Name: generation of human nasal epithelial cell spheroids for individualized cystic fibrosis transmembrane conductance regulator study
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Description: Watch this Scientific Journal Video about Generation of Human Nasal Epithelial Cell Spheroids for Individualized Cystic Fibrosis Transmembrane Conductance Regulator Study at JoVE.com

This work was supported by Cystic Fibrosis Foundation Therapeutics, grant number CLANCY14XX0, and through Cystic Fibrosis Foundation, grant number CLANCY15R0. The authors wish to thank Kristina Ray for her assistance in patient recruitment and regulatory oversight. The authors also wish to thank the HNE working group, supported by the Cystic Fibrosis Foundation, who assisted in generation of HNE culture capabilities: Preston Bratcher, Calvin Cotton, Martina Gentzsch, Elizabeth Joseloff, Michael Myerburg, Dave Nichols, Scott Randell, Steve Rowe, G. Marty Solomon, and Katherine Tuggle.

HNE samples were procured from subjects recruited through the Cincinnati Children&#39;s Hospital Medical Center CF Research Center. All methods described here have been approved by the Institutional Review Board (IRB) of Cincinnati Children&#39;s Hospital Medical Center. Written consent was obtained from all subjects prior to testing.
1. Prepare Expansion Media and Antibiotic Media
<ol>
	<li>Gather media components listed in Table 1. Thaw frozen materials at room temperature...

