We warmly thank all patients and their families for participation in the study. This work was supported by grants from French Association Vaincre la Mucoviscidose; French Association ABCF 2 and Vertex Pharmaceuticals Innovation Awards.

All experiments were performed following the guidelines and regulations described by the Declaration of Helsinki and the Huriet-Serusclat law on human research ethics.
1. Preparation of flasks and different media
<ol>
	<li>Prepare amplification, air-liquid, and freezing medium as described in Table 1.</li>
	<li>Prepare a stock solution of human collagen IV by dissolving 50 mg of collagen in 100 mL of 0.2% glacial acetic acid. Mix on a magnetic stirrer for at...

<ol>
	<li>Kim, S. J., Skach, W. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechanisms+of+CFTR+folding+at+the+endoplasmic+reticulum.">Mechanisms of CFTR folding at the endoplasmic reticulum.</a> Frontiers in Pharmacology. 3, 201 (2012).</li><li>Lukacs, G. L., Verkman, A. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=CFTR:+folding,+misfolding+and+correcting+the+&#916;F508+conformational+defect.">CFTR: folding, misfolding and correcting the &#916;F508 conformational defect.</a> Trends in Molecular Medicine. 18 (2), 81-91 (2012).</li><li>Wainwright, C. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lumacaftor-Ivacaftor+in+patients+with+cystic+fibrosis+homozygous+for+Phe508del+CFTR.">Lumacaftor-Ivacaftor in patients with cystic fibrosis homozygous for Phe508del CFTR.</a> The New England Journal of Medicine. 373 (3), 220-231 (2015).</li><li>Griese, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+and+efficacy+of+elexacaftor/tezacaftor/ivacaftor+for+24+weeks+or+longer+in+people+with+cystic+fibrosis+and+one+or+more+F508del+alleles:+Interim+results+of+an+open-label+phase+3+clinical+trial.">Safety and efficacy of elexacaftor/tezacaftor/ivacaftor for 24 weeks or longer in people with cystic fibrosis and one or more F508del alleles: Interim results of an open-label phase 3 clinical trial.</a> American Journal of Respiratory and Critical Care Medicine. 203 (3), 381-385 (2021).</li><li>Horani, A., Nath, A., Wasserman, M. G., Huang, T., Brody, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rho-associated+protein+kinase+inhibition+enhances+airway+epithelial+basal-cell+proliferation+and+lentivirus+transduction.">Rho-associated protein kinase inhibition enhances airway epithelial basal-cell proliferation and lentivirus transduction.</a> American Journal of Respiratory Cell and Molecular Biology. 49 (3), 341-347 (2013).</li><li>Liu, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Conditional+reprogramming+and+long-term+expansion+of+normal+and+tumor+cells+from+human+biospecimens.">Conditional reprogramming and long-term expansion of normal and tumor cells from human biospecimens.</a> Nature Protocols. 12 (2), 439-451 (2017).</li><li>Saint-Criq, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Choice+of+differentiation+media+significantly+impacts+cell+lineage+and+response+to+CFTR+modulators+in+fully+differentiated+primary+cultures+of+cystic+fibrosis+human+airway+epithelial+cells.">Choice of differentiation media significantly impacts cell lineage and response to CFTR modulators in fully differentiated primary cultures of cystic fibrosis human airway epithelial cells.</a> Cells. 9 (9), 2137 (2020).</li><li>Bukowy-Biery&#322;&#322;o, Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+differentiating+primary+human+airway+epithelial+cell+cultures:+how+far+are+we.">Long-term differentiating primary human airway epithelial cell cultures: how far are we.</a> Cell Communication and Signaling: CCS. 19 (1), 1-18 (2021).</li><li>Pranke, I. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Correction+of+CFTR+function+in+nasal+epithelial+cells+from+cystic+fibrosis+patients+predicts+improvement+of+respiratory+function+by+CFTR+modulators.">Correction of CFTR function in nasal epithelial cells from cystic fibrosis patients predicts improvement of respiratory function by CFTR modulators.</a> Scientific Reports. 7 (1), 7375 (2017).