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Zeitlin, P.L. et al.

Zeitlin, Diener-West, Rubenstein, Boyle, Lee, Brass-Ernst,

Evidence of CFTR function in cystic fibrosis after systemic administration of 4-phenylbutyrate.

Most individuals with cystic fibrosis ( CF) carry one or two mutations that result in a maturation defect of the full-length protein. One such mutation, deltaF508, results in a mutant membrane glycoprotein that fails to progress to the apical membrane, where the wild-type protein normally functions as a cyclic AMP-regulated chloride channel. 4-Phenylbutyrate (Buphenyl), an orally bioavailable short chain fatty acid, modulates heat shock protein expression and restores maturation of the deltaF508 protein in vitro and in vivo. We performed a randomized, double-blind, placebo-controlled, dose-escalation and safety study of Buphenyl in 19 adults with CF (homozygous deltaF508) to test the hypothesis that Buphenyl would be safe, well-tolerated, and associated with an increase in chloride transport in nasal epithelia. Three dose levels (20, 30, or 40 g divided t.i.d.) of drug or placebo were given for 1 week. Serial measurements of chloride transport by nasal potential difference (NPD) testing and metabolic safety testing were performed. A maximum tolerated dose of 20 g was defined based on minimal adverse reactions, the safety profile, and a statistically significant induction of chloride transport that was maximal by day 3. This short-term phase I/II study demonstrates proof of principle that modulation of deltaF508 CFTR biosynthesis and trafficking is a viable therapeutic approach for cystic fibrosis.[1]

References

Evidence of CFTR function in cystic fibrosis after systemic administration of 4-phenylbutyrate. Zeitlin, P.L., Diener-West, M., Rubenstein, R.C., Boyle, M.P., Lee, C.K., Brass-Ernst, L. Mol. Ther. (2002) [Pubmed]

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