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The role of anaerobic bacteria in the cystic fibrosis airway

Sherrard, Laura J.; Bell, Scott C.; Tunney, Michael M.

Current Opinion in Pulmonary Medicine: November 2016 - Volume 22 - Issue 6 - p 637ā€“643
doi: 10.1097/MCP.0000000000000299
CYSTIC FIBROSIS: Edited by Nicholas Simmonds and Harry Heijerman

Purpose of review Anaerobic bacteria are not only normal commensals, but are also considered opportunistic pathogens and have been identified as persistent members of the lower airway community in people with cystic fibrosis of all ages and stages of disease. Currently, the role of anaerobic bacteria in cystic fibrosis lower airway disease is not well understood. Therefore, this review describes the recent studies relating to the potential pathophysiological role(s) of anaerobes within the cystic fibrosis lungs.

Recent findings The most frequently identified anaerobic bacteria in the lower airways are common to both cystic fibrosis and healthy lungs. Studies have shown that in cystic fibrosis, the relative abundance of anaerobes fluctuates in the lower airways with reduced lung function and increased inflammation associated with a decreased anaerobic load. However, anaerobes found within the lower airways also produce virulence factors, may cause a host inflammatory response and interact synergistically with recognized pathogens.

Summary Anaerobic bacteria are potentially members of the airway microbiota in health but could also contribute to the pathogenesis of lower airway disease in cystic fibrosis via both direct and indirect mechanisms. A personalized treatment strategy that maintains a normal microbial community may be possible in the future.

aLung Bacteria Group, QIMR Berghofer Medical Research Institute

bAdult Cystic Fibrosis Centre, The Prince Charles Hospital

cSchool of Medicine, The University of Queensland, Brisbane, Queensland, Australia

dCF & Airways Microbiology Group, Queen's University Belfast

eSchool of Pharmacy, Queen's University Belfast, Belfast, UK

Correspondence to Laura J. Sherrard, PhD, Lung Bacteria Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Brisbane, QLD 4006, Australia. Tel: +61 7 3845 3886; e-mail:

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