Personalized medicine in cystic fibrosis: genistein supplementation as a treatment option for patients with a rare S1045Y-CFTR mutation

Am J Physiol Lung Cell Mol Physiol. 2016 Aug 1;311(2):L364-74. doi: 10.1152/ajplung.00134.2016. Epub 2016 Jun 3.

Abstract

Cystic fibrosis (CF) is a life-shortening disease caused by the mutations that generate nonfunctional CF transmembrane conductance regulator (CFTR) protein. A rare serine-to-tyrosine (S1045Y) CFTR mutation was earlier reported to result in CF-associated fatality. We identified an African-American patient with the S1045Y mutation in CFTR, as well as a stop-codon mutation, who has a mild CF phenotype. The underlying mechanism of CF caused by S1045Y-CFTR has not been elucidated. In this study, we determined that S1045Y-CFTR exhibits twofold attenuated function compared with wild-type (WT)-CFTR. We report that serine-to-tyrosine mutation leads to increased tyrosine phosphorylation of S1045Y-CFTR, followed by recruitment and binding of E3-ubiquitin ligase c-cbl, resulting in enhanced ubiquitination and passage of S1045Y-CFTR in the endosome/lysosome degradative compartments. We demonstrate that inhibition of tyrosine phosphorylation partially rescues S1045Y-CFTR surface expression and function. Based on our findings, it could be suggested that consuming genistein (a tyrosine phosphorylation inhibitor) would likely ameliorate CF symptoms in individuals with S1045Y-CFTR, providing a unique personalized therapy for this rare CF mutation.

Keywords: cystic fibrosis transmembrane conductance regulator; rare cystic fibrosis mutations.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Cystic Fibrosis / diagnostic imaging*
  • Cystic Fibrosis / drug therapy
  • Cystic Fibrosis / genetics
  • Cystic Fibrosis Transmembrane Conductance Regulator / genetics*
  • Cystic Fibrosis Transmembrane Conductance Regulator / metabolism
  • DNA Mutational Analysis
  • Drug Evaluation, Preclinical
  • Genistein / pharmacology*
  • HEK293 Cells
  • Humans
  • Male
  • Mutation, Missense
  • Phosphorylation
  • Precision Medicine
  • Protein Binding
  • Protein Kinase Inhibitors / pharmacology*
  • Protein Processing, Post-Translational
  • Protein Transport
  • Proto-Oncogene Proteins c-cbl / metabolism

Substances

  • CFTR protein, human
  • Protein Kinase Inhibitors
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Genistein
  • Proto-Oncogene Proteins c-cbl
  • CBL protein, human