<ol>
	<li>Rowe, S. M., Miller, S., Sorscher, E. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cystic+fibrosis.">Cystic fibrosis.</a> N Engl J Med. 352 (19), 1992-2001 (2005).</li><li>Rommens, J. 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=Identification+of+the+cystic+fibrosis+gene:+chromosome+walking+and+jumping.">Identification of the cystic fibrosis gene: chromosome walking and jumping.</a> Science. 245 (4922), 1059-1065 (1989).</li><li>Anderson, M. P., 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=Nucleoside+triphosphates+are+required+to+open+the+CFTR+chloride+channel.">Nucleoside triphosphates are required to open the CFTR chloride channel.</a> Cell. 67 (4), 775-784 (1991).</li><li>Boucher, R. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+airway+ion+transport.+Part+one.">Human airway ion transport. Part one.</a> Am J Respir Crit Care Med. 150 (1), 271-281 (1994).</li><li>Ehre, C., Ridley, C., Thornton, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cystic+fibrosis:+an+inherited+disease+affecting+mucin-producing+organs.">Cystic fibrosis: an inherited disease affecting mucin-producing organs.</a> Int J Biochem Cell Biol. 52, 136-145 (2014).</li><li>Accurso, F. 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=Effect+of+VX-770+in+persons+with+cystic+fibrosis+and+the+G551D-CFTR+mutation.">Effect of VX-770 in persons with cystic fibrosis and the G551D-CFTR mutation.</a> N Engl J Med. 363 (21), 1991-2003 (2010).</li><li>De Boeck, 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=Efficacy+and+safety+of+ivacaftor+in+patients+with+cystic+fibrosis+and+a+non-G551D+gating+mutation.">Efficacy and safety of ivacaftor in patients with cystic fibrosis and a non-G551D gating mutation.</a> J Cyst Fibros. 13 (6), 674-680 (2014).</li><li>Moss, R. B., 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=Efficacy+and+safety+of+ivacaftor+in+patients+with+cystic+fibrosis+who+have+an+Arg117His-CFTR+mutation:+a+double-blind,+randomised+controlled+trial.">Efficacy and safety of ivacaftor in patients with cystic fibrosis who have an Arg117His-CFTR mutation: a double-blind, randomised controlled trial.</a> Lancet Respir Med. 3 (7), 524-533 (2015).</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> N Engl J Med. , (2015).</li><li>Brewington, J. J., McPhail, G. L., Clancy, J. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lumacaftor+alone+and+combined+with+ivacaftor:+preclinical+and+clinical+trial+experience+of+F508del+CFTR+correction.">Lumacaftor alone and combined with ivacaftor: preclinical and clinical trial experience of F508del CFTR correction.</a> Expert Rev Respir Med. 10 (1), 5-17 (2016).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> CFTR2 Database. , (2017).</li><li>Mou, H., Brazauskas, K., Rajagopal, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Personalized+medicine+for+cystic+fibrosis:+establishing+human+model+systems.">Personalized medicine for cystic fibrosis: establishing human model systems.</a> Pediatr Pulmonol. 50 Suppl 40, S14-S23 (2015).</li><li>Randell, S. H., Fulcher, M. L., O'Neal, W., Olsen, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Primary+epithelial+cell+models+for+cystic+fibrosis+research.">Primary epithelial cell models for cystic fibrosis research.</a> Methods Mol Biol. 742, 285-310 (2011).</li><li>Whitcutt, M. J., Adler, K. B., Wu, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+biphasic+chamber+system+for+maintaining+polarity+of+differentiation+of+cultured+respiratory+tract+epithelial+cells.">A biphasic chamber system for maintaining polarity of differentiation of cultured respiratory tract epithelial cells.</a> In Vitro Cell Dev Biol. 24 (5), 420-428 (1988).</li><li>Worthington, E. N., Tarran, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Methods+for+ASL+measurements+and+mucus+transport+rates+in+cell+cultures.">Methods for ASL measurements and mucus transport rates in cell cultures.</a> Methods Mol Biol. 742, 77-92 (2011).</li><li>Van Goor, 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=Correction+of+the+F508del-CFTR+protein+processing+defect+in+vitro+by+the+investigational+drug+VX-809.">Correction of the F508del-CFTR protein processing defect in vitro by the investigational drug VX-809.</a> Proc Natl Acad Sci U S A. 108 (46), 18843-18848 (2011).</li><li>Hug, M. J., Tummler, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intestinal+current+measurements+to+diagnose+cystic+fibrosis.">Intestinal current measurements to diagnose cystic fibrosis.</a> J Cyst Fibros. 3 Suppl 2, 157-158 (2004).</li><li>van Barneveld, A., Stanke, F., Ballmann, M., Naim, H. Y., Tummler, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ex+vivo+biochemical+analysis+of+CFTR+in+human+rectal+biopsies.">Ex vivo biochemical analysis of CFTR in human rectal biopsies.</a> Biochim Biophys Acta. 1762 (4), 393-397 (2006).</li><li>Dekkers, J. 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=A+functional+CFTR+assay+using+primary+cystic+fibrosis+intestinal+organoids.">A functional CFTR assay using primary cystic fibrosis intestinal organoids.</a> Nat Med. 19 (7), 939-945 (2013).</li><li>Dekkers, J. 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=Optimal+correction+of+distinct+CFTR+folding+mutants+in+rectal+cystic+fibrosis+organoids.">Optimal correction of distinct CFTR folding mutants in rectal cystic fibrosis organoids.</a> Eur Respir J. 48 (2), 451-458 (2016).</li><li>Dekkers, R., 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=A+bioassay+using+intestinal+organoids+to+measure+CFTR+modulators+in+human+plasma.">A bioassay using intestinal organoids to measure CFTR modulators in human plasma.</a> J Cyst Fibros. 14 (2), 178-181 (2015).</li><li>Zomer-van Ommen, D. 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=Limited+premature+termination+codon+suppression+by+read-through+agents+in+cystic+fibrosis+intestinal+organoids.">Limited premature termination codon suppression by read-through agents in cystic fibrosis intestinal organoids.</a> J Cyst Fibros. , (2015).</li><li>Bridges, M. A., Walker, D. C., Davidson, A. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cystic+fibrosis+and+control+nasal+epithelial+cells+harvested+by+a+brushing+procedure.">Cystic fibrosis and control nasal epithelial cells harvested by a brushing procedure.</a> In Vitro Cell Dev Biol. 27a (9), 684-686 (1991).</li><li>Di Lullo, A. 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=An+&amp;#34;ex+vivo+model&amp;#34;+contributing+to+the+diagnosis+and+evaluation+of+new+drugs+in+cystic+fibrosis.">An &amp;#34;ex vivo model&amp;#34; contributing to the diagnosis and evaluation of new drugs in cystic fibrosis.</a> Acta Otorhinolaryngol Ital. 37 (3), 207-213 (2017).</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> Sci Rep. 7 (1), 7375 (2017).</li><li>Devalia, J. L., 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=Human+nasal+and+bronchial+epithelial+cells+in+culture:+an+overview+of+their+characteristics+and+function.">Human nasal and bronchial epithelial cells in culture: an overview of their characteristics and function.</a> Allergy Proc. 12 (2), 71-79 (1991).</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> Respir Med. 84 (4), 303-312 (1990).</li><li>Thavagnanam, 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=Nasal+epithelial+cells+can+act+as+a+physiological+surrogate+for+paediatric+asthma+studies.">Nasal epithelial cells can act as a physiological surrogate for paediatric asthma studies.</a> PLoS One. 9 (1), e85802 (2014).</li><li>Jorissen, M., Van der Schueren, B., Van den Berghe, H., Cassiman, J. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+preservation+and+regeneration+of+cilia+on+human+nasal+epithelial+cells+cultured+in+vitro.">The preservation and regeneration of cilia on human nasal epithelial cells cultured in vitro.</a> Arch Otorhinolaryngol. 246 (5), 308-314 (1989).</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=Detection+of+CFTR+function+and+modulation+in+primary+human+nasal+cell+spheroids.">Detection of CFTR function and modulation in primary human nasal cell spheroids.</a> J Cyst Fibros. , (2017).</li><li>Sun, H., 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=Tgf-beta+downregulation+of+distinct+chloride+channels+in+cystic+fibrosis-affected+epithelia.">Tgf-beta downregulation of distinct chloride channels in cystic fibrosis-affected epithelia.</a> PLoS One. 9 (9), e106842 (2014).</li><li>Boucher, R. 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This protocol describes the generation of patient-derived nasal cell spheroid cultures able to produce an individualized, specific model of CFTR function. There are several key steps in the process that should be closely attended to avoid difficulty. First is a good sample acquisition from the patient's nose. A good sample should have &gt;50,000 cells, limited mucus/debris, and be ready for processing within 4 h (though success is also easily achievable with overnight shipping on ice). Practice acquiring samples with cur...

