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Cystic fibrosis summary

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Covers: clinical features, symptoms, pathophysiology, epidemiology, genetic expression, diagnosis, treatment, emerging therapies for CF










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Uploaded on
June 30, 2021
Number of pages
9
Written in
2020/2021
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Summary

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Cystic fibrosis
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What is cystic fibrosis?
Inherited autosomal recessive disorder affecting the CFTR (cystic fibrosis
transmembrane conductance regulator) gene

CFTR gene is located on chromosome 7

The CFTR protein is a gated ion channel protein that allows (negative ions) mainly
Cl- ion movement into and out of cells into the surrounding mucus

This mediates the movement of sodium and water

Clinical features and effects of cystic fibrosis



💨 Chronic airway infection/inflammation resulting in bronchiectasis
(abnormal dilatation of airway from bronchial tissue destruction) and
advancing airway obstruction (sputum overproduction)


Airway surface liquid (ASL): thin layer of mucus which enables the full
extension and wafting motion of cilia (that removes irritants/pathogens
trapped in the mucus) in the airways

Optimal depth of ASL is 7 um

Height and mucus hydration mediated by Na+ absorption and Cl- secretion

Mucus plug formation may occur

Normal Cl- efflux restricts how much Na+ comes into the epithelial
cells

Cl- cannot be transported out of the epithelial cells effectively,
resulting in Na+ hyper-absorption = osmosis of water into the


Cystic fibrosis 1

, epithelial cells (ASL becomes dry (surface dehydration), mucus has
increased viscosity and reduces mucus clearance)

Results in accumulation of bacteria and irritants = infections
and inflammation in airway

A common infection in CF patients is P. aeruginosa

Some bacterial infections make CF patients ineligible for a lung
transplant



🍽 Impaired intestinal and hepatic function




🍬 Pancreatic insufficiency


Loss of more than 90% pancreatic function

About 90% of adult CF patients develop pancreatic insufficiency

Results in steatorrhoea (excess fat excretion in the stool)

Vessels transporting digestive enzymes out of the pancreas become blocked
with mucus, so food is not digested efficiently for absorption

Bicarbonate (a negatively charged digestive enzyme) cannot be properly so
it stays in the pancreas and damages/digests the pancreas

Reduced/ absent exocrine secretion = poor digestion of starch, fat and
protein

Cystic fibrosis-related diabetes may occur from scarring/inflammation of
pancreas = reducing effective insulin production



😰 Abnormal sweat gland function



Individuals with CF can become dehydrated upon physical exertion or being in
a warm environment



Cystic fibrosis 2
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