</li><li>Noel, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Correlating+genotype+with+phenotype+using+CFTR-mediated+whole-cell+Cl&#8722;+currents+in+human+nasal+epithelial+cells.">Correlating genotype with phenotype using CFTR-mediated whole-cell Cl&#8722; currents in human nasal epithelial cells.</a> The Journal of Physiology. , (2021).</li><li>Brewington, J. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Brushed+nasal+epithelial+cells+are+a+surrogate+for+bronchial+epithelial+CFTR+studies.">Brushed nasal epithelial cells are a surrogate for bronchial epithelial CFTR studies.</a> JCI Insight. 3 (13), 99385 (2018).</li><li>Pranke, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Might+brushed+nasal+cells+be+a+surrogate+for+cftr+modulator+clinical+response.">Might brushed nasal cells be a surrogate for cftr modulator clinical response.</a> American Journal of Respiratory and Critical Care Medicine. 199 (1), 123-126 (2019).</li><li>de Courcey, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+primary+human+nasal+epithelial+cell+cultures+for+the+study+of+cystic+fibrosis+pathophysiology.">Development of primary human nasal epithelial cell cultures for the study of cystic fibrosis pathophysiology.</a> American Journal of Physiology-Cell Physiology. 303 (11), 1173-1179 (2012).</li><li>Devalia, J. L., Sapsford, R. J., Wells, C. W., Richman, P., Davies, R. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Culture+and+comparison+of+human+bronchial+and+nasal+epithelial+cells+in+vitro.">Culture and comparison of human bronchial and nasal epithelial cells in vitro.</a> Respiratory Medicine. 84 (4), 303-312 (1990).</li><li>McDougall, C. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nasal+epithelial+cells+as+surrogates+for+bronchial+epithelial+cells+in+airway+inflammation+studies.">Nasal epithelial cells as surrogates for bronchial epithelial cells in airway inflammation studies.</a> American Journal of Respiratory Cell and Molecular Biology. 39 (5), 560-568 (2008).</li><li>Mosler, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Feasibility+of+nasal+epithelial+brushing+for+the+study+of+airway+epithelial+functions+in+CF+infants.">Feasibility of nasal epithelial brushing for the study of airway epithelial functions in CF infants.</a> Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society. 7 (1), 44-53 (2008).</li><li>Tosoni, K., Cassidy, D., Kerr, B., Land, S. C., Mehta, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+drugs+to+probe+the+variability+of+trans-epithelial+airway+resistance.">Using drugs to probe the variability of trans-epithelial airway resistance.</a> PLOS One. 11 (2), 0149550 (2016).</li><li>Sch&#246;gler, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterization+of+pediatric+cystic+fibrosis+airway+epithelial+cell+cultures+at+the+air-liquid+interface+obtained+by+non-invasive+nasal+cytology+brush+sampling.">Characterization of pediatric cystic fibrosis airway epithelial cell cultures at the air-liquid interface obtained by non-invasive nasal cytology brush sampling.</a> Respiratory Research. 18 (1), 215 (2017).</li><li>M&#252;ller, L., Brighton, L. E., Carson, J. L., Fischer, W. A., Jaspers, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Culturing+of+human+nasal+epithelial+cells+at+the+air+liquid+interface.">Culturing of human nasal epithelial cells at the air liquid interface.</a> Journal of Visualized Experiments: JoVE. (80), e50646 (2013).</li><li>Awatade, N. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measurements+of+functional+responses+in+human+primary+lung+cells+as+a+basis+for+personalized+therapy+for+cystic+fibrosis.">Measurements of functional responses in human primary lung cells as a basis for personalized therapy for cystic fibrosis.</a> EBioMedicine. 2 (2), 147-153 (2014).</li><li>Brewington, J. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Generation+of+human+nasal+epithelial+cell+spheroids+for+individualized+cystic+fibrosis+transmembrane+conductance+regulator+study.">Generation of human nasal epithelial cell spheroids for individualized cystic fibrosis transmembrane conductance regulator study.