Cystic Lung Research Articles

374 - An abnormal finding of lung blebs in an infant with RSV bronchiolitis

374 - An abnormal finding of lung blebs in an infant with RSV bronchiolitis

Devant un pneumothorax bilatéral, il faut bien se gratter la tête !

Head and neck skin angiosarcoma is a rare and aggressive tumor (1% of head and neck tumors). Prognosis remains poor, with a 5-year survival rate ranging from 10 to 54%, depending on the initial stage. Metastatic disease markedly worsens the prognosis. Metastatic lung involvement is classic and can take on several forms. The cystic form is responsible for numerous complications, particularly pneumothorax. In this case, an 83-year-old patient was diagnosed with bilateral pneumothorax complicating cystic interstitial lung disease, which was revealed by hemoptoic sputum. Skin examination revealed two large necrotic lesions of the calvaria. Anatomo-pathological examination confirmed cutaneous angiosarcoma on both skin biopsy and lung resection. At a metastatic stage, only systemic treatment with paclitaxel can be proposed. The clinical course was unfavorable, leading to death before any specific treatment. This observation highlights the importance of a complete clinical skin examination in the assessment of pulmonary cystic lesions.

Pulmonary Hydatid Cyst in Children and Adults: Diagnosis and Management.

Hydatid cyst disease induced by Echinococcus granulosus is a parasitic disease known since ancient times. Today, it continues to be seen in many countries and creates serious problems. The lung is the second most frequently affected organ by hydatid cysts after the liver. Lung involvement is more prevalent in children than adults, and the growth of the cyst is faster in children. Hydatid cysts are mostly seen in the right lower lobe of the lung. Common symptoms are chest pain, cough, and shortness of breath, with the most diagnostic symptom being the expectoration of cyst fluid or membranes. In endemic areas, the diagnosis of hydatid cysts can usually be made easily by clinical findings, serology tests, and radiological findings. When the hydatid cyst ruptures and becomes complicated, it is clinically and radiologically confused with many diseases, especially lung cancer. Surgery is accepted as primary treatment of lung hydatid cysts all over the world. The surgical approach is related to several factors such as the size of the cyst, whether it is intact or complicated, unilateral or bilateral, solitary or multiple, and the presence of destruction of the lung parenchyma. Although it is stated by some surgeons that capitonnage is not required, the most frequently applied surgical technique is cystotomy and capitonnage. Pulmonary resection should be avoided as much as possible, particularly in children. Albendazole or mebendazole treatment in pulmonary hydatid cyst is generally used after surgery and to prevent recurrences.

Diagnóstico por imagen de abscesos hepáticos y pulmonares por estreptococos del grupo viridans. Presentación de caso

Streptococcus viridans is more commonly known as an infectious agent in endocarditis, however, little is known about its infectious potential in other organs or systems, where it has shown high mortality. The recognition of Streptococcus viridans as an abscess-producing agent in other locations, such as the liver or lungs, will allow timely diagnosis using different imaging methods, reducing serious consequences for the patient and hospitalization times. We present the case of a 33-year-old male patient with no chronic degenerative history, who started symptoms 7 months prior to admission, with intermittent fever, fatigue, asthenia, anorexia and weight loss, on physical examination he presented pain at the medium and deep palpation in the right hypochondrium, in the laboratory panel I present striking neutrophilia, in the tomography of the thorax and abdomen a cavernous lesion in the lung and complicated hepatic cysts are shown, to which percutaneous drainage guided by ultrasound is performed, with sending of cultured samples with a positive result for Streptococcus viridans. Thus, allowing treatment to be provided to the patient, thereby achieving remission of the disease. Key words: Liver abscess; lung abscess; streptococcal infections; residual abscess; cavitary lung injury; Streptococcus viridans.

Follow-up of patients with a 5-year survival after paraquat poisoning using computed tomography images and spirometry.

The study aimed to examine long-term survival of patients with acute paraquat poisoning using computed tomography (CT) images and spirometry. A total of 36 patients with long-term survival after paraquat poisoning were followed-up and divided into mild (11 patients), moderate (17 patients), and severe (8 patients) paraquat poisoning groups. Differences among the groups were compared using clinical indicators, such as peripheral capillary oxygen saturation, arterial partial pressure of oxygen and 6-min walk test (6-MWT), chest CT, spirometry, and serum immunoglobulin E (IgE). The 6-MWT distance was significantly shorter in the severe paraquat poisoning group than that in the mild and moderate paraquat poisoning groups. In the mild paraquat poisoning group, CT revealed no obvious lung injury, and spirometry showed normal lung function in most patients. In moderate or severe paraquat poisoning group, CT images showed fibrotic lesions as cord-like high-density shadows, reticulations, and honeycombs. In addition, other pulmonary changes, including bronchiectasis, increased lung transparency, and pulmonary bullae, were discovered. In moderate or severe paraquat poisoning group, obvious obstructive ventilation dysfunction with slight restrictive and diffuse impairment were observed in some patients, with positive bronchial relaxation test and high serum IgE level. In the long-term follow-up, patients with severe paraquat poisoning showed the lowest exercise endurance. In moderate or severe paraquat poisoning group, CT images revealed diversified changes, not only dynamic evolution of pulmonary fibrosis process, but also signs of bronchiectasis, and chronic obstructive pulmonary disease. Some patients with moderate or severe paraquat poisoning developed obstructive ventilatory dysfunction with airway hyperresponsiveness.

