Inhibition of cAMP-activated intestinal chloride secretion by diclofenac: cellular mechanism and potential application in cholera

PLoS Negl Trop Dis. 2014 Sep 4;8(9):e3119. doi: 10.1371/journal.pntd.0003119. eCollection 2014 Sep.

Abstract

Cyclic AMP-activated intestinal Cl- secretion plays an important role in pathogenesis of cholera. This study aimed to investigate the effect of diclofenac on cAMP-activated Cl- secretion, its underlying mechanisms, and possible application in the treatment of cholera. Diclofenac inhibited cAMP-activated Cl- secretion in human intestinal epithelial (T84) cells with IC50 of ∼ 20 µM. The effect required no cytochrome P450 enzyme-mediated metabolic activation. Interestingly, exposures of T84 cell monolayers to diclofenac, either in apical or basolateral solutions, produced similar degree of inhibitions. Analyses of the apical Cl- current showed that diclofenac reversibly inhibited CFTR Cl- channel activity (IC50 ∼ 10 µM) via mechanisms not involving either changes in intracellular cAMP levels or CFTR channel inactivation by AMP-activated protein kinase and protein phosphatase. Of interest, diclofenac had no effect on Na(+)-K(+) ATPases and Na(+)-K(+)-Cl- cotransporters, but inhibited cAMP-activated basolateral K(+) channels with IC50 of ∼ 3 µM. In addition, diclofenac suppressed Ca(2+)-activated Cl- channels, inwardly rectifying Cl- channels, and Ca(2+)-activated basolateral K(+) channels. Furthermore, diclofenac (up to 200 µM; 24 h of treatment) had no effect on cell viability and barrier function in T84 cells. Importantly, cholera toxin (CT)-induced Cl- secretion across T84 cell monolayers was effectively suppressed by diclofenac. Intraperitoneal administration of diclofenac (30 mg/kg) reduced both CT and Vibrio cholerae-induced intestinal fluid secretion by ∼ 70% without affecting intestinal fluid absorption in mice. Collectively, our results indicate that diclofenac inhibits both cAMP-activated and Ca(2+)-activated Cl- secretion by inhibiting both apical Cl- channels and basolateral K+ channels in intestinal epithelial cells. Diclofenac may be useful in the treatment of cholera and other types of secretory diarrheas resulting from intestinal hypersecretion of Cl-.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biological Transport
  • Calcium / metabolism
  • Cell Line
  • Cell Survival
  • Chlorides / metabolism*
  • Cholera / metabolism*
  • Cholera / pathology
  • Cholera Toxin
  • Cyclic AMP / metabolism
  • Cystic Fibrosis Transmembrane Conductance Regulator / antagonists & inhibitors
  • Cystic Fibrosis Transmembrane Conductance Regulator / genetics
  • Cystic Fibrosis Transmembrane Conductance Regulator / metabolism
  • Diclofenac / pharmacology*
  • Epithelial Cells / drug effects
  • Epithelial Cells / metabolism*
  • Humans
  • Intestinal Mucosa / drug effects
  • Male
  • Mice
  • Potassium Channel Blockers
  • Potassium Channels / genetics
  • Potassium Channels / metabolism

Substances

  • CFTR protein, human
  • Chlorides
  • Potassium Channel Blockers
  • Potassium Channels
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Diclofenac
  • Cholera Toxin
  • Cyclic AMP
  • Calcium

Grants and funding

This work was supported by a grant RSA5680006 from Thailand Research Fund and Mahidol University (to CM). Financial support from Faculty of Science, Mahidol University, and the Office of the Higher Education Commission and Mahidol University under the National Research Universities Initiative are also gratefully acknowledged (to CM). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.