</a> Journal of Visualized Experiments: JoVE. (134), e57492 (2018).</li><li>Wiszniewski, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+cultures+of+polarized+airway+epithelial+cells+from+patients+with+cystic+fibrosis.">Long-term cultures of polarized airway epithelial cells from patients with cystic fibrosis.</a> American Journal of Respiratory Cell and Molecular Biology. 34 (1), 39-48 (2006).</li><li>Reynolds, S. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Airway+progenitor+clone+formation+is+enhanced+by+Y-27632-dependent+changes+in+the+transcriptome.">Airway progenitor clone formation is enhanced by Y-27632-dependent changes in the transcriptome.</a> American Journal of Respiratory Cell and Molecular Biology. 55 (3), 323-336 (2016).</li><li>Suprynowicz, F. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Conditionally+reprogrammed+cells+represent+a+stem-like+state+of+adult+epithelial+cells.">Conditionally reprogrammed cells represent a stem-like state of adult epithelial cells.</a> Proceedings of the National Academy of Sciences of the United States of America. 109 (49), 20035-20040 (2012).</li><li>Awatade, N. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Significant+functional+differences+in+differentiated+Conditionally+Reprogrammed+(CRC)-+and+Feeder-free+Dual+SMAD+inhibited-expanded+human+nasal+epithelial+cells.">Significant functional differences in differentiated Conditionally Reprogrammed (CRC)- and Feeder-free Dual SMAD inhibited-expanded human nasal epithelial cells.</a> Journal of Cystic Fibrosis. 20 (2), 364-371 (2021).</li><li>Veit, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Allosteric+folding+correction+of+F508del+and+rare+CFTR+mutants+by+elexacaftor-tezacaftor-ivacaftor+(Trikafta)+combination.">Allosteric folding correction of F508del and rare CFTR mutants by elexacaftor-tezacaftor-ivacaftor (Trikafta) combination.</a> JCI Insight. 5 (18), 139983 (2020).</li><li>Dale, T. P., Borg D'anastasi, E., Haris, M., Forsyth, N. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rock+Inhibitor+Y-27632+enables+feeder-free,+unlimited+expansion+of+Sus+scrofa+domesticus+swine+airway+stem+cells+to+facilitate+respiratory+research.">Rock Inhibitor Y-27632 enables feeder-free, unlimited expansion of Sus scrofa domesticus swine airway stem cells to facilitate respiratory research.</a> Stem Cells International. 2019, 1-15 (2019).</li><li>Laselva, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Rescue+of+multiple+class+II+CFTR+mutations+by+elexacaftor+tezacaftor+ivacaftor+mediated+in+part+by+the+dual+activities+of+elexacaftor+as+both+corrector+and+potentiator.">Rescue of multiple class II CFTR mutations by elexacaftor+tezacaftor+ivacaftor mediated in part by the dual activities of elexacaftor as both corrector and potentiator.</a> The European Respiratory Journal. 57 (6), 2002774 (2021).</li><li>Li, X., Krawetz, R., Liu, S., Meng, G., Rancourt, D. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=ROCK+inhibitor+improves+survival+of+cryopreserved+serum/feeder-free+single+human+embryonic+stem+cells.">ROCK inhibitor improves survival of cryopreserved serum/feeder-free single human embryonic stem cells.</a> Human Reproduction. 24 (3), 580-589 (2008).</li><li>Neuberger, T., Burton, B., Clark, H., Van Goor, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+primary+cultures+of+human+bronchial+epithelial+cells+isolated+from+cystic+fibrosis+patients+for+the+pre-clinical+testing+of+CFTR+modulators.">Use of primary cultures of human bronchial epithelial cells isolated from cystic fibrosis patients for the pre-clinical testing of CFTR modulators.</a> Methods in Molecular Biology. 741, 39-54 (2011).</li><li>Laselva, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Emerging+pre-clinical+modulators+developed+for+F508del-CFTR+have+the+potential+to+be+effective+for+ORKAMBI+resistant+processing+mutants.">Emerging pre-clinical modulators developed for F508del-CFTR have the potential to be effective for ORKAMBI resistant processing mutants.</a> Journal of Cystic Fibrosis. 20 (1), 106-119 (2021).</li></ol>

