Mr. Knowles et al., IN-VIVO NASAL POTENTIAL DIFFERENCE - TECHNIQUES AND PROTOCOLS FOR ASSESSING EFFICACY OF GENE-TRANSFER IN CYSTIC-FIBROSIS, Human gene therapy, 6(4), 1995, pp. 445-455
Cystic fibrosis (CF) is a monogenetic disease that is associated with
chronic airways disease and early death, The pulmonary disease reflect
s mutations in the cystic fibrosis transmembrane conductance regulator
(CFTR) gene, and associated abnormal epithelial ion transport, includ
ing defective cAMP-mediated (CFTR) Cl- secretion and an accelerated ra
te of basal Na+ transport, With the development of vectors for gene th
erapy, the airway epithelium of CF patients has been targeted for stud
ies of gene transfer, The biological efficacy of gene transfer of the
normal CFTR cDNA into CF respiratory epithelia can be assessed by in v
ivo measurements of the transepithelial potential difference (PD), a p
arameter of ion transport that reflects the expression and function of
CFTR, This paper describes techniques that can be used to discriminat
e in vivo between the ion transport phenotype of normal subjects and p
atients with cystic fibrosis, Protocols are outlined to allow assessme
nt of individual components of the electrolyte transport phenotype, i.
e., the magnitude of the basal and cAMP-mediated (CFTR) Cl- secretion,
and the rate of Na+ transport, The physiologic basis of the protocols
and important technical features of these measurements are defined, I
f performed properly, the in vivo nasal PD technique clearly discrimin
ates between normal subjects and cystic fibrosis patients, and can yie
ld estimates of the biological efficacy of gene transfer to achieve co
rrection of the electrolyte transport defects in CF patients.