• Keine Ergebnisse gefunden

Part V: Generation of bioluminescent Pseudomonads

2. Mouse models of CF

Although CF is considered to be a rare disease a large number of patients rely on science to provide a cure or at least alleviation of their condition. As for all diseases new drugs or treatment options cannot immediately be tested in humans for obvious reasons. As animal testing is not regarded favorable by the general population, and should indeed also be questioned by the researcher, alternatives or improvements of

Conclusions and outlook

C-3

existing models should be performed whenever possible. This concept is commonly known as the 3R’s – Reduce, Refine, Replace [Russell and Burch 1959]. In the context of CF various approaches to improve existing models have been undertaken.

Replacement has been attempted by using cell culture models and refinement by investigating a wide variety of species (mice, ferrets, pigs) for their ability to serve as a meaningful model. A complete elimination of animal models is unrealistic as they still are too important for the study of disease mechanisms and the testing of new treatment options. This thesis therefore focused on the refinement of existing models, by utilizing a very sensitive method which is also non-invasive, thus in turn reducing the number of animals that need to be tested. Two mouse models of CF, which are available at the central animal laboratory of Hannover Medical School, were assessed for their potential to serve as animal models of CF. The results from chapter III were quite encouraging, showing small initial differences in the breathing pattern of CF and wild type mice of either genotype. Faster, shallower breathing was observed apparently to overcome pulmonary limitations. In addition lower weight gain was observed in one mouse model – a characteristic feature of CF.

However, the findings of Teichgräber and coworkers [Teichgräber et al 2008]

reporting a higher susceptibility to infection in Cftr-deficient mice could not be confirmed. Reasons for this originate most likely from the mode of infection. They utilized an intranasal infection, which leads to a distribution of the inoculate preferentially in the large conducting airways, while only a small amount penetrates into the deeper airways. We utilized an intratracheal inoculation, therefore bypassing the large conducting airways and distributing more bacteria in the lower airways. In this setting no age-dependent difference between Cftr-deficient and wild type mice could be observed

Further reasons might be attributed to the leaky expression of CFTR in the lungs of both models. New mouse models of CF would therefore be desirable for the study of CF related pulmonary issues. As the method is now established further mouse models of CF could be assessed for their usability, since lung function measurements using non-invasive head-out spirometry are very rare and not commonly performed for all models.

Conclusions and outlook

C-4 3. Bioluminescent Pseudomonads

With the emergence of systems able to measure luminescence in whole animals (mice and rats) without the need to sacrifice them, a new methodology became available to study the course of infections utilizing bioluminescent bacteria. Not only could they be used for the study of CF-related pulmonary issues but also in other contexts where P. aeruginosa is involved, e.g. burn wounds. Consequently, a representative panel of bioluminescent strains with various origins/properties would be useful. Bioluminescent Pseudomonads were created by a rather simple and easy procedure using the vector system from Herbert P. Schweizer. As long as the target site is not degenerated virtually all Pseudomonas strains could be made bioluminescent, including strains not utilized in this study, like environmental strains (Pseudomonas putida) that degrade pollutants, or important plant pathogens (Pseudomonas syringae).

Luminescence was about a factor 4 lower than for the firefly system, albeit with certain advantages in terms of kinetics and cost. Therefore, the bioluminescent strains hold great promise for the study of infections. However, a more sensitive analysis system than the IVIS® 200 would be needed, as the sensitivity limit in mice is very quickly reached. Furthermore measurements take quite long, resulting in high background and lower sensitivity. Sufficient luminescence can currently only be achieved through the application of high doses leading to unrealistic models.

Clearance by the immune system proved to be very efficient and resulted in a marked reduction of luminescence below the sensitivity limit of the apparatus within 24 hours post inoculation. Investigating a more chronic infection model, like the agar bead model reviewed by van Heeckeren [van Heeckeren and Schluchter 2002] could be worthwhile. Topical infections with P. aeruginosa, however can be easily investigated, e.g. in the study of burn wound models. Other in vitro applications of the strains are possible as well.

