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Large-conductance, Ca 2+ -activated, voltage-dependent K +  (BK) channel function is critical for adequate airway hydration and mucociliary function. In airway epithelia, BK function is regulated by its γ subunit leucine-rich repeat-containing protein 26 (LRRC26). Since patients with cystic fibrosis (CF)-related diabetes mellitus (CFRD) have worse lung function outcomes, this study determined the effects of hyperglycaemia on BK function in CF bronchial epithelial (CFBE) cells  in vitro  and evaluated the correlation between glycaemic excursions and mRNA expression of  LRRC26  in the upper airways of CF and CFRD patients.  CFBE cells were re-differentiated at the air-liquid interface (ALI) in media containing either 5.5 mM or 12.5 mM glucose. BK activities were measured in Ussing chambers. Airway surface liquid (ASL) volumes were estimated by meniscus scanning and inflammatory marker expression was measured by quantitative real-time PCR (qPCR) and enzyme-linked immunosorbent assay (ELISA). CF patients were assessed by 7 days of continuous glucose monitoring.  LRRC26  mRNA expression was measured by qPCR from nasal cells obtained at the end of glucose monitoring.  BK currents were significantly decreased in CFBE cells cultured under high glucose. These cells revealed significantly lower ASL volumes and increased inflammation, including RAGE, compared to cells cultured in normal glucose.  In vivo , nasal cell expression of  LRRC26  mRNA was inversely correlated with hyperglycaemic excursions, consistent with the  in vitro  results.  Our findings demonstrate that hyperglycaemia induces inflammation and impairs BK channel function in CFBE cells  in vitro . These data suggest that declining lung function in CFRD patients may be related to BK channel dysfunction.

Hyperglycaemia in CF adversely affects BK channel function critical for mucus clearance