PROJECT SUMMARY
Dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) Cl- channel impedes mucus
clearance and leads to the airway disease, cystic fibrosis (CF). New CFTR modulators improve mucociliary
transport (MCT) and pathophysiologic manifestations of the disease in genetic mutation-specific patients, but
do not completely restore airway function. We recently discovered ginsenosides derived from Korean Red
Ginseng serve as potentiators of the Ca2+-activated Cl− channel (CaCC) [TMEM16A] and can restore MCT in
vitro and in vivo through this alternative Cl- pathway. Yet, poor clinical trial results with activators of TMEM16A
and a recently described role for the channel in mucus hypersecretion in infected airways has led to some to
suggest that inhibiting TMEM16A is a better strategy. However, we hypothesize that potentiating TMEM16A,
rather than channel activation through purinergic, intracellular Ca2+- driven pathways, will rescue MCT in
infected CF airways. Specific Aim 1 will isolate the ginsenoside that most effectively potentiates TMEM16A and
measure its effects on MCT parameters and mucus pathology. We anticipate finding the optimal ginsenoside
through Ussing chamber and patch clamp experiments, while also measuring the impact on markers of MCT
and mucus viscosity. Specific Aim 2 will assess whether a TMEM16A potentiator improves epithelial Cl-
secretion, histopathology, and MCT parameters in infected CF rat airways. We will determine single dose
pharmacokinetics for the selected ginsenoside and administer to Pseudomonas-infected CF rats to evaluate
nasal potential difference, MCT, lung micro-CTs, histopathology, mucus properties (viscosity, solids, mass,
density), and inflammatory cytokines. We will answer questions about the therapeutic utility of targeting the
TMEM16A pathway and identify a new TMEM16A potentiator as an effective treatment for CF airway disease.