In summary, both newly established methods aimed at the non-invasive, non-lethal investigation of bacterial pulmonary infections hold great promise for future experiments.

References

R-1 References

Andersen DH. Cystic fibrosis of the pancreas and its relation to celiac disease: a clinical and pathological study. Am J Dis Child 1938; 56(2):344-399

Bates JHT and Irvin CG. Measuring lung function in mice: the phenotyping uncertainty principle. J Appl Physiol 2003; 94(4):1297-1306

Becher A. and Schweizer HP. Integration-proficient Pseudomonas aeruginosa vectors for isolation of single-copy chromosomal lacZ and lux gene fusions.

Biotechniques 2000; 29(5): 948-952

Bertani G. Lysogeny at mid-twentieth century: P1, P2, and other experimental systems. J Bacteriol 2004; 186(3): 595-600

Boat TF, Welsh MJ, Beaudet AL in The Metabolic Basis of Inherited Disease.

McGraw-Hill, New York, ed. 6, 1989, pp. 2649-2680

Bobadilla JL, Macek M, Fine JP and Farrell PM. Cystic fibrosis: a worldwide analysis of CFTR mutations–correlation with incidence data and application to screening. Hum Mutat 2002; 19(6): 575-606

Borowitz D, Baker RD, Stallings V. Consensus report on nutrition for pediatric patients with cystic fibrosis. J Pediatr Gastroenterol Nutr 2002; 35(3): 246-259 Boucher RC. Evidence for airway surface dehydration as the initiating event in CF

airway disease. J Intern Med 2007; 261(1): 5-16

Brown RH, Walters DM, Greenberg RS and Mitzner W. A method of endotracheal intubation and pulmonary functional assessment for repeated studies in mice.

J Appl Physiol 1999; 87(6): 2362-2365

Casals T, Bassas L, Egozcue S, Ramos MD, Giménez J, Segura A, Garcia F, Carrera M, Larriba S, Sarquella J and Estivill X. Heterogeneity for mutations in the CFTR gene and clinical correlations in patients with congenital absence of the vas deferens. Hum Reprod 2000; 15(7): 1476-1483

Chang YST, Klockgether J and Tümmler B. An intragenic deletion in pilQ leads to nonpiliation of a Pseudomonas aeruginosa strain isolated from cystic fibrosis lung. FEMS Microbiol Lett 2007; 270(2): 201-206

Choi KH, Kumar A and Schweizer HP. A 10-min method for preparation of highly electrocompetent Pseudomonas aeruginosa cells: application for DNA fragment transfer between chromosomes and plasmid transformation.

J Microbiol Methods 2006; 64(3): 391-397

Courtney JM, Dunbar KEA, McDowell A, Moore JE, Warke TJ, Stevenson M and Elborn JS. Clinical outcome of Burkholderia cepacia complex infection in cystic fibrosis adults. J Cyst Fibros 2004; 3(2): 93-98

References

R-2

Davies JC and Bilton D. Bugs, biofilms, and resistance in cystic fibrosis. Respir Care 2009; 54(5): 628-640

de Araújo FG, Novaes FC, dos Santos NPC, Martins VC, de Souza SM, dos Santos SEB and Ribeiro dos Santos AKC. Prevalence of deltaF508, G551D, G542X, and R553X mutations among cystic fibrosis patients in the North of Brazil.

Braz J Med Biol Res 2005; 38(1): 11-15

Derichs N, Sanz J, Von Kanel T, Stolpe C, Zapf A, Tümmler B, Gallati S and Ballmann M. Intestinal current measurement for diagnostic classification of patients with questionable cystic fibrosis: validation and reference data.

