Adenylate Cyclase 6 Targets in Mucociliary Clearance

Background. Mucociliary clearance (MCC) is a frontline airway defense mechanism that relies on the appropriate interactions between the epithelium, ciliary beat frequency, and the quantity and quality of mucus. MCC is severely impaired in cystic fibrosis (CF) and drives lung function decline and ultimate respiratory failure and death. A great need remains to identify the key molecular players that regulate MCC in CF outside the scope of FDA approved CFTR therapy and to specifically target MCC dysfunction in CF using small molecules. Results. We discover a novel key role of cAMP-synthesizing enzyme Adenylate cyclase 6 (AC6) in MCC via (a) regulation of CFTR chloride channels in the secretory cells that generate airway surface liquid (ASL) component of MCC and (b) AC6 mediated regulation of ciliary beat frequency in the ciliated cells that is required for the mechanical clearance. Specific activators of AC6 (C20: Top candidate) were developed and improved MCC process ex vivo in CF explant tissues and cells. Together these mechanisms and small molecule approach that improve airway fluid balance and cilia function could be beneficial in CF and other respiratory diseases. Experimental Approach. We performed CFTR functional assessment in normal and CF patient derived airway epithelial cells by adapting patch-sequencing approach and using the specific activators of AC6. The effect of AC6 activators on MCC will be evaluated ex vivo in patient derived lung explant tissues , in vivo (micro-CT) in CF rat models and in vitro (ciliary beat frequency and bead flow measurements) in air-liquid interface airway epithelial cultures. Overall, these studies will be mechanistic and translational involving human disease specimens, animal models, drug development and computational analysis. Significance of the results. The proposed research can improve our understanding of epithelial biology and advance activators of AC6 as therapeutic agents to treat mucus clearance defects. These findings can be leveraged to modulate CFTR function and cilia-generate flow, presenting a potential therapeutic avenue for conditions that involve CFTR and cilia dysregulation associated with several respiratory diseases. National Institutes of Health (NIH) DK080834 and P30-DK117467 and HL147351 (to APN). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.