Microbiota, Mucus, and Modulators: Cystic Fibrosis Infection Pathogenesis in the Cystic Fibrosis Transmembrane Conductance Regulator Modulator Era - Summary - MDSpire
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The Role of Microbiota, Mucus, and Therapeutic Modulators in the Pathogenesis of Infections in Cystic Fibrosis During the Era of CFTR Modulator Treatments

  • By

  • Christina S Thornton

  • Drake C Bouzek

  • Lindsay J Caverly

  • December 17, 2025

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Objective:

To address specific gaps in understanding chronic infection dynamics and management in cystic fibrosis (CF) during the era of CFTR modulator treatments.

Key Findings:
  • CFTR modulators improve airway hydration and mucociliary clearance but do not eliminate chronic infections.
  • Chronic infections with pathogens like Pseudomonas aeruginosa, Staphylococcus aureus, and others lead to accelerated lung function decline and increased mortality risk.
  • Diversity of the airway microbiome decreases with disease progression, dominated by a few pathogenic taxa, including various CF pathogens.
Interpretation:

The introduction of CFTR modulators has altered the management of CF but has not resolved chronic infections, necessitating ongoing research into infection dynamics and microbiome interactions to inform future therapies.

Limitations:
  • Long-term effects of CFTR modulators on infection dynamics remain unclear, potentially impacting treatment efficacy.
  • Current understanding of the airway microbiome in CF is still evolving, which may limit the development of targeted therapies.
Conclusion:

Future CF care must consider the complex interactions between microbiota, mucus, and therapeutic interventions to improve clinical outcomes.

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