Thorax 2010; 65(7): 594-599

Diekema DJ, Pfaller MA, Jones RN, Doern GV, Winokur PL, Gales AC, Sader HS, Kugler K and Beach M. Survey of bloodstream infections due to gram-negative bacilli: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, and Latin America for the SENTRY Antimicrobial Surveillance Program, 1997. Clin Infect Dis 1999; 29(3): 595-607 DiGiandomenico A, Rao J and Goldberg JB. Oral vaccination of BALB/c mice with

Salmonella enterica serovar Typhimurium expressing Pseudomonas aeruginosa O antigen promotes increased survival in an acute fatal pneumonia model. Infect Immun 2004;72(12): 7012-7021

DiGiandomenico A, Rao J, Harcher K, Zaidi TS, Gardner J, Neely AN, Pier GB and Goldberg JB. Intranasal immunization with heterologously expressed polysaccharide protects against multiple Pseudomonas aeruginosa infections.

Proc Natl Acad Sci U S A 2007; 104(11): 4624-4629

Dodge JA. Male fertility in cystic fibrosis. Lancet 1995; 346(8975): 587-588

Dorin JR, Dickinson P, Alton EW, Smith SN, Geddes DM, Stevenson BJ, Kimber WL, Fleming S, Clarke AR and Hooper ML. Cystic fibrosis in the mouse by targeted insertional mutagenesis. Nature 1992; 359(6392): 211-215

Dorin JR, Stevenson BJ, Fleming S, Alton EW, Dickinson P, Porteous DJ. Long-term survival of the exon 10 insertional cystic fibrosis mutant mouse is a consequence of low level residual wild-type Cftr gene expression. Mamm Genome 1994; 5(8): 465-472

Emori TG and Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993; 6(4): 428-442

Geissmann F, Manz MG, Jung S, Sieweke MH, Merad M and Ley K. Development of monocytes, macrophages, and dendritic cells. Science 2010; 327(5966): 656-661

Gerritsen J. Host defence mechanisms of the respiratory system. Paediatr Respir Rev 2000; 1(2): 128-134

References

R-3

Gibson RL, Burns JL and Ramsey BW. Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med 2003;

168(8): 918-951

Gilljam M, Antoniou M, Shin J, Dupuis A, Corey M and Tullis DE. Pregnancy in cystic fibrosis. Fetal and maternal outcome. Chest 2000; 118(1): 85-91

Govan JR and Nelson JW. Microbiology of lung infection in cystic fibrosis. Br Med Bull 1992; 48(4): 912-930

Griesenbach U, Geddes DM and Alton EW. Gene therapy progress and prospects:

cystic fibrosis. Gene Ther 2006; 13(14): 1061-1067

Grubb BR and Boucher RC. Pathophysiology of gene-targeted mouse models for cystic fibrosis. Physiol Rev 1999; 79(1): 193-214

Haggie PM and Verkman AS. Unimpaired lysosomal acidification in respiratory epithelial cells in cystic fibrosis. J Biol Chem 2009; 284(12): 7681-7686

Hamelmann E, Schwarze J, Takeda K, Oshiba A, Larsen GL, Irvin CG and Gelfand EW. Noninvasive measurement of airway responsiveness in allergic mice using barometric plethysmography. Am J Respir Crit Care Med 1997;

156;3(1): 766-775

Hierholzer C, Kalff JC, Omert L, Tsukada K, Loeffert JE, Watkins SC, Billiar TR and Tweardy DJ. Interleukin-6 production in hemorrhagic shock is accompanied by neutrophil recruitment and lung injury. Am J Physiol 1998; 275(3): 611-621 Jenkins C. COPD management. Part I. Strategies for managing the burden of

established COPD. Int J Tuberc Lung Dis 2008; 12(6): 586–594

Jones AM and Helm JM. Emerging treatments in cystic fibrosis. Drugs 2009; 69(14):

1903-1910

Jones PM and George AM. The ABC transporter structure and mechanism:

perspectives on recent research. Cell Mol Life Sci 2004; 61(6): 682-699

Joseph PM, O'Sullivan BP, Lapey A, Dorkin H, Oren J, Balfour R, Perricone MA, Rosenberg M, Wadsworth SC, Smith AE, St George JA and Meeker DP.

