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Considerations for CF airway infection sampling and impact of CFTR modulators

Published:September 22, 2022DOI:https://doi.org/10.1016/j.jcf.2022.09.004
      Airway infection is a major contributor to lung disease progression in people with cystic fibrosis (CF), and regular sampling of airway secretions for infection monitoring is a key component of CF clinical care. Sputum has long been the preferred method for routine infection monitoring in CF, with alternative methods including bronchoalveolar lavage (BAL) (considered the gold standard, but invasive and impractical for routine monitoring) and oropharyngeal swabs (minimally invasive, but less sensitive than sputum) [
      • Zemanick ET
      • Wagner BD
      • Robertson CE
      • Stevens MJ
      • Szefler SJ
      • Accurso FJ
      • Sagel SD
      • Harris JK.
      Assessment of airway microbiota and inflammation in cystic fibrosis using multiple sampling methods.
      ]. The recent availability of highly effective CF transmembrane conductance regulator modulator therapy (HEMT) is having a marked impact on many aspects of CF disease, including airway infections [
      • Zemanick ET
      • Taylor-Cousar JL
      • Davies J
      • Gibson RL
      • Mall MA
      • McKone EF
      • McNally P
      • Ramsey BW
      • Rayment JH
      • Rowe SM
      • Tullis E
      • Ahluwalia N
      • Chu C
      • Ho T
      • Moskowitz SM
      • Noel S
      • Tian S
      • Waltz D
      • Weinstock TG
      • Xuan F
      • Wainwright CE
      • McColley SA
      A phase 3 open-label study of elexacaftor/tezacaftor/ivacaftor in children 6 through 11 years of age with cystic fibrosis and at least one F508del allele.
      ]. Two important ways in which HEMT impact airway infections are addressed by articles in this issue of Journal of Cystic Fibrosis, including how to monitor for infection, and how HEMT change the airway bacterial communities.
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