Cystic Fibrosis: Clinical Manifestations and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: 25 January 2025 | Viewed by 1586

Special Issue Editors


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Guest Editor
Mother and Child Department, University of Medicine and Pharmacy Grigore T. Popa, Iasi, Romania
Interests: cystic fibrosis; obesity; metabolic syndrome; coeliac disease; malabsorption syndromes
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Guest Editor
Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: medical genetics; congenital anomalies; chronic kidney disease; nephrogenetics and kidney genomics; cardiogenetics; neurogenetics; vascular congenital anomalies; reproduction genetic disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the last few decades, significant progress has been made in medical innovations related to cystic fibrosis (CF), a chronic and life-threatening genetic disorder that affects both the digestive and respiratory systems. Although CF is a monogenic disease, people with the same pathogenic mutation may have a variable phenotype due to the intervention of modifier genes or environmental factors. The research on modifier genes opens up new perspectives, both in terms of the diagnosis and prognosis of the disease as well as therapeutic interventions.

Following the introduction of screening programs, the incidence of the disease has been more accurately documented, enabling healthcare providers to initiate treatment and management strategies promptly, ultimately improving the quality of life for individuals with CF. Moreover, new treatments such as CFTR (cystic fibrosis transmembrane conductance regulator) modulators have revolutionized the treatment of CF by targeting the underlying cause of the disease.

However, treating a child with CF still presents a myriad of challenges due to the complex and progressive nature of the disease. Although the majority of the CF population is benefiting from the CFTR modulators, there are still people with CF without a treatment program targeting their specific genetic mutations. Since monitoring the disease is crucial for achieving positive outcomes, it is essential to properly assess and manage new techniques such as liver elastography and continuous glycemia monitoring. In this context, personalized medicine approaches hold promise for further advancements in the management of CF in children, ultimately leading to better outcomes and improved life expectancy for individuals with this condition.

We invite researchers, clinicians, and other experts in the field to contribute their insights and expertise to this Special Issue. We are looking for reviews and original articles reflecting the latest progress in the field of clinical and molecular diagnostics, as well as novel therapeutic approaches. Topics include, but are not limited to, the following:

  • Clinical manifestations and complications of cystic fibrosis in different organ systems;
  • Novel diagnostic tools and biomarkers for the early detection of cystic fibrosis;
  • Pharmacological and non-pharmacological treatment strategies for cystic fibrosis;
  • Nutritional care in children with cystic fibrosis;
  • Emerging therapies and personalized medicine approaches for cystic fibrosis management.

We hope that by sharing knowledge and collaborating on new ideas, we can work together to enhance our understanding of CF in children and ultimately improve the care and outcomes for these young patients.

Prof. Dr. Laura Trandafir
Dr. Lǎcrǎmioara Ionela Butnariu
Guest Editors

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Keywords

  • cystic fibrosis
  • modifier genes
  • CFTR modulator
  • CF newborn screening
  • CF nutrition
  • CF complications

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Published Papers (2 papers)

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Research

9 pages, 834 KiB  
Article
Phenotypic Evaluation of Rare Cystic Fibrosis Transmembrane Conductance Regulator Mutation Combinations in People with Cystic Fibrosis in Queensland, Australia
by Ieuan Edward Shepherd Evans, Michelle Wood, Vanessa Moore and David William Reid
J. Clin. Med. 2024, 13(20), 6210; https://doi.org/10.3390/jcm13206210 - 18 Oct 2024
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Abstract
Background: Cystic fibrosis (CF) is a multisystem disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. We describe the distribution of CFTR mutation profiles in sub-tropical Queensland, Australia, and characterise the phenotypes associated with ‘rare’ CFTR mutation combinations. Methods: [...] Read more.
Background: Cystic fibrosis (CF) is a multisystem disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. We describe the distribution of CFTR mutation profiles in sub-tropical Queensland, Australia, and characterise the phenotypes associated with ‘rare’ CFTR mutation combinations. Methods: We conducted a retrospective observational study to analyse the CFTR mutation profiles of 322 people with CF (pwCF) under the care of a large adult CF centre in Queensland, Australia. Molecular pathology results were available for all identifiable CFTR mutations. The CFTR2 database was utilised to characterise the less common CFTR mutations to define mutation classes and explore associated phenotypic sequelae. Results: In total, eighty-seven different genotypes were identified within our CF cohort, with the most abundant mutation being the F508del mutation, 298/322 (92.5%). Thirty-six pwCF with CFTR mutations are considered to have ‘rare’ CFTR mutations, and eleven with previously undefined phenotypes. For these eleven pwCF, late diagnosis in adulthood was confirmed in 5/11 pwCF (45.5%) with CFTR modulator therapy only initiated in 5/11 (45.5%). Conclusions: The profile of more common CFTR genotypes within our cohort of adult pwCF living in Queensland, Australia, generally reflects the global predominance of F508del, G542X, G551D, N1303K, and R117H. The phenotypic heterogeneity of disease seen within the eleven pwCF in our cohort with previously undefined CFTR genotypes highlights that rare mutations can also be associated with severe disease and continue to be at risk of delayed diagnosis. Access to CFTR modulator therapies for this group of pwCF remains limited and should remain a research priority. Full article
(This article belongs to the Special Issue Cystic Fibrosis: Clinical Manifestations and Treatment)
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9 pages, 777 KiB  
Article
CFTR Modulators Therapy Efficacy in Reducing Cystic Fibrosis (CF) Exacerbation and Improving Selected Spirometry Parameters: A Real-Life Study in a Single-Centre Polish Population
by Hanna M. Winiarska, Daria Springer, Filip Wojtaś, Ewa Wysocka and Szczepan Cofta
J. Clin. Med. 2024, 13(15), 4491; https://doi.org/10.3390/jcm13154491 - 31 Jul 2024
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Abstract
Background/Objectives: Cystic fibrosis is a genetically determined disease that significantly influences and shortens life. Treatment with CFTR modulators (CFTR-T) is a new hope for patients. It can change the predictive values of a poor prognosis (e.g., exacerbation rate and FEV1 value). The aim [...] Read more.
Background/Objectives: Cystic fibrosis is a genetically determined disease that significantly influences and shortens life. Treatment with CFTR modulators (CFTR-T) is a new hope for patients. It can change the predictive values of a poor prognosis (e.g., exacerbation rate and FEV1 value). The aim of the study was to analyse exacerbation incidence and spirometry data before and after one year (+/− 2 weeks) of CFTR-T in 85 CF patients at the CF Centre in Poznań. To our knowledge, this is the first analysis of CFTR-T efficiency in the Central–Eastern Europe population. Methods: We retrospectively analysed the spirometry and exacerbation data of 85 CF adult patients (both men and women), who in the middle of 2022 began treatment with CFTR modulators. Results: The one-year ratio of hospitalisation caused by severe exacerbations lowered from 1.25 to 0.21 per patient per year. We also saw a 66% decline in ambulatory exacerbations. The median FEV1% increased by 9.60% in absolute values and by 460 mL. Even in the group with very severe obstruction (FEV1 < 35%), there was an increase in median FEV1% of 5.9 in absolute values. We also proved the increase in FVC% (median 17.10% in absolute value and 600 mL) in the study group. Conclusions: After one year of treatment, an impressive improvement was observed in two important predictive values of poor prognosis: exacerbation rate and FEV1 values. Further observation is needed to determine how long the improvement will be present and its influence on quality of life and life expectancy. Full article
(This article belongs to the Special Issue Cystic Fibrosis: Clinical Manifestations and Treatment)
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