Cystic Fibrosis (CF) is a fatal, autosomal recessive disease affecting over 70,000 people worldwide1. This life-shortening genetic disease is caused by mutations in the Cystic Fibrosis Transmembrane conductance Regulator protein (CFTR)2. CFTR is a member of the adenosine triphosphate-binding cassette family, and functions as an ion channel allowing movement of chloride and bicarbonate across the apical membranes of multiple polarized epithelia including the gastrointestinal tract, sweat gland, and respiratory tree, among others3,4. As such, dysfunctional CFTR leads to multisystem epithelial dysfunction, with most mortality stemming from the respiratory disease1. In the CF lung, loss of CFTR-driven airway surface liquid (ASL) regulation and mucus release leads to thickened mucus, airway obstruction, chronic infection, and progressive airway remodeling and loss of lung function1,5.
Despite the identification of CFTR dysfunction as the cause of disease, therapies in CF traditionally focused on mitigation of symptoms (e.g., pancreatic enzyme replacement therapy, airway clearance therapies)1. This approach was recently revolutionized by the advent of novel therapeutics, termed &#34;CFTR modulators,&#34; that directly target dysfunctional CFTR. This approach has shifted the clinical landscape from symptom management to disease-modifying care but carries several limitations6,7,8,9,10. Modulator activity is specific to the protein defect accompanying each CFTR mutation and limited to select genetic populations11. This limitation is driven by the heterogeneous nature of protein defects, but also by the impracticality of clinical trials in rare mutation groups. In addition, among subjects with well-studied genotypes (e.g., F508del/F508del CFTR, the most common CFTR mutation), there is wide variability in disease burden and modulator response6,7,8,9,11.
To overcome both of these issues, investigators have proposed the use of personalized models for preclinical testing12. This concept utilizes patient-specific tissue to generate an individualized ex vivo model system for compound testing, predicting in vivo subject response to therapies in a personalized fashion. Once validated, such a model could be used by clinicians to drive precision therapy regardless of the patient&#39;s underlying CFTR genotype.
Human bronchial epithelial (HBE) cells obtained from explant tissue at the time of lung transplant established the possibility of such a model for CF13,14. HBEs grown at an air-liquid interface (ALI) allow for functional CFTR quantification directly through electrophysiologic testing or indirectly through measures of ASL homeostasis13,15. This model has been critical to understanding CFTR biology and was a key driver in the development of CFTR modulators16. Unfortunately, HBE models are not tenable as a personalized model due to the invasive nature of acquisition (lung transplant or bronchial brushing) and lack of samples for those with rare mutations or mild disease. Conversely, intestinal tissue, obtained from rectal or duodenal biopsy specimens, can be used for intestinal current measurement (ICM) or a swelling-based organoid assay to study individualized CFTR function17,18,19. Organoid assays, in particular, are very sensitive models of CFTR activity20,21,22. Both models are limited by the tissue source (intestinal tissue, while most disease pathology is respiratory) and the semi-invasive method of acquisition. Alternatively, several investigators have studied human nasal epithelial (HNE) cells to model CFTR restoration23,24,25. HNEs can be safely harvested by brush or curettage in subjects of any age and, when cultured in ALI, recapitulate many characteristics of HBEs25,26,27,28. HNE monolayer cultures have traditionally been limited by squamous transformation and a long time to maturity29. Moreover, reported short-circuit current measurements in HNEs are smaller than those in HBEs, suggesting a smaller window to detect therapeutic efficacy25.
Given the need for a personalized, non-invasive, respiratory tissue culture model of CFTR function, we sought to merge the sensitivity of a swelling-based, organoid assay with the non-invasive and respiratory nature of HNEs. Here, we describe our method of generating 3-dimensional &#34;spheroid&#34; cultures of HNEs for individualized CFTR study in a swelling-based assay30. HNE spheroids polarize reliably with the epithelial apex towards the sphere center, or lumen. This model recapitulates numerous characteristics of a lower respiratory epithelium and matures more quickly than ALI cultures. As a functional assay, HNE spheroids reliably quantify a range of CFTR function, as well as modulation in well-studied mutation groups (e.g., F508del CFTR). This swelling-based assay capitalizes on the ion/salt transport properties of CFTR, indirectly measuring fluid influx into the spheroid as water follows apical salt efflux. In this fashion, stimulated spheroids with fully functional CFTR swell robustly, while those with dysfunctional CFTR swell less or shrink. This is quantified through image analysis of pre- and 1 h post-stimulation spheroids, measuring luminal area and determining the percent change. This measure can then be compared across experimental groups to screen for drug bioactivity in a patient-specific fashion.

