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Cystic Fibrosis and

Membrane Transport

Cystic Fibrosis

CF causes the body to produce an abnormally thick,

sticky mucus on epithelial surfaces.

A genetic disease affecting approximately 30,000

children and adults in the United States.

It is one of the most common lethal inherited disorders

among caucasians

In 1997, the median survival age for males with CF

was 32.7 years versus 28.9 years in females

One in 31 Americans (one in 28 Caucasians) - more

than 10 million people - is an unknowing, symptom-

less heterozygous carrier of the defective gene

Source: Cystic Fibrosis Foundation

Symptoms and complications

Decreased mucociliary clearance of sputum leads to

chronic endobronchial bacterial colonization, and…

• Production of large amounts of sputum

• Wheezing

• Dyspnea

• Limited exercise tolerance

• Death

Pancreatic insufficiency in 85% of patients, leading to

malabsorption of fat and malnutrition.

Also diabetes mellitus, bowel obstructions, arthritis,

and infertility.

Fact 1: The phospholipid bilayer is a

selectively permeable barrier

Factors determining

the permeability of a

bilayer to a

molecule:



Size

Charge/polarity

Fact 2: There are concentration gradients across

the membrane for many molecules



Ion [inside] mM [outside]



Potassium 140 5





Sodium 10 145





Calcium 0.0001 1

Therefore…

If membranes are selectively permeable, and…

There exist concentration gradients of some

molecules, but not others, then…



There must be “transporters” that allow specific

solutes to cross the membrane, and…

Some solutes must be moved across actively.

What determines the direction a solute “wants”

to go?

Chemical gradient

• Solutes tend to move from more concentrated areas to less

concentrated areas

Electrical gradient

• Charged solutes tend to move towards an oppositely

charged environment

• Cells are universally more negative on the inside than the

outside. This membrane potential is typically ≈ -70 mV.



The combination of the two is called an

“electrochemical gradient”

ΔG for transport of x into a cell



 xin 

Gin  RT ln 

 x    zFVm

 out 



R = gas constant = 1.987 cal/mol/°K

T = absolute temperature in °Kelvin

F = Faraday constant = 23,062 cal/mol/V

z = charge on species

Vm = membrane potential in volts

Self test: What direction will K+ go?

Chemical gradient pushes out [K+] = 5 mM

• Inside = 140mM

• Outside = 5 mM

Electrical gradient pushes in [K+] = 140 mM

• Z = +1 Vm = -70 mV

• Vm = -70 mV = -0.07V

Body temp = 37ºC

R = gas constant = 1.987 cal/mol/°K

T = absolute temperature in °Kelvin

 x  F = Faraday constant = 23,062 cal/mol/V

Gin  RT ln  in   zFVm

 x 

 out  z = charge on species

Vm = membrane potential in volts

The kind of transport you need depends on ΔG



Diffusion (ΔG 0)

• Primary

• Secondary

Facilitated diffusion (ΔG 5 mM



ΔGglucose IN = +1,418 cal/mol

ΔGsodium IN = -3,261 cal/mol



So one sodium CAN drive the import of one glucose from the

interior of your intestine!

Tight Junctions in epithelium

Functions:

1) Diffusion barrier

between cells

2) Segregates the

membranes

Apical vs. Baso-lateral

surfaces

Provides for

directional and

regulated transport

Cystic Fibrosis Transconductance

Regulator (CFTR)

A member of the ABC superfamily of transport proteins

However, it does not appear to act as an active transporter

A chloride channel – facilitated diffusion

Activated by phosphorylation

Permits chloride movement to the epithelial surface.

This results in osmotic flux of water to the apical surface,

diluting mucus.



In about 70% of CR cases, a mutated form of the CFTR is

reaches the ER, but is then degraded.

P

Basolateral







Cl- CFTR Cl-







Na+ Na+

Na+ Na+





K+









Apical

K+









H2O H2O

Basolateral





Cl-

Cl-



ER

Na+ Na+

Na+ Na+





K+









Apical

K+









H2O H2O

Current treatments

Treatment for Lung Problems

• Antibiotics

• Chest physical therapy (like percussion)

• Exercise

• Other medications

• Anti-inflammatory medications

• Bronchodilators,

• Mucus-thinning drugs

• Oxygen Therapy

Lung Transplantation

Management of Digestive Problems

• Oral pancreatic enzymes

• Fat-soluble vitamins A, D, E, and K

• Feeding tube

• Enemas and mucus-thinning medications to treat intestinal blockages

Brainstorm

What else might work?



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