microOCT imaging, a joint invention of investigators at UAB and Harvard Medical School, lets researchers "see things no one has ever seen before," in the words of UAB's Steven Rowe. microOCT imaging, a joint invention of investigators at UAB and Harvard Medical School, lets researchers "see things no one has ever seen before," in the words of UAB's Steven Rowe.

Muco-vision: a new imaging approach for cystic fibrosis, asthma and beyond

November 05, 2018
By Matt Windsor
microOCT imaging, a joint invention of UAB researchers and investigators at Harvard Medical School, "lets us see things no one has ever seen before."

This is the final part of a series exploring breakthroughs in cystic fibrosis research that are paving the way for new treatments to help millions with other diseases, including COPD, asthma and more. Read part one, After cystic fibrosis 'miracle,' researchers are exploring ways to reach millions more, part two, How did we get here? Cystic fibrosis drugs go from 0-90 percent effective in a few short years, part three, Attacking nonsense mutations in cystic fibrosis and a host of other diseases, part four, Clinical trial for one: the promise of patient-derived assays, and part five, From cystic fibrosis to COPD: potentiators and chronic bronchitis.


Several imaging devices let researchers focus on mucus in airways, the epithelial cells that line those airways, or the tiny, hair-like cilia swaying on the outside of the epithelial cells. Only one technology — a joint invention of UAB researchers and investigators at Harvard Medical School — lets them observe all three at once. Known as micro-optical coherence tomography, or microOCT, it is “basically like ultrasound with a laser,” says Steven Rowe, M.D., director of the UAB Gregory Fleming James Cystic Fibrosis Research Center.

mix rccm.201404 0670oc f1Images from the microOCT system, taken from the 2014 paper "A functional anatomic defect of the cystic fibrosis airway" in the American Journal of Respiratory and Critical Care Medicine. Reprinted with permission of the American Thoracic Society. Copyright © 2018 American Thoracic Society. Cite: Birket, Chu, Liu, Houser, Diephuis, Wilsterman, Dierksen, Mazur, Shastry, Li, Watson, Smith, Schuster, Hanes, Grizzle, Sorscher, Tearney, Rowe/2014/"A functional anatomic defect of the cystic fibrosis airway"/American Journal of Respiratory and Critical Care Medicine/Vol. 190, No. 4/Pages 421-32. The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society.

In the lab, microOCT “lets us see things no one has ever seen before,” he explains — “features of the pathology of CF that we didn’t imagine, including what’s wrong with CF mucus and what we might need to do to improve it.” That’s especially important with new mucus-focused drugs on the horizon. The team’s latest advance is a miniaturized version of microOCT for patient use, which will let them monitor patient reactions to drugs in near real time, and personalize therapy.


microOCT video of mucus movement in non-cystic fibrosis human bronchial epithelial (HBE) cells (top) and cystic fibrosis HBE cells.
Video supplement from the article "A functional anatomic defect of the cystic fibrosis airway," 2014. Reprinted with permission of the American Thoracic Society. Copyright © 2018 American Thoracic Society. Cite: Birket, Chu, Liu, Houser, Diephuis, Wilsterman, Dierksen, Mazur, Shastry, Li, Watson, Smith, Schuster, Hanes, Grizzle, Sorscher, Tearney, Rowe/2014/"A functional anatomic defect of the cystic fibrosis airway"/American Journal of Respiratory and Critical Care Medicine/Vol. 190, No. 4/Pages 421-32. The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society.


Finding new ways forward

MicroOCT could also help researchers find new ways forward in the treatment of other airway diseases, including COPD and asthma. “The diseased biology of epithelial cells causes almost all the mortality of cystic fibrosis,” says George Solomon, M.D., a researcher in the CF Center and assistant professor in the Division of Pulmonary, Allergy and Critical Medicine. “Damage to the mucus-clearance apparatus is a feature of many other diseases as well. What exactly happens on the cell surface when the CFTR protein is not working, or once it begins to be activated by a drug? This system allows us to start answering these questions. When you can see the cilia and the mucus and the epithelial cells all interacting, in real-time, you have an entirely new perspective.”

The microOCT research began, like much of the CF Center’s work, with a willingness to take risks — and the backing of philanthropic funding, Rowe says. Seed money from the Gwaltney Endowed Chair enabled the project to get started. “With that support, we were able to take this shot on goal,” says Rowe. “That’s always been our philosophy, at that of the CF Foundation — the more shots we can take, the more chances we have to make a difference in the lives of our patients.”


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