<table border="0" cellpadding="0" cellspacing="0" width="633">
	<tbody>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">1.5 mL Eppendorf Tube</td>
			<td style="width:149px;">USA Scientific&#160;</td>
			<td style="width:131px;">4036-3204</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">150 mL Filter Flask</td>
			<td style="width:149px;">Midsci&#160;</td>
			<td style="width:131px;">TP99150</td>
			<td style="width:173px;">To filter Media</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">15 mL Conical Tube</td>
			<td style="width:149px;">Midsci&#160;</td>
			<td style="width:131px;">TP91015</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">1 L Filter Flask</td>
			<td style="width:149px;">Midsci&#160;</td>
			<td style="width:131px;">TP99950</td>
			<td style="width:173px;">To filter Media</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">35 mm Glass-Bottom Dish</td>
			<td style="width:149px;">MatTek Corporation</td>
			<td style="width:131px;">P35G-0-20-C</td>
			<td style="width:173px;">Optional</td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:180px;">3-Isobutyl-1-Methylxanthine (IBMX)</td>
			<td style="width:149px;">Fisher Scientific&#160;</td>
			<td style="width:131px;">AC228420010&#160;</td>
			<td style="width:173px;">Prepare a 100 mM stock solution of 22.0 mg in 1 mL of DMSO</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">50 mL Conical Tube</td>
			<td style="width:149px;">Midsci&#160;</td>
			<td style="width:131px;">&#160;TP91050</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Accutase</td>
			<td style="width:149px;">Innovative Cell Technologies, Inc.</td>
			<td style="width:131px;">AT-104</td>
			<td style="width:173px;">Cell detachment solution</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Adenine</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">A2786-25G</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Amphotericin B</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">A9528-100MG</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Bovine Brain Extract (9mg/mL)</td>
			<td style="width:149px;">Lonza&#160;</td>
			<td style="width:131px;">CC-4098</td>
			<td style="width:173px;">See Table 2</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Ceftazidime hydrate</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">C3809-1G</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Cell Scrapers 20 cm&#160;</td>
			<td style="width:149px;">Midsci&#160;</td>
			<td style="width:131px;">TP99010</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:180px;">CFTR Inh172</td>
			<td style="width:149px;">Tocris Bioscience</td>
			<td style="width:131px;">3430</td>
			<td style="width:173px;">Prepare a 10 mM stock solution of 4.0 mg in 1 mL of DMSO</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Cholera Toxin B (From Vibrio cholerae)</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">C8052-.5MG</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">CYB-1</td>
			<td style="width:149px;">Medical Packaging Corporation</td>
			<td style="width:131px;">CYB-1</td>
			<td style="width:173px;">Cytology brush</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Dimethyl sulfoxide (DMSO)</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">D5879-500ML</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Dulbecco&#39;s Modified Eagle Media (DMEM)/F12 Hepes&#160;</td>
			<td style="width:149px;">Life Technologies&#160;</td>
			<td style="width:131px;">11330-057</td>
			<td style="width:173px;">Base Medium; See Tables 1 and 2</td>
		</tr>
		<tr height="80">
			<td height="80" style="height:80px;width:180px;">Epidermal Growth Factor (Recombinant Human Protein, Animal-Origin Free)</td>
			<td style="width:149px;">Thermo Fisher Scientific</td>
			<td style="width:131px;">PHG6045</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Epinephrine</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">E4250-1G</td>
			<td style="width:173px;">See Table 2</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Ethanol</td>
			<td style="width:149px;">Fisher Scientific&#160;</td>
			<td style="width:131px;">2701</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Ethanolamine</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">E0135-500ML</td>
			<td style="width:173px;">16.6 mM solution; See Table 2</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Ethylenediaminetetraacetic Acid (EDTA)</td>
			<td style="width:149px;">TCI America&#160;</td>
			<td style="width:131px;">E0084</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Fetal Bovine Serum (high performance FBS)</td>
			<td style="width:149px;">Invitrogen&#160;</td>
			<td style="width:131px;">10082147</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:180px;">Forskolin</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">F6886-50</td>
			<td style="width:173px;">Prepare a 10 mM stock solution of 4.1 mg in 1 mL of DMSO</td>
		</tr>
		<tr height="101">
			<td height="101" style="height:101px;width:180px;">Growth Factor-Reduced Matrigel</td>
			<td style="width:149px;">Corning, Inc.</td>
			<td style="width:131px;">356231</td>
			<td style="width:173px;">Corning Matrigel Growth Factor Reduced (GFR) Basement Membrane Matrix, Phenol Red-Free, LDEV-Free, 10 mL.</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Hemacytometer</td>
			<td style="width:149px;">Hausser Scientific</td>
			<td style="width:131px;">1483</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Human Collagen Solution, Type I (VitroCol; 3 mg/mL)</td>
			<td style="width:149px;">Advanced BioMatrix</td>
			<td style="width:131px;">5007-A</td>
			<td style="width:173px;">Collagen solution</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">HyClone (aka FetalClone II)&#160;</td>