Aerosol and lobar administration of a recombinant adenovirus to individuals with cystic fibrosis. I. Methods, safety, and clinical implications. Hum Gene Ther 2001; 12(11): 1369-1382

Kaszab E, Kriszt B, Atzél B, Szabó G, Szabó I, Harkai P and Szoboszlay S. The occurrence of multidrug-resistant Pseudomonas aeruginosa on hydrocarbon-contaminated sites. Microb Ecol 2010; 59(1): 37-45

References

R-4

Kerem B, Rommens JM, Buchanan JA, Markiewicz D, Cox TK, Chakravarti A, Buchwald M and Tsui LC. Identification of the cystic fibrosis gene: genetic analysis. Science 1989; 245(4922): 1073-1080

Kozlowska WJ, Bush A, Wade A, Aurora P, Carr SB, Castle RA, Hoo A, Lum S, Price J, Ranganathan S, Saunders C, Stanojevic S, Stroobant J, Wallis C, Stocks J.

Lung function from infancy to the preschool years after clinical diagnosis of cystic fibrosis. Am J Respir Crit Care Med 2008; 178(1): 42-49

Kresse AU, Dinesh SD, Larbig K and Römling U. Impact of large chromosomal inversions on the adaptation and evolution of Pseudomonas aeruginosa chronically colonizing cystic fibrosis lungs. Mol Microbiol 2003; 47(1): 145-158 Kukavica-Ibrulj I and Levesque RC. Animal models of chronic lung infection with

Pseudomonas aeruginosa: useful tools for cystic fibrosis studies. Lab Anim 2008; 42(4): 389-412

Kumar V, Becker T, Jansen S, van Barneveld A, Boztug K, Wölfl S, Tümmler B and Stanke F. Expression levels of FAS are regulated through an evolutionary conserved element in intron 2, which modulates cystic fibrosis disease severity. Genes Immun 2008; 9(8): 689-696

Kuver R and Lee SP. Hypertonic saline for cystic fibrosis. N Engl J Med 2006;

354(17): 1848-51; author reply 1848-51

Leblond F, Davis SC, Valdés PA and Pogue BW. Pre-clinical whole-body fluorescence imaging: Review of instruments, methods and applications.

J Photochem Photobiol B 2010; 98(1): 77-94

Lee DG, Urbach JM, Wu G, Liberati NT, Feinbaum RL, Miyata S, Diggins LT, He J, Saucier M, Déziel E, Friedman L, Li L, Grills G, Montgomery K, Kucherlapati R, Rahme LG and Ausubel FM. Genomic analysis reveals that Pseudomonas aeruginosa virulence is combinatorial. Genome Biol 2006; 7(10): R90

LeGrys VA, Yankaskas JR, Quittell LM, Marshall BC, Mogayzel PJ Jr; Cystic Fibrosis Foundation. Diagnostic sweat testing: the Cystic Fibrosis Foundation guidelines. J Pediatr 2007; 151(1): 85-89

Lipuma JJ. The changing microbial epidemiology in cystic fibrosis. Clin Microbiol Rev 2010; 23(2): 299-323

Littlewood JM in History of cystic fibrosis. Cystic Fibrosis. London: Hodder Arnold.

2007 p. 3-19

Lockshin MD. Nonhormonal explanations for sex discrepancy in human illness.

