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Azoicai AN, Lupu A, Trandafir LM, Alexoae MM, Alecsa M, Starcea IM, Cuciureanu M, Knieling A, Salaru DL, Hanganu E, Mocanu A, Lupu VV, Ioniuc I. Cystic fibrosis management in pediatric population-from clinical features to personalized therapy. Front Pediatr 2024; 12:1393193. [PMID: 38798310 PMCID: PMC11116730 DOI: 10.3389/fped.2024.1393193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations of the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR). In 1949, it's been identified as a monogenic disease and was thought to primarily affect individuals of Northern European descent. It was the most prevalent autosomal recessive disease that shortens life. With the availability of multiple testing methodologies nowadays, there is a chance to create novel and enhanced treatment options. Even in the absence of a high sweat chloride test (SCT) result, the discovery of two causal mutations is diagnostic for cystic fibrosis (CF). For a CF diagnosis, however, at least two positive E sweat chloride tests are still required. In order to achieve early and active intervention to manage cystic fibrosis (CF) and its comorbidities, treatment regimens for pediatric patients should be evaluated, improved, and closely monitored. New developments in the treatment of cystic fibrosis (CF) have led to the development of medications derived from molecules that target the pathogenetic pathway of the illness. These options are very efficient and allow pediatric patients to receive individualized care. However, in order to better direct patient care and enhance patient outcomes, it is crucial to research uncommon CF mutations, which can provide crucial information about the prognosis of the disease and the relationships between genotype and phenotype. To ensure the success of creating novel, safer, and more efficient treatment approaches, a deeper understanding of the pathogeny of the illness is required. In the age of customized medicine, genetic research will be essential to improving patient care and quality of life for those with uncommon mutations.
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Affiliation(s)
| | - Ancuta Lupu
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | | | | | - Mirabela Alecsa
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | | | - Magdalena Cuciureanu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Anton Knieling
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Delia Lidia Salaru
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Elena Hanganu
- Department of Biomedical Sciences, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Adriana Mocanu
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Vasile Valeriu Lupu
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Ileana Ioniuc
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
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Fitzgerald DA. In modulators we trust. Paediatr Respir Rev 2022; 42:1-2. [PMID: 35491312 DOI: 10.1016/j.prrv.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 04/05/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Dominic A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, 2145, Australia.
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The First 4 Years – Outcome of Children Identified by Newborn
Screening for CF in Germany. KLINISCHE PADIATRIE 2022; 234:284-292. [DOI: 10.1055/a-1700-5105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Background Newborn screening (NBS) has been shown to improve cystic
fibrosis (CF) disease course and has been widely implemented worldwide. This
monocentric study compared children diagnosed by NBS vs. a cohort preceding the
implementation of NBS in Germany in 2016 to evaluate ascribed benefits of
NBS.
Methods We compared all children with confirmed CF diagnosis
(n=19, “NBS group”) out of all children presenting with
positive NBS at our center after implementation of NBS (n=100) to
children diagnosed with CF at our center within 4 years before NBS
implementation (n=29, “pre-NBS group”) for outcomes of
anthropometry, gastrointestinal and pulmonary disease manifestations and
respiratory microbiology.
Results Children diagnosed by NBS had a lower incidence of initial
difficulty to thrive (15 vs. 41%) and showed higher mean z-scores for
Body-Mass-Index (BMI), weight and length at diagnosis and during study period.
Children in the pre-NBS group displayed higher proportions of oxygen-dependent
pulmonary exacerbations (10 vs. 0%). They show a significantly lower
amount of normal bacterial flora (p=0.005) along with a significantly
higher number of throat swab cultures positive for Pseudomonas aeruginosa
(p=0.0154) in the first year of life. Yet, pulmonary imaging did not
reveal less pulmonary morbidity in the NBS group.
Conclusions Our results confirm that NBS for CF leads to earlier diagnosis
and improves nutritional outcomes in early childhood. Although trajectories of
structural lung damage at early age were unaffected by NBS, NBS positive CF
patients at preschool age displayed less pulmonary exacerbations and
pathological bacteria in throat swabs.
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