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Nutrition and Cystic Fibrosis in Children

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: 5 November 2025 | Viewed by 2614

Special Issue Editor


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Guest Editor
Division of Pediatric Gastroenterology and Nutrition, Children’s Medical Center Dallas, University of Texas Southwestern, Dallas, TX 75235, USA
Interests: nutrition; cystic fibrosis-associated liver disease; cystic fibrosis and nutrition

Special Issue Information

Dear Colleagues,

Cystic Fibrosis (CF) is an autosomal dominant genetic disorder that impacts approximately 105,000 persons in 94 countries throughout the world. The primary F508 mutation in the cystic fibrosis transmembrane receptor (CFTR) gene was discovered in 1989 and is the dominant allele in 2/3 persons with CF. The classic presentation of CF remains that of malnutrition, lung disease, and pancreatic insufficiency. Malnutrition was one of the early targets of therapy and focused on a high-fat, high-calorie diet based on a pivotal study in the 1970s comparing the nutritional management practices of two centers in Toronto and Boston. Since then, many treatments have been developed to decrease morbidity and mortality in CF including CFTR modulators which aid in folding and stabilizing the CFTR protein. New highly effective modulator therapy (HEMT) has shown a significant improvement in weight gain due to an improvement in whole-body inflammation, decreased resting energy expenditure, and improvements in malabsorption. The impact of HEMT along with the recognition of more than 2000 mutations with variable clinical presentations is creating new challenges for clinicians. This Special Issue aims to collect manuscripts focusing on the change in the traditional approach to nutritional therapy, unveiling the importance for personalized medicine in CF.

Dr. Meghana Nitin Sathe
Guest Editor

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Keywords

  • cystic fibrosis
  • cystic fibrosis transmembrane regulator modulators
  • elexacaftor/tezacaftor/ivacaftor
  • ivacaftor
  • nutritional therapy
  • highly effective modulator therapy
  • pancreatic insufficiency

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Published Papers (2 papers)

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Research

13 pages, 1266 KiB  
Article
The Impact of Complementary Feeding on Fecal Microbiota in Exclusively Breast-Fed Infants with Cystic Fibrosis (A Descriptive Study)
by Andrea Asensio-Grau, María Garriga, Saioa Vicente, Ana Andrés, Carmen Ribes-Koninckx and Joaquim Calvo-Lerma
Nutrients 2024, 16(23), 4071; https://doi.org/10.3390/nu16234071 - 27 Nov 2024
Viewed by 922
Abstract
Background/Objectives: Early life gut microbiota plays a pivotal role in shaping immunity, metabolism, and overall health outcomes. This is relevant in healthy infants but may be even more crucial in infants with chronic devastating diseases, such as cystic fibrosis (CF). While the introduction [...] Read more.
Background/Objectives: Early life gut microbiota plays a pivotal role in shaping immunity, metabolism, and overall health outcomes. This is relevant in healthy infants but may be even more crucial in infants with chronic devastating diseases, such as cystic fibrosis (CF). While the introduction of solid foods in healthy infants modifies the composition of colonic microbiota, less knowledge is available on those with CF. The aim of this descriptive observational study was to assess the composition of fecal microbiota in six exclusively breast-fed infants with CF, and then explore the changes induced upon the introduction of different foods. Methods: two types of fecal samples were collected from each subject: one during the exclusive-breastfeeding period, and the other after incorporating each new food in the ad libitum diet. The microbiota composition was analyzed by 16S rRNA amplicon sequencing. Results: Wide heterogenicity in the composition at the phylum level (variable proportions of Actinobacteriota, Proteobacteria, and Firmicutes, and the absence of Bacteroidota in all subjects) was found, and different enterotypes were characterized in each subject by the main presence of one genus: Bifidobacterium in Subject 1 (relative abundance of 54.4%), Klebsiella in Subject 3 (49.1%), Veillonella in Subjects 4 and 5 (32.7% and 36.9%, respectively), and Clostridium in Subject 6 (48.9%). The transition to complementary feeding induced variable changes in microbiota composition, suggesting a subject-specific response and highlighting the importance of inter-individual variation. Conclusions: Further studies are required to identify which foods contribute to shaping colonic microbiota in the most favorable way for patients with CF using a personalized approach. Full article
(This article belongs to the Special Issue Nutrition and Cystic Fibrosis in Children)
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12 pages, 782 KiB  
Article
Polymorphisms of the Vitamin D Binding Protein (VDBP) and Free Vitamin D in Patients with Cystic Fibrosis
by Paula Quesada-Colloto, Noelia Avello-Llano, Ruth García-Romero, María Garriga-García, Marina Álvarez-Beltrán, Ana Isabel Reyes-Domínguez, Ana Estefanía Fernández-Lorenzo, Helena Gil-Peña, Carlos Gómez-Alonso, Carmen García-Gil-Albert, Saioa Vicente-Santamaria, Luis Peña-Quintana, Juan José Díaz-Martin, José Ramon Gutiérrez-Martínez, Carmen Martin-Fernández, Agustín De la Mano-Hernández, Ana Moreno-Álvarez and David González-Jiménez
Nutrients 2024, 16(22), 3850; https://doi.org/10.3390/nu16223850 - 11 Nov 2024
Cited by 1 | Viewed by 1327
Abstract
Objectives/Background: Vitamin D-binding protein (VDBP) and free vitamin D are new markers that are being studied as a possible markers of vitamin D status. The main aim of our study was to analyze the VDBP genotype and quantify the levels of free vitamin [...] Read more.
Objectives/Background: Vitamin D-binding protein (VDBP) and free vitamin D are new markers that are being studied as a possible markers of vitamin D status. The main aim of our study was to analyze the VDBP genotype and quantify the levels of free vitamin D in a sample of cystic fibrosis (CF) patients. Methods: We conducted a multicenter, cross-sectional, and prospective study including patients with CF and exocrine pancreatic insufficiency who were clinically stable. We investigated vitamin D levels (total and free) and the different VDBP haplotypes. Free vitamin D levels were measured using an electro-chemiluminescence assay. Results: A sample of 48 patients was obtained (52% male; median age 13.8 years). The most common allele of VDBP was Gc1s (72%) > Gc2 (52%) > Gc1f (27%). The median calcidiol was 21.2 ng/mL (IR 15.3–26.9), and 81% had levels in the insufficiency range: 23 patients (48%) below 20 ng/mL, and 16 (33%) between 20 and 30 ng/mL. The median free vitamin D level was 4.2 pg/mL (IR 3.9–5.6). A positive correlation was observed between calcidiol and free vitamin D levels (r = 0.871; p < 0.0001). After adjustment for season, vitamin D supplementation, sex, and CF-related diabetes, patients with Gc1f polymorphism had a lower risk of vitamin D deficiency, OR 0.22 (95% CI 0.05–0.99), and p = 0.027. A negative linear trend was observed between the polymorphisms grouped into three categories (Gc1/Gc1, Gc1/Gc2, and Gc2/Gc2, in that order) and vitamin D and free vitamin D levels (p = 0.025 and p = 0.033, respectively). Conclusion: In CF, as in the general population, the most common VDBP haplotype in the Caucasian race is Gc1s. VDBP polymorphisms influence serum vitamin D and free vitamin D levels in CF patients. There is a good correlation between free vitamin D and calcidiol levels, suggesting that measuring the latter in CF does not seem to provide any additional benefit. Full article
(This article belongs to the Special Issue Nutrition and Cystic Fibrosis in Children)
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