Ann N Y Acad Sci 2010; 1193(1): 22-24

Lommatzsch ST and Aris R. Genetics of cystic fibrosis. Semin Respir Crit Care Med 2009; 30(5): 531-538

References

R-5

Mahenthiralingam E, Urban TA and Goldberg JB. The multifarious, multireplicon Burkholderia cepacia complex. Nat Rev Microbiol 2005; 3(2): 144-156

Manafi A, Kohanteb J, Mehrabani D, Japoni A, Amini M, Naghmachi M, Zaghi AH and Khalili N. Active immunization using exotoxin A confers protection against Pseudomonas aeruginosa infection in a mouse burn model. BMC Microbiol 2009;9: 23

Mann HB, Whitney DR. On a test of whether one of two random variables is stochastically larger than the other. Ann. Math. Statist 1947; 18(1): 50-60 Martin TR, Gerard NP, Galli SJ, Drazen JM. Pulmonary responses to

bronchoconstrictor agonists in the mouse. J Appl Physiol 1988; 64: 2318-2323 Matel JL and Milla CE. Nutrition in cystic fibrosis. Semin Respir Crit Care Med 2009;

30(5): 579-586

Matsui H, Grubb BR, Tarran R, Randell SH, Gatzy JT, Davis CW and Boucher RC.

Evidence for periciliary liquid layer depletion, not abnormal ion composition, in the pathogenesis of cystic fibrosis airways disease. Cell 1998; 95(7): 1005-1015

Matsui H, Wagner VE, Hill DB, Schwab UE, Rogers TD, Button B, Taylor RM, Superfine R, Rubinstein M, Iglewski BH and Boucher RC. A physical linkage between cystic fibrosis airway surface dehydration and Pseudomonas aeruginosa biofilms. Proc Natl Acad Sci U S A 2006; 103(48): 18131-18136 Meyerholz DK, Stoltz DA, Pezzulo AA and Welsh MJ. Pathology of gastrointestinal

organs in a porcine model of cystic fibrosis. Am J Pathol 2010; 176;(3): 1377-1389

Morrison AJ and Wenzel RP. Epidemiology of infections due to Pseudomonas aeruginosa. Rev Infect Dis 1984; 6(3): 627-642

Morton J and Glanville AR. Lung transplantation in patients with cystic fibrosis.

Semin Respir Crit Care Med 2009; 30(5): 559-568

Munder A, Zelmer A, Schmiedl A, Dittmar KEJ, Rohde M, Dorsch M, Otto K, Hedrich, HJ, Tümmler B, Weiss S and Tschernig T. Murine pulmonary infection with Listeria monocytogenes: differential susceptibility of BALB/c, C57BL/6 and DBA/2 mice. Microbes Infect 2005; 7(4): 600-611

Olsen GJ, Woese CR and Overbeek R. The winds of evolutionary change: breathing new life into microbiology. J Bacteriol 1994; 176(1): 1-6

Ostedgaard LS, Rogers CS, Dong Q, Randak CO, Vermeer DW, Rokhlina T, Karp PH and Welsh MJ. Processing and function of CFTR-DeltaF508 are species-dependent. Proc Natl Acad Sci U S A 2007; 104(39): 15370-15375

References

R-6

Pai VB and Nahata MC. Efficacy and safety of aerosolized tobramycin in cystic fibrosis. Pediatr Pulmonol 2001; 32(4): 314-327

Qiu X, Gurkar AU and Lory S. Interstrain transfer of the large pathogenicity island PAPI-1 of Pseudomonas aeruginosa. Proc Natl Acad Sci U S A 2006; 103(52):

19830-19835

Rakhimova E, Munder A, Wiehlmann L, Bredenbruch F and Tümmler B. Fitness of isogenic colony morphology variants of Pseudomonas aeruginosa in murine airway infection. PLoS One 2008; 3;2: e1685

Riordan JR, Rommens JM, Kerem B, Alon N, Rozmahel R, Grzelczak Z, Zielenski J, Lok S, Plavsic N and Chou JL. Identification of the cystic fibrosis gene: cloning and characterization of complementary DNA. Science 1989; 245(4922): 1066-1073 determination of siderophores. Anal Biochem 1987; 160(1): 47-56

