Abstract
BackgroundEarly diagnosis and treatment are improving significantly the quality of life of patients with cystic fibrosis (CF). This recessive disease is caused by a great variability of mutations in the CF transmembrane conductance (CFTR) gene, whose spectrum and frequency can be different across populations. MethodsWe performed a retrospective cross-sectional study of CF patients from the island of São Miguel (Azores, Portugal) through a clinical, genealogical, genetic and epidemiological investigation. The clinical course of patients was analyzed as a whole and according to their genotype.ResultsWe identified 14 CF patients within a 23-year period, corresponding to a cumulative incidence of 1:3012 births, being three of them born from consanguineous unions. Genetic analysis revealed three CFTR genotypes: p.[Ser4Ter];[Gln1100Pro] was present in one patient with a less severe phenotype (1/14); c.[120del23];p.[Phe508del], a very rare one (2/14); and p.[Phe508del];[Phe508del] in the remaining patients (11/14). Clinically, respiratory infections (8/14) and growth failure (6/14) were the most common initial manifestations. All patients presented pancreatic dysfunction, with 21.4 and 100% of them showing endocrine and exocrine insufficiency, respectively. As expected, patients with severe phenotype were homozygous for p.Phe508del and had the lowest value of body mass index.ConclusionsThe present study demonstrated that São Miguel Island has an increased incidence of CF when compared to recent Portuguese data (1:7500 live births). It also allowed a comprehensive overview of CF in São Miguel, improving medical practice along with genetic counselling and creating opportunities for genotype-targeted therapies.
Highlights
Diagnosis and treatment are improving significantly the quality of life of patients with cystic fibrosis (CF)
In São Miguel, we identified three CF transmembrane conductance (CFTR) mutated genotypes: p.[Ser4Ter]; [Gln1100Pro], a new one; c.[120del23];p.[Phe508del], a very rare; and p.[Phe508del];[Phe508del], the most common genotype found in CF patients worldwide
The p.Ser4Ter belongs to the functional CFTR class IB; the p.Gln1100Pro is only classified according to its pathogenicity as pathogenic / likely pathogenic (ClinVar)
Summary
Diagnosis and treatment are improving significantly the quality of life of patients with cystic fibrosis (CF). This recessive disease is caused by a great variability of mutations in the CF transmembrane conductance (CFTR) gene, whose spectrum and frequency can be different across populations. Recurrent sino-pulmonary infections are one of the main challenges in CF, requiring a mounting use of antibiotics. This aspect, along with improved nutrition and new therapies, is responsible for the increase in survival rates in these patients and alters the antimicrobial susceptibility [4]. The most common pathogens of recurrent infections are Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenza, Burkholderia spp. and Mycobacteria spp. [12]
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