The gut-lung axis in the CFTR modulator era

Florian Lussac-Sorton; Éléna Charpentier; Sébastien Imbert; Maxime Lefranc; Stéphanie Bui; Michael Fayon; Patrick Berger; Raphaël Enaud; Laurence Delhaes

doi:10.3389/fcimb.2023.1271117

The gut-lung axis in the CFTR modulator era

Front Cell Infect Microbiol. 2023 Sep 15:13:1271117. doi: 10.3389/fcimb.2023.1271117. eCollection 2023.

Authors

Florian Lussac-Sorton^{1

2}, Éléna Charpentier^{1

2}, Sébastien Imbert^{1

2

3}, Maxime Lefranc³, Stéphanie Bui^{1

2

3}, Michael Fayon^{1

2

3}, Patrick Berger^{1

2

3}, Raphaël Enaud^{1

2

3}, Laurence Delhaes^{1

2

3}

Affiliations

¹ Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Pessac, France.
² INSERM, Centre de Recherche Cardio-thoracique de Bordeaux, Pessac, France.
³ CHU Bordeaux, Service de Parasitologie et Mycologie, Centre de Ressources et de Compétences de la Mucoviscidose (CRCM), Service de Pédiatrie, Service d'Exploration Fonctionnelle Respiratoire, CIC, Bordeaux, France.

Abstract

The advent of CFTR modulators represents a turning point in the history of cystic fibrosis (CF) management, changing profoundly the disease's clinical course by improving mucosal hydration. Assessing changes in airway and digestive tract microbiomes is of great interest to better understand the mechanisms and to predict disease evolution. Bacterial and fungal dysbiosis have been well documented in patients with CF; yet the impact of CFTR modulators on microbial communities has only been partially deciphered to date. In this review, we aim to summarize the current state of knowledge regarding the impact of CFTR modulators on both pulmonary and digestive microbiomes. Our analysis also covers the inter-organ connections between lung and gut communities, in order to highlight the gut-lung axis involvement in CF pathophysiology and its evolution in the era of novel modulators therapies.

Keywords: CFTR modulators; cystic fibrosis; gut-lung axis; microbiota; mycobiota.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Bacteria
Cystic Fibrosis Transmembrane Conductance Regulator / genetics
Cystic Fibrosis* / drug therapy
Dysbiosis* / microbiology
Humans
Lung
Microbiota*

Substances

CFTR protein, human
Cystic Fibrosis Transmembrane Conductance Regulator

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. LD team had annual grants from the Bordeaux University Hospital, University of Bordeaux and INSERM U1045; they also benefited from Vaincre la Mucoviscidose’s grant (RCI20210502769). All the funders had no role in article design, data analysis, decision to publish, or preparation of the manuscript.