Cystic Fibrosis Transmembrane Regulator Correction Attenuates Heart
Failure-Induced Lung Inflammation
Abstract
Background and Purpose: Heart failure (HF) affects 64 million people
worldwide. Despite advancements in prevention and therapy, quality of
life remains poor for many HF patients due to target organ damage.
Pulmonary manifestations of HF are well-established. However,
difficulties in the treatment of HF patients with chronic lung
phenotypes remain, as standard therapies are often complicated by
contraindications. Here, we verify the downregulation of the cystic
fibrosis transmembrane regulator (CFTR) in the HF lung, a concept that
may provide new mechanism-based therapies for HF patients with pulmonary
complications. Experimental Approach: Ligation of the left anterior
descending coronary artery in mice was used to induce myocardial
infarction (MI). At 10 weeks post-MI, pharmacological CFTR corrector
therapy (Lumacaftor (Lum)) was applied systemically or lung-specific for
2 weeks, and the lungs were analysed using histology, flow cytometry,
Western blotting, and qPCR. Key Results: Experimental HF associated with
an apparent lung phenotype characterized by reduction of pulmonary CFTR+
cells, vascular remodelling, and pronounced tissue inflammation as
evidenced by infiltration of pro-inflammatory monocytes and elevation of
classically-activated macrophages in the lung. PharmacologicalCFTR
correction with Lum mitigated the HF-induced downregulation of pulmonary
CFTR expression, increased the proportion of CFTR+ cells in the lung,
and diminished the HF-associated elevation of classically-activated
non-alveolar macrophages within the lungs with implication for vessel
wall thickness. Conclusion and Implications: Collectively, our data
suggest that pharmacological CFTR correction possesses the capacity to
alleviate HF-induced inflammation in the lung and may emerge as
treatment option for HF patients with chronic lung phenotypes.