Discovery of CFTR modulators for the treatment of cystic fibrosis

Expert Opin Drug Discov. 2021 Aug;16(8):897-913. doi: 10.1080/17460441.2021.1912732. Epub 2021 Apr 13.

Abstract

Introduction: Cystic fibrosis (CF) is a life-threatening inherited disease caused by mutations in the gene encoding the CF transmembrane conductance regulator (CFTR) protein, an anion channel expressed at the apical membrane of secretory epithelia. CF leads to multiorgan dysfunction with progressive deterioration of lung function being the major cause of untimely death. Conventional CF therapies target only symptoms and consequences downstream of the primary genetic defect and the current life expectancy and quality of life of these individuals are still very limited.

Area covered: CFTR modulator drugs are novel-specialized therapies that enhance or even restore functional expression of CFTR mutants and have been approved for clinical use for individuals with specific CF genotypes. This review summarizes classical approaches used for the pre-clinical development of CFTR correctors and potentiators as well as emerging strategies aiming to accelerate modulator development and expand theratyping efforts.

Expert opinion: Highly effective CFTR modulator drugs are expected to deeply modify the disease course for the majority of individuals with CF. A multitude of experimental approaches have been established to accelerate the development of novel modulators. CF patient-derived specimens are valuable cell models to predict therapeutic effectiveness of existing (and novel) modulators in a precision medicine approach.

Keywords: Cell models; cftr mutations; correctors; drug discovery; personalized therapies; potentiators; precision medicine; theratyping.

Publication types

  • Review

MeSH terms

  • Cystic Fibrosis Transmembrane Conductance Regulator / genetics
  • Cystic Fibrosis* / drug therapy
  • Cystic Fibrosis* / genetics
  • Humans
  • Mutation
  • Precision Medicine
  • Quality of Life

Substances

  • CFTR protein, human
  • Cystic Fibrosis Transmembrane Conductance Regulator