Hyperglycaemia and Pseudomonas aeruginosa acidify cystic fibrosis airway surface liquid by elevating epithelial monocarboxylate transporter 2 dependent lactate-H+ secretion

Sci Rep. 2016 Nov 29:6:37955. doi: 10.1038/srep37955.


The cystic fibrosis (CF) airway surface liquid (ASL) provides a nutrient rich environment for bacterial growth including elevated glucose, which together with defective bacterial killing due to aberrant HCO3- transport and acidic ASL, make the CF airways susceptible to colonisation by respiratory pathogens such as Pseudomonas aeruginosa. Approximately half of adults with CF have CF related diabetes (CFRD) and this is associated with increased respiratory decline. CF ASL contains elevated lactate concentrations and hyperglycaemia can also increase ASL lactate. We show that primary human bronchial epithelial (HBE) cells secrete lactate into ASL, which is elevated in hyperglycaemia. This leads to ASL acidification in CFHBE, which could only be mimicked in non-CF HBE following HCO3- removal. Hyperglycaemia-induced changes in ASL lactate and pH were exacerbated by the presence of P. aeruginosa and were attenuated by inhibition of monocarboxylate lactate-H+ co-transporters (MCTs) with AR-C155858. We conclude that hyperglycaemia and P. aeruginosa induce a metabolic shift which increases lactate generation and efflux into ASL via epithelial MCT2 transporters. Normal airways compensate for MCT-driven H+ secretion by secreting HCO3-, a process which is dysfunctional in CF airway epithelium leading to ASL acidification and that these processes may contribute to worsening respiratory disease in CFRD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cells, Cultured
  • Cystic Fibrosis / metabolism
  • Cystic Fibrosis / microbiology
  • Cystic Fibrosis / pathology*
  • Epithelial Cells / metabolism
  • Epithelial Cells / pathology
  • Homeostasis
  • Humans
  • Hydrogen-Ion Concentration
  • Hyperglycemia / physiopathology*
  • Lactates / metabolism*
  • Monocarboxylic Acid Transporters / metabolism*
  • Pseudomonas Infections / metabolism
  • Pseudomonas Infections / microbiology
  • Pseudomonas Infections / pathology*
  • Pseudomonas aeruginosa / pathogenicity*
  • Respiratory Mucosa / metabolism
  • Respiratory Mucosa / pathology*


  • Lactates
  • Monocarboxylic Acid Transporters
  • SLC16A7 protein, human