Scott CC, Botelho RJ and Grinstein S. Phagosome maturation: a few bugs in the system. J Membr Biol 2003; 193(3): 137-152

Smith EE, Buckley DG, Wu Z, Saenphimmachak C, Hoffman LR, D'Argenio DA, Miller SI, Ramsey BW, Speert DP, Moskowitz SM, Burns JL, Kaul R and Olson MV. Genetic adaptation by Pseudomonas aeruginosa to the airways of cystic fibrosis patients. Proc Natl Acad Sci U S A 2006; 103(22): 8487-8492

Stanier RY, Palleroni NJ and Doudoroff M. The aerobic pseudomonads: a taxonomic study. J Gen Microbiol 1966; 43(2): 159-271

Stanke F, Becker T, Cuppens H, Kumar V, Cassiman JJ, Jansen S, Radojkovic D, Siebert B, Yarden J, Ussery DW, Wienker TF and Tümmler B. The TNFalpha receptor TNFRSF1A and genes encoding the amiloride-sensitive sodium channel ENaC as modulators in cystic fibrosis. Hum Genet 2006; 119(3): 331-343

Steinkamp G, Wiedemann B, Rietschel E, Krahl A, Gielen J, Bärmeier H, Ratjen F and Group, Emerging Bacteria Study. Prospective evaluation of emerging bacteria in cystic fibrosis. J Cyst Fibros 2005; 4(1): 41-48

Stotland PK, Radzioch D and Stevenson MM. Mouse models of chronic lung infection with Pseudomonas aeruginosa: models for the study of cystic fibrosis. Pediatr Pulmonol 2000; 30(5): 413-424

References Saier MH, Hancock RE, Lory S and Olson MV. Complete genome sequence of Pseudomonas aeruginosa PAO1, an opportunistic pathogen. Nature 2000;

406(6799): 959-964

Tablan OC, Martone WJ, Doershuk CF, Stern RC, Thomassen MJ,Klinger JD, White JW, Carson LA, Jarvis WR. Colonization of the respiratory tract with Pseudomonas cepacia in cystic fibrosis. Risk factors and outcomes Chest 1987; 91(4): 527-532

Tate S and Elborn S. Progress towards gene therapy for cystic fibrosis. Expert Opin Drug Deliv 2005; 2(2): 269-280

Teichgräber V, Ulrich M, Endlich N, Riethmüller J, Wilker B, De Oliveira-Munding CC, van Heeckeren AM, Barr ML, von Kürthy G, Schmid KW, Weller M, Tümmler B, Lang F, Grassme H, Döring G and Gulbins E. Ceramide accumulation mediates inflammation, cell death and infection susceptibility in cystic fibrosis.

Nat Med 2008; 14(4): 382-391

Tümmler B, Bosshammer J, Breitenstein S, Brockhausen I, Gudowius P, Herrmann C, Herrmann S, Heuer T, Kubesch P, Mekus F, Römling U, Schmidt KD, Spangenberg C and Walter S. Infections with Pseudomonas aeruginosa in patients with cystic fibrosis. Behring Inst Mitt 1997 Feb; 98: 249-255

Tümmler B, Koopmann U, Grothues D, Weissbrodt H, Steinkamp G and von der Hardt H. Nosocomial acquisition of Pseudomonas aeruginosa by cystic fibrosis patients. J Clin Microbiol 1991; 29(6): 1265-1267

van der Schans C, Prasad A and Main E. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis. Cochrane Database Syst Rev 2 2000;

CD001401

van Goor F, Hadida S, Grootenhuis PDJ, Burton B, Cao D, Neuberger T, Turnbull A, Singh A, Joubran J, Hazlewood A, Zhou J, McCartney J, Arumugam V, Decker C, Yang J, Young C, Olson ER, Wine JJ, Frizzell RA, Ashlock M and Negulescu P. Rescue of CF airway epithelial cell function in vitro by a CFTR potentiator, VX-770. Proc Natl Acad Sci U S A 2009; 106(44): 18825-18830 van Heeckeren AM and Schluchter MD. Murine models of chronic Pseudomonas

aeruginosa lung infection. Lab Anim 2002; 36(3): 291-312

Vijayaraghavan R, Schaper M, Thompson R, Stock MF, Boylstein LA, Luo JE and Alarie Y. Computer assisted recognition and quantitation of the effects of airborne chemicals acting at different areas of the respiratory tract in mice.

