4.7 Article

Evaluation of the Complex p.[Leu467Phe;Phe508del] CFTR Allele in the Intestinal Organoids Model: Implications for Therapy

Journal

Publisher

MDPI
DOI: 10.3390/ijms231810377

Keywords

cystic fibrosis (CF); CFTR; complex allele [L467F;F508de1]; intestinal current measurements (ICM); intestinal organoids; CFTR modulators

Funding

  1. Russian Science Foundation [22-15-00473]

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This study evaluated the frequency of the [L467F;F508del] complex allele in Russian cystic fibrosis patients and found that it is present in 8.2% of homozygous F508del patients. Although patients with the F508del/[L467F;F508del] genotype have a severe disease course and lower CFTR channel function, targeted therapy with a combination of ivacaftor + tezacaftor + elexacaftor medication is recommended.
In the cohort of Russian patients with cystic fibrosis, the p.[Leu467Phe;Phe508del] complex allele (legacy name [L467F;F508del]) of the CFTR gene is understudied. In this research, we present the results of frequency evaluation of the [L467F;F508del] complex allele in the Russian Federation among patients with a F508del/F508del genotype, its effect on the clinical course of cystic fibrosis, the intestinal epithelium ionic channel function, and the effectiveness of target therapy. The frequency of the [L467F;F508del] complex allele among patients with homozygous F508del was determined with multiplex ligase-dependent probe amplification followed by polymerase chain reaction and fragment analysis. The function of ionic channels, including the residual CFTR function, and the effectiveness of CFTR modulators was analyzed using intestinal current measurements on rectal biopsy samples and the forskolin-induced swelling assay on organoids. The results showed that the F508del/[L467F;F508del] genotype is present in 8.2% of all Russian patients with F508del in a homozygous state. The clinical course of the disease in patients with the F508del/[L467F;F508del] genotype is severe and does not vary from the course in the cohort with homozygous F508del, although the CFTR channel function is significantly lower. For patients with the F508del/[L467F;F508del] genotype, we can recommend targeted therapy using a combined ivacaftor + tezacaftor + elexacaftor medication.

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