The use of patient-derived nasal epithelial cells as surrogates for human bronchial epithelial (HBE) cells to measure CFTR activity in the context of personalized medicine has been proposed as HNE reproduce cells&#39; properties in culture9,11. The strong advantage of HNE over HBE cell cultures is that they are easily and non-invasively sampled. Short-circuit current measurements in HNE cell cultures enable assessment of CFTR-dependent Cl- transport ac...

Cystic Fibrosis (CF) is an autosomal recessive disorder resulting from mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene leading to the absence or dysfunction of the CFTR protein, an anion channel located at the apical surface of epithelia1,2. Recent advances in CFTR therapy have improved the prognosis of the disease, and the last approved drugs combining CFTR correctors and CFTR potentiators led to major improvements in lung function and quality of life for CF patients carrying the most frequent mutation p.Phe508del mutation (F508del)3,4. Despite this promising therapeutic progress, around 10% of CF patients are ineligible as they carry mutations that are unrescuable by these CFTR modulators. For these patients, there is a need to test other drugs or drug combinations to find the most efficient combination for specific mutations, highlighting the importance of personalized therapies.
Human nasal epithelial (HNE) cells are easy to collect by simple, non-invasive nasal brushing and allow quantification of cyclic AMP-mediated Chloride (Cl&#8722;) transport as an index of CFTR function. HNE cells yield an accurate model of human airway, but their lifespan is limited in culture. Thanks to the optimization of culture techniques, patient-derived primary HNE cells can be conditionally reprogrammed with Rho-associated kinase inhibitor (ROCKi), amplified, and differentiated into a pseudo-stratified epithelium in air-liquid interface (ALI) conditions on microporous filters5,6. Numerous culture protocols for HNE culture exist (commercially available, serum-free, &#34;homemade&#34;, co-culture with feeder-cells, etc.), and choice of media and culture conditions have been described to impact growth, cell population differentiation and epithelial function7,8. The protocol here presents a simplified, feeder-free, ROCKi amplification method that allows to successfully obtain a large number of HNE cells that are then differentiated at ALI for CFTR function assays.
We have demonstrated that, in differentiated HNE cells, a 48 h treatment with CFTR modulators is sufficient to induce electrophysiological correction of CFTR dependent Cl- current and that the correction observed in vitro may be correlated with the patient&#39;s clinical improvement9. HNE cells, therefore, represent an appropriate model not only for fundamental CF research but for pre-clinical studies with patient-specific CFTR modulator testing. In this context of personalized therapy, the goal of the protocol was to validate that cryopreserved HNE cells from CF patients, grown in our conditions, were an appropriate model for CFTR correction studies, and similar results could be expected when comparing CFTR dependent Cl- transport from fresh and frozen-thawed cells. The study also assessed different CFTR modulators&#39; efficacy when using dual and triple therapies.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>ABBV-2222</td>
			<td>Selleckchem</td>
			<td>S8535</td>
			<td></td>
		</tr>
		<tr>
			<td>ABBV-974</td>
			<td>Selleckchem</td>
			<td>S8698</td>
			<td></td>
		</tr>
		<tr>
			<td>Advanced DMEM/F-12</td>
			<td>Life Technologies</td>
			<td>12634010</td>
			<td></td>
		</tr>
		<tr>
			<td>Alexa 488 goat secondary antibody</td>
			<td>Invitrogen</td>
			<td>A11001</td>
			<td></td>
		</tr>
		<tr>