			<td style="width:149px;">GE Healthcare&#160;</td>
			<td style="width:131px;">SH30066.03HI</td>
			<td style="width:173px;">See Table 2</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Hydrocortisone</td>
			<td style="width:149px;">StemCell Technologies</td>
			<td style="width:131px;">07904</td>
			<td style="width:173px;">See Tables 1 and 2</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Insulin, human recombinant, zinc solution</td>
			<td style="width:149px;">Life Technologies&#160;</td>
			<td style="width:131px;">12585014</td>
			<td style="width:173px;">4 mg/mL solution; see Table 2</td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:180px;">IVF 4-Well Dish, Non-treated</td>
			<td style="width:149px;">NUNC (via Fisher Scientific)</td>
			<td style="width:131px;">12566350</td>
			<td style="width:173px;">4-well plate for spheroids; similar well size to a 24-well plate</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">MEF-CF1-IRR</td>
			<td style="width:149px;">Globalstem</td>
			<td style="width:131px;">GSC-6001G</td>
			<td style="width:173px;">Irradiated murine embryonic fibroblasts</td>
		</tr>
		<tr height="160">
			<td height="160" style="height:160px;width:180px;">Metamorph 7.7</td>
			<td style="width:149px;">Molecular Devices</td>
			<td style="width:131px;"></td>
			<td style="width:173px;">Analysis Software; https://www.moleculardevices.com/systems/metamorph-research-imaging/metamorph-microscopy-automation-and-image-analysis-software for a quote</td>
		</tr>
		<tr height="140">
			<td height="140" style="height:140px;width:180px;">Olympus IX51 Inverted Microscope</td>
			<td style="width:149px;">Olympus Corporation</td>
			<td style="width:131px;">Discontinued</td>
			<td style="width:173px;">Imaging Microscope. Replacment: Olympus IX53, https://www.olympus-lifescience.com/pt/microscopes/inverted/ix53/&#160; for a quote</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Pen Strep</td>
			<td style="width:149px;">Life Technologies&#160;</td>
			<td style="width:131px;">15140122</td>
			<td style="width:173px;">See Table 2</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Phsophoryletheanolamine</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">P0503-5G</td>
			<td style="width:173px;">See Table 2</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Retinoic Acid</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">R2625-50MG</td>
			<td style="width:173px;">See Table 2</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Rhinoprobe</td>
			<td style="width:149px;">Arlington Scientific, Inc.</td>
			<td style="width:131px;">96-0905</td>
			<td style="width:173px;">Nasal curette</td>
		</tr>
		<tr height="101">
			<td height="101" style="height:101px;width:180px;">Slidebook 5.5</td>
			<td style="width:149px;">3i, Intelligent Imaging Innovations</td>
			<td style="width:131px;">Discontinued</td>
			<td style="width:173px;">Imaging Software. Replacement: Slidebook 6, https://www.intelligent-imaging.com/slidebook for a quote</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Sterile Phosphate Buffered Saline (PBS)</td>
			<td style="width:149px;">Thermo Fisher Scientific</td>
			<td style="width:131px;">20012050</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Sterile Water</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">W3500-6X500ML</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Tissue Culture Dish 100</td>
			<td style="width:149px;">Techno Plastic Products</td>
			<td style="width:131px;">93100</td>
			<td style="width:173px;">Tissue culture dish for expansion</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:180px;">Tobramycin</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">T4014-100MG</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Transferrin (Human Transferrin 0.5 mL)</td>
			<td style="width:149px;">Lonza&#160;</td>
			<td style="width:131px;">CC-4205</td>
			<td style="width:173px;">See Table 2</td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:180px;">Triiodothryonine</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">T6397-1G</td>
			<td style="width:173px;">3,3&#8242;,5-Triiodo-L-thyronine sodium salt&#160; [T3]; See Table 2</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Trypsin from Porcine Pancreas</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">T4799-10G</td>
			<td style="width:173px;"></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;width:180px;">Ultroser-G</td>
			<td style="width:149px;">Crescent Chemical (via Fisher Scientific)</td>
			<td style="width:131px;">NC0393024</td>
			<td style="width:173px;">20 mL lypophilized powder; See Table 2</td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:180px;">Vancomycin hydrochloride from Streptomyces orientalis</td>
			<td style="width:149px;">Sigma-Aldrich</td>
			<td style="width:131px;">V2002-5G</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:180px;">VX770</td>
			<td style="width:149px;">Selleck Chemicals</td>
			<td style="width:131px;">S1144</td>
			<td style="width:173px;">Prepare a 1 mM stock solution of 0.4 mg in 1 mL of DMSO</td>
		</tr>
		<tr height="60">
			<td height="60" style="height:60px;width:180px;">VX809</td>
			<td style="width:149px;">Selleck Chemicals</td>
			<td style="width:131px;">S1565</td>
			<td style="width:173px;">Purchase or prepare a 10 mM stock solution of 4.5 mg in 1 mL of DMSO</td>
		</tr>
		<tr height="41">
			<td height="41" style="height:41px;width:180px;">Y-27632 Dihydrochloride&#160; ROCK inhibitor&#160;</td>
			<td style="width:149px;">Enzo LifeSciences&#160;</td>
			<td style="width:131px;">ALX-270-333-M025&#160;</td>
			<td style="width:173px;">See Table 1</td>
		</tr>
	</tbody>
</table>

