, EB00415, EY13574, and DK35124 from the National Institutes of Health; a Cystic Fibrosis Foundation fellowship (to J.R.T.); and student fellowships from the American Heart Association, Western States Affiliate (to T.B. and E.H.).

    View full text