			<td>Alexa 594 goat secondary antibody</td>
			<td>Invitrogen</td>
			<td>A11012</td>
			<td></td>
		</tr>
		<tr>
			<td>Amphotericin B</td>
			<td>Life Technologies</td>
			<td>15290026</td>
			<td></td>
		</tr>
		<tr>
			<td>Anti-alpha-tubulin antibody</td>
			<td>Abcam</td>
			<td>ab80779</td>
			<td></td>
		</tr>
		<tr>
			<td>Anti-CFTR monoclonal antibody (24-1)</td>
			<td>R&#38;D Systems</td>
			<td>MAB25031</td>
			<td></td>
		</tr>
		<tr>
			<td>Anti-cytokeratin 8 antibody</td>
			<td>Progen</td>
			<td>61038</td>
			<td></td>
		</tr>
		<tr>
			<td>Anti-Muc5AC antibody</td>
			<td>Santa Cruz Biotech</td>
			<td>sc-20118</td>
			<td></td>
		</tr>
		<tr>
			<td>Anti-ZO-1 antibody</td>
			<td>Santa Cruz Biotech</td>
			<td>sc-10804</td>
			<td></td>
		</tr>
		<tr>
			<td>Ciprofloxacin</td>
			<td></td>
			<td>provided by Necker Hospital Pharmacy</td>
			<td></td>
		</tr>
		<tr>
			<td>Colimycin</td>
			<td>Sanofi</td>
			<td>provided by Necker Hospital Pharmacy</td>
			<td></td>
		</tr>
		<tr>
			<td>Collagen type IV</td>
			<td>Sigma-Aldrich Merck</td>
			<td>C-7521</td>
			<td></td>
		</tr>
		<tr>
			<td>cytology brush</td>
			<td>Laboratory GYNEAS</td>
			<td>02.104</td>
			<td></td>
		</tr>
		<tr>
			<td>DMSO</td>
			<td>Sigma-Aldrich Merck</td>
			<td>D2650</td>
			<td></td>
		</tr>
		<tr>
			<td>EGF</td>
			<td>Life Technologies</td>
			<td>PHG0311</td>
			<td></td>
		</tr>
		<tr>
			<td>Epinephrin</td>
			<td>Sigma-Aldrich Merck</td>
			<td>E4375</td>
			<td></td>
		</tr>
		<tr>
			<td>F12-Nutrient Mixture</td>
			<td>Life Technologies</td>
			<td>11765054</td>
			<td></td>
		</tr>
		<tr>
			<td>FBS</td>
			<td>Life Technologies</td>
			<td>10270106</td>
			<td></td>
		</tr>
		<tr>
			<td>Ferticult</td>
			<td>Fertipro NV</td>
			<td>FLUSH020</td>
			<td></td>
		</tr>
		<tr>
			<td>Flasks 25</td>
			<td>Thermo Scientific</td>
			<td>156.367</td>
			<td></td>
		</tr>
		<tr>
			<td>Flasks 75</td>
			<td>Thermo Scientific</td>
			<td>156.499</td>
			<td></td>
		</tr>
		<tr>
			<td>Glacial acetic acid</td>
			<td>VWR</td>
			<td>20104.298</td>
			<td></td>
		</tr>
		<tr>
			<td>HEPES</td>
			<td>Sigma-Aldrich Merck</td>
			<td>H3375</td>
			<td></td>
		</tr>
		<tr>
			<td>Hydrocortisone</td>
			<td>Sigma-Aldrich Merck</td>
			<td>SLCJ0893</td>
			<td></td>
		</tr>
		<tr>
			<td>Insulin</td>
			<td>Sigma-Aldrich Merck</td>
			<td>I0516</td>
			<td></td>
		</tr>
		<tr>
			<td>Mg2+ and Ca2+-free DPBS</td>
			<td>Life Technologies</td>
			<td>14190094</td>
			<td></td>
		</tr>
		<tr>
			<td>Penicillin/Streptomycin</td>
			<td>Life Technologies</td>
			<td>15140130</td>
			<td></td>
		</tr>
		<tr>
			<td>Tazocillin</td>
			<td>Mylan</td>
			<td>provided by Necker Hospital Pharmacy</td>
			<td></td>
		</tr>
		<tr>
			<td>Transwell Filters</td>
			<td>Sigma-Aldrich Merck</td>
			<td>CLS3470-48EA</td>
			<td></td>
		</tr>
		<tr>
			<td>Triton-X100</td>
			<td>Sigma-Aldrich Merck</td>
			<td>T8787</td>
			<td></td>
		</tr>
		<tr>
			<td>Trypsin 0,25%</td>
			<td>Life Technologies</td>
			<td>25200056</td>
			<td></td>
		</tr>
		<tr>
			<td>Vectashield mounting medium with DAPI</td>
			<td>Vector Laboratories</td>
			<td>H-1200</td>
			<td></td>
		</tr>
		<tr>
			<td>VX-445</td>
			<td>Selleckchem</td>
			<td>S8851</td>
			<td></td>
		</tr>
		<tr>
			<td>VX-661</td>
			<td>Selleckchem</td>
			<td>S7059</td>
			<td></td>
		</tr>
		<tr>
			<td>VX-770</td>
			<td>Selleckchem</td>
			<td>S1144</td>
			<td></td>
		</tr>
		<tr>
			<td>VX-809</td>
			<td>Selleckchem</td>
			<td>S1565</td>
			<td></td>
		</tr>
		<tr>
			<td>Xylocaine naphazoline 5%</td>
			<td>Aspen France</td>
			<td>provided by Necker Hospital Pharmacy</td>
			<td></td>
		</tr>
		<tr>
			<td>Y-27632</td>
			<td>Selleckchem</td>
			<td>S1049</td>
			<td></td>
		</tr>
	</tbody>
</table>