generation of human nasal epithelial cell spheroids for individualized cystic fibrosis transmembrane conductance regulator study

While the introduction of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulator drugs has revolutionized care in Cystic Fibrosis (CF), the genotype-directed therapy model currently in use has several limitations. First, rare or understudied mutation groups are excluded from definitive clinical trials. Moreover, as additional modulator drugs enter the market, it will become difficult to optimize the modulator choices for an individual subject. Both of these issues are addressed with the use of patient-derived, individualized preclinical model systems of CFTR function and modulation. Human nasal epithelial cells (HNEs) are an easily accessible source of respiratory tissue for such a model. Herein, we describe the generation of a three-dimensional spheroid model of CFTR function and modulation using primary HNEs. HNEs are isolated from subjects in a minimally invasive fashion, expanded in conditional reprogramming conditions, and seeded into the spheroid culture. Within 2 weeks of seeding, spheroid cultures generate HNE spheroids that can be stimulated with 3',5'-cyclic adenosine monophosphate (cAMP)-generating agonists to activate CFTR function. Spheroid swelling is then quantified as a proxy of CFTR activity. HNE spheroids capitalize on the minimally invasive, yet respiratory origin of nasal cells to generate an accessible, personalized model relevant to an epithelium reflecting disease morbidity and mortality. Compared to the air-liquid interface HNE cultures, spheroids are relatively quick to mature, which reduces the overall contamination rate. In its current form, the model is limited by low throughput, though this is offset by the relative ease of tissue acquisition. HNE spheroids can be used to reliably quantify and characterize CFTR activity at the individual level. An ongoing study to tie this quantification to in vivo drug response will determine if HNE spheroids are a true preclinical predictor of patient response to CFTR modulation.