Arch Toxicol 1994; 68(8): 490-499

References

R-8

Welham PA and Stekel DJ. Mathematical model of the Lux luminescence system in the terrestrial bacterium Photorhabdus luminescens. Mol Biosyst 2009; 5(1):

68-76

Welsh MJ, Denning GM, Ostedgaard LS and Anderson MP. Dysfunction of CFTR bearing the delta F508 mutation. J Cell Sci Suppl 1993; 17: 235-239

Welsh MJ, Rogers CS, Stoltz DA, Meyerholz DK and Prather RS. Development of a porcine model of cystic fibrosis. Trans Am Clin Climatol Assoc 2009; 120; 149-162

Wiehlmann L, Munder A, Adams T, Juhas M, Kolmar H, Salunkhe P and Tümmler B.

Functional genomics of Pseudomonas aeruginosa to identify habitat-specific determinants of pathogenicity. Int J Med Microbiol 2007; 297;(7-8): 615-623 Wiehlmann L, Wagner G, Cramer N, Siebert B, Gudowius P, Morales G, Köhler T,

van Delden C, Weinel C, Slickers P and Tümmler B. Population structure of Pseudomonas aeruginosa. Proc Natl Acad Sci U S A 2007A; 104(19): 8101-8106

Yorifuji T, Lemna WK, Ballard CF, Rosenbloom CL, Rozmahel R, Plavsic N, Tsui LC and Beaudet AL. Molecular cloning and sequence analysis of the murine cDNA for the cystic fibrosis transmembrane conductance regulator. Genomics 1991;10(3): 547-550

Zhou L, Dey CR, Wert SE, DuVall MD, Frizzell RA and Whitsett JA. Correction of lethal intestinal defect in a mouse model of cystic fibrosis by human CFTR.

Science 1994; 266(5191): 1705-1708

References

R-9 Internet resources

1. Cystic Fibrosis Mutation Database.

Available at: http://www.genet.sickkids.on.ca/cftr/app

2. Cystic Fibrosis Foundation. Annual Report 2009. Available at http://www.cff.org/UploadedFiles/aboutCFFoundation/AnnualReport/2009-Annual-Report.pdf

Picture sources Taken from:

1. http://upload.wikimedia.org/wikipedia/commons/e/ef/Autorecessive_en_01.png 2. http://www.cfgenetherapy.org.uk/CFTR/cftr1.htm

3. http://www.electromedsys.com/index.html 4. http://www.hugo-sachs.de/frame1.htm

5. Taken from the IVIS® 200 Series Product brochure available at http://www.caliperls.com/products/ivis-imaging-system-200-series.htm

Abbreviations

A-1 Abbreviations

aa Amino acid

ABC ATP-binding cassette

AHL N-acyl homoserine lactone

AM Alveolar macrophage

ASL Airway surface liquid

Asm Acid sphingomyelinase

attB Gene locus, host attachment site for phage

bp Base pairs

CCD Charge-coupled device

CF Cystic fibrosis

CFF Cystic fibrosis foundation

CFTR Cystic fibrosis transmembrane conductance

regulator

CFU Colony forming units

ddH2O Double destilled water

DMSO Dimethyl sulfoxide

e.g. exempli gratia (for example)

EF50 Midtidal expiratory flow at 50% expiration

EF50 Midtidal expiratory flow at 50% expiration