primary human nasal epithelial cells: biobanking in the context of precision medicine

Human nasal epithelial (HNE) cells are easy to collect by simple, non-invasive nasal brushing. Patient-derived primary HNE cells can be amplified and differentiated into a pseudo-stratified epithelium in air-liquid interface conditions to quantify cyclic AMP-mediated Chloride (Cl-) transport as an index of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) function. If critical steps such as quality of nasal brushing and cell density upon cryopreservation are performed efficiently, HNE cells can be successfully biobanked. Moreover, short-circuit current studies demonstrate that freeze-thawing does not significantly modify HNE cells&#39; electrophysiological properties and response to CFTR modulators. In the culture conditions used in this study, when less than 2 x 106 cells are frozen per cryovial, the failure rate is very high. We recommend freezing at least 3 x 106 cells per cryovial. We show that dual therapies combining a CFTR corrector with a CFTR potentiator have a comparable correction efficacy for CFTR activity in F508del-homozygous HNE cells. Triple therapy VX-445 + VX-661 + VX-770 significantly increased correction of CFTR activity compared to dual therapy VX-809 + VX-770. The measure of CFTR activity in HNE cells is a promising pre-clinical biomarker useful to guide CFTR modulator therapy.

Fresh HNE cells cultured at the air-liquid interface display typical features of the polarized and differentiated respiratory epithelium as assessed by immunostaining (Figure 1). HNE cells re-differentiate into a heterogeneous layer of epithelial cells (positive keratin 8 immunostaining) that mimic the in vivo situation of a pseudo-stratified respiratory epithelium composed of ciliated (positive alpha-tubulin staining) and non-ciliated mucus-producing goblet cells (positive Muc5Ac i...

Watch this Scientific Journal Video about Primary Human Nasal Epithelial Cells: Biobanking in the Context of Precision Medicine at JoVE.com

Primary Human Nasal Epithelial Cells: Biobanking in the Context of Precision Medicine

Here we describe the isolation, amplification, and differentiation of primary human nasal epithelial (HNE) cells at the air-liquid interface and a biobanking protocol allowing to successfully freeze and then thaw amplified HNE. The protocol analyzes electrophysiological properties of differentiated HNE cells and CFTR-related chloride secretion correction upon different modulator treatments.

Human nasal epithelial (HNE) cells are easy to collect by simple, non-invasive nasal brushing. Patient-derived primary HNE cells can be amplified and ...

