Is Cystic Fibrosis Caused by Microbial Imbalances?

Cystic fibrosis is an inherited disease of the secretory gland that mainly affects the lungs, pancreas, liver, intestines, sinuses, and sex organs. Although cystic fibrosis is considered a genetic disorder, a new study shows that patients with cystic fibrosis have a dysbiotic microbiota, with “…a significantly lower abundance and temporal stability of bifidobacteria and Clostridium cluster XIVa…” (1).

This is the first study to report specific microbial alterations in cystic fibrosis, and more research is needed before we can determine the importance of the microbiome in the etiology of the disease. Until we know more, there’s basically three possible scenarios:

  • 1) Dysbiosis is one of the underlying causes of the disease.
    Cystic fibrosis and inflammation go hand in hand, and one “plasma analysis of fourteen CF patients revealed high levels of LPS compared to healthy volunteers” (2). Lipopolysaccharides (LPS) are endotoxins found in the outer membrane of gram-negative bacteria, and high levels of circulating LPS indicate gut dysbiosis and increased intestinal permeability. Patients with cystic fibrosis also have lungs that are chronically infected by pathogens (2). Bacteria are passed on from mother to child (e.g., birth, breastfeeding) and therefore the dysbiotic flora of a mother with CF will pass onto the child.
  • 2) Dysbiosis is caused by the use of antimicrobials in the treatment of cystic fibrosis and then exacerbates the disease
  • 3) Dysbiosis is caused by the use of antimicrobials in the treatment of cystic fibrosis, but has nothing to do with the disease.

1. Duytschaever G, Huys G, Bekaert M, Boulanger L, De Boeck K, Vandamme P. Dysbiosis of bifidobacteria and Clostridium cluster XIVa in the cystic fibrosis fecal microbiota.
J Cyst Fibros. 2012 Nov 11. pii: S1569-1993(12)00183-X. doi: 10.1016/j.jcf.2012.10.003. [Epub ahead of print]

2. del Campo R, Martínez E, del Fresno C, Alenda R, Gómez-Piña V, Fernández-Ruíz I, Siliceo M, Jurado T, Toledano V, Arnalich F, García-Río F, López-Collazo E. Translocated LPS might cause endotoxin tolerance in circulating monocytes of cystic fibrosis patients.
PLoS One. 2011;6(12):e29577. Epub 2011 Dec 28.

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