HNEs should attach to the culture dish and form small islands of cells within 72 h of seeding; examples of good and poor island formation at one week are shown in Figure 1A and 1B, respectively. These islands should expand to cover the dish over the course of 15-30 days. Small or suboptimal samples may take longer, and often will not yield useful spheroids. Contamination with infectious agents is evidenced by deep yellow/cloudy media, failure...

Watch this Scientific Journal Video about Generation of Human Nasal Epithelial Cell Spheroids for Individualized Cystic Fibrosis Transmembrane Conductance Regulator Study at JoVE.com

Generation of Human Nasal Epithelial Cell Spheroids for Individualized Cystic Fibrosis Transmembrane Conductance Regulator Study

Here we describe a method to generate three-dimensional spheroid cultures of human nasal epithelial cells. Spheroids are then stimulated to drive Cystic Fibrosis Transmembrane Conductance Regulator (CFTR)-dependent ion and fluid secretion, quantifying the change in the spheroid luminal size as a proxy for CFTR function.

While the introduction of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulator drugs has revolutionized care in Cystic Fibrosis (CF), the ...

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Optimized LC-MS/MS Method for the High-throughput Analysis of Clinical Samples of Ivacaftor, Its Major Metabolites, and Lumacaftor in Biological Fluids of Cystic Fibrosis Patients

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