This protocol highlights the key steps for amplifying, differentiating, and cryopreserving primary nasal epithelial cells. In our culture conditions, primary nasal epithelial cells mimic the lung epithelium. This allows patient derived cultures and personalized medicine studies from fresh or biobanked cells.The patient-derived nasal epithelial cultures can be used to evaluate CFTR activity and help with cystic fibrosis therapy by evaluating the patient's individual response to new therapies. Demonstrating the procedure will be Aurelie Hatton, an engineer from my laboratory. To begin, grow nasal epithelial or HNE cells, in 10 milliliters of amplification medium.Incubate at 37 degrees Celsius and 5%carbon dioxide in a 75 square centimeter collagen coated flask until it reaches 80 to 90%confluency. Change the medium every 48 to 72 hours. Later, wash the cells with 10 milliliters of magnesium and calcium free DPBS.Aspirate and discard the saline. Before adding two milliliters of 0.25%trypsin and returning the flask to the incubator for eight to 12 minutes. Later, tap the flask firmly with a palm to help cell detachment.Add 10 milliliters of the amplification medium to stop the enzymatic reaction. Vigorously rinse the flask using a 10 milliliter pipette to draw up and expel the amplification medium over the flask surface to rinse and detach cells and collect the cells in a 15 milliliter tube. Centrifuge the cell suspension at 500 times G for five minutes at four degrees Celsius and discard the supernatant.Re-suspend the pellet in five to 10 milliliters of amplification medium. Then count the cells on a hemocytometer. After cell counting, centrifuge the cells at 500 times G for five minutes at four degrees Celsius and discard the supernatant.Then re-suspend the pellet in the enriched freezing medium to obtain three to five times 10 to the six cells per milliliter and place in a cryo vial. Slowly freeze the cells by reducing the temperature by approximately one degree Celsius per minute in an appropriate cryofreezing container at minus 80 degree Celsius. The next day, move the preserved sample to a nitrogen storage container for longterm storage.Warm the freshly prepared amplification medium in a water bath set to 37 degrees Celsius. Remove cryo vials from the nitrogen storage tank and rapidly place them in the water bath, taking care not to submerge the whole vial in water. Remove the cryo vials from the water bath when only a small frozen droplet remains.Wipe the vials with 70%alcohol and place them under the hood. Using a one milliliter pipette, transfer the thawed cells to a 15 milliliter tube. Then add one milliliter of warm amplification medium in a drop-wise manner.After one minute, add another one milliliter of amplification medium and wait for a minute. Add 10 milliliters of amplification medium and centrifuge at 500 times G for two minutes at four degrees Celsius. Aspirate and discard the supernatant.Re-suspend the pellet in a volume of amplification medium required to achieve a cell density of one times 10 to the six cells per milliliter. After seeding the cells onto a 25 square centimeter collagen coated flask, containing amplification medium, incubate the cells at 37 degrees Celsius and 5%carbon dioxide. Visually observe cell expansion over two to three days before performing cell amplification as demonstrated earlier.Seed the cells at a density of 3.3 times 10 to the fifth cells per filter on 0.33 square centimeter collagen coated porous filters, supplemented with 300 microliters of amplification medium at the apical side and 900 microliters of air liquid medium at the basolateral side. After three days, aspirate the apical medium and culture the cells at the air-liquid interface for three to four weeks in the air-liquid medium to establish a differentiated epithelium. Change the basal medium every 48 to 72 hours.Fresh HNE cells cultured at the air-liquid interface displayed a typical features of the polarized and differentiated respiratory epithelium. In the 78 HNE cell samples, success rates were compared in nasal brushing seeded immediately and after one to seven days of transport in a flushing medium. The initial mean percentage of successful cultures was 82%and reached 87%in samples seeded between zero to five days.83%of the samples that differentiated successfully in fresh conditions also were successful in cryopreserved samples. Similarly, in samples that failed to differentiate in fresh conditions, 71%were also unsuccessful in freeze-thaw conditions. Moreover, 50%of samples frozen between two to three times 10 to the six cells per cryo vial failed to grow when thawed, reaching 80%for below two times 10 to the six cells.For short circuit current change in response to forskolin and short circuit current change in response to CFTR inhibitor 172 in DMSO treated HNE cells, no significant difference was observed between fresh or frozen thawed HNE. Upon treatment, both cell types displayed significant correction with an increase in short circuit current change in response to forskolin and a decrease in short circuit current change in response to CFTR inhibitor 172. the corrective response of CFTR function dual therapies were assessed as compared to DMSO treated HNE cells short circuit current change in response to forskolin and in response to CFTR inhibitor 172 were significantly improved by both VX-809 plus VX-770, and VX-661 plus VX-770.Three different CFTR modulator therapies in HNE from six F508del homozygous patients were compared. When used in combination with a CFTR corrector and potentiator, both vertex and a CFTR modulators, corrected short circuit current change in response to forskolin and short circuit current change in response to CFTR inhibitor 172 to a similar extent. When freezing HNE cells, it is important to have at least 3 million cells per cryo vial to increase the chances of a good outcome upon thawing.CFTR activity in HNE cells has been shown to be a good predictive model to evaluate and adjust personalized therapies in cystic fibrosis.

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JoVE Journal

Biology

2.6K visualizações.  Institut Necker Enfants Malades. Este protocolo destaca os principais passos para amplificar, diferenciar e criopreservar células epiteliais primárias. Em nossas condições culturais, as células epiteliais nasais primárias imitam o epitélio pulmonar. Isso permite culturas derivadas do paciente e estudos de medicina personalizados de células frescas ou biobancaradas.As culturas epiteliais nasais derivadas do paciente podem ser usadas para avaliar a atividade do CFTR e ajudar na terapia de fibrose cística, avali...