Airway bacterial community composition in persons with advanced cystic fibrosis lung disease

BackgroundThe progression of lung disease in people with cystic fibrosis (pwCF) has been associated with a decrease in the diversity of airway bacterial communities. How often low diversity communities occur in advanced CF lung disease and how they may be associated with clinical outcomes is not clear, however. MethodsWe sequenced a region of the bacterial 16S ribosomal RNA gene to characterize bacterial communities in sputum from 190 pwCF with advanced lung disease (FEV1≤40% predicted), with particular attention to the prevalence and relative abundance of dominant genera. We evaluated relationships between community diversity and clinical outcomes. ResultsAlthough most of the 190 pwCF with advanced lung disease had airway bacterial communities characterized by low diversity with a dominant genus, a considerable minority (40%) did not. The absence of a dominant genus, presence of methicillin-susceptible Staphylococcus aureus, and greater bacterial richness positively correlated with lung function. Higher relative abundance of the dominant genus and greater antimicrobial use negatively correlated with lung function. PwCF with a low diversity community and dominant genus had reduced lung transplant-free survival compared to those without (median survival of 1.6 vs 2.9 years). ConclusionsA considerable proportion of pwCF with advanced lung disease do not have airway bacterial communities characterized by low diversity and a dominant genus and these individuals had better survival. An understanding of the antecedents of low diversity airway communities– and the impact these may have on lung disease trajectory - may provide avenues for improved management strategies.

TRACK-CF prospective cohort study: Understanding early cystic fibrosis lung disease.

Lung disease as major cause for morbidity in patients with cystic fibrosis (CF) starts early in life. Its large phenotypic heterogeneity is partially explained by the genotype but other contributing factors are not well delineated. The close relationship between mucus, inflammation and infection, drives morpho-functional alterations already early in pediatric CF disease, The TRACK-CF cohort has been established to gain insight to disease onset and progression, assessed by lung function testing and imaging to capture morpho-functional changes and to associate these with risk and protective factors, which contribute to the variation of the CF lung disease progression. TRACK-CF is a prospective, longitudinal, observational cohort study following patients with CF from newborn screening or clinical diagnosis throughout childhood. The study protocol includes monthly telephone interviews, quarterly visits with microbiological sampling and multiple-breath washout and as well as a yearly chest magnetic resonance imaging. A parallel biobank has been set up to enable the translation from the deeply phenotyped cohort to the validation of relevant biomarkers. The main goal is to determine influencing factors by the combined analysis of clinical information and biomaterials. Primary endpoints are the lung clearance index by multiple breath washout and semi-quantitative magnetic resonance imaging scores. The frequency of pulmonary exacerbations, infection with pro-inflammatory pathogens and anthropometric data are defined as secondary endpoints. This extensive cohort includes children after diagnosis with comprehensive monitoring throughout childhood. The unique composition and the use of validated, sensitive methods with the attached biobank bears the potential to decisively advance the understanding of early CF lung disease. The study protocol was approved by the Ethics Committees of the University of Heidelberg (approval S-211/2011) and each participating site and is registered at clinicaltrials.gov (NCT02270476).

“Air Bubble Sign” and Fibreoptic Bronchoscopy in Complicated Pulmonary Hydatid Cysts: Steps in the Right Direction

“Air Bubble Sign” and Fibreoptic Bronchoscopy in Complicated Pulmonary Hydatid Cysts: Steps in the Right Direction

Characteristic Chest Computed Tomography Findings for Birt-Hogg-Dube Syndrome Indicating Requirement for Genetic Evaluation.

Background: Chest computed tomography (CT) findings are important for identifying Birt−Hogg−Dube (BHD) syndrome. However, the predictive power of classical criteria for chest CT findings is weak. Here, we aimed to identify more specific chest CT findings necessitating genetic examination for FLCN gene mutations. Methods: From June 2016 to December 2017, we prospectively enrolled 21 patients with multiple bilateral and basally located lung cysts on chest CT with no other apparent cause, including cases with and without spontaneous primary pneumothorax. All enrolled patients underwent FLCN mutation testing for diagnosis confirmation. Results: BHD was diagnosed in 10 of 21 enrolled patients (47.6%). There were no differences in clinical features between the BHD and non-BHD groups. Maximal cyst diameter was significantly greater in the BHD group (mean ± standard deviation; 4.1 ± 1.1 cm) than in the non-BHD group (1.6 ± 0.9 cm; p < 0.001). Diversity in cyst size was observed in 100.0% of BHD cases and 18.2% of non-BHD cases (p = 0.001). Morphological diversity was observed in 100.0% of BHD cases and 54.6% of non-BHD cases (p = 0.054). Areas under the receiver operating characteristic curves for predicting FLCN gene mutations were 0.955 and 0.909 for maximal cyst diameter and diversity in size, respectively. The optimal cut-off value for maximal diameter FLCN mutations prediction was 2.1 cm (sensitivity: 99%; specificity: 82%). Conclusions: Reliable chest CT features suggesting the need for FLCN gene mutations screening include variations in cyst size and the presence of cysts > 2.1 cm in diameter, predominantly occurring in the bilateral basal lungs.

Successful Treatment of Bilateral Pulmonary Hydatic Cysts in a Child with Acute Myeloid Leukemia

Few data are available about hydatid cysts in patients with malignancy; however, these have rarely been described in association with leukemia. The purpose of this report was to present an unusual case of coexisting leukemia and pulmonary hydatid cysts.This study presented a 13-year-old boy with acute myeloid leukemia who was diagnosed with bilateral pulmonary hydatid cysts after the completion of chemotherapy and successfully treated with surgery and albendazole. Managing hydatid cysts in patients with leukemia is difficult, and these individuals are also at risk of developing ruptured and infected cysts during chemotherapy. Based on our experience with this case, an oncologist could postpone surgery until the chemotherapy was completed and begin albendazole if hydatid cysts were detected.

A Validated Model for the Imaging Diagnosis of Cystic Lung Disease

Rationale and Objectives: Cystic lung disease may be accurately diagnosed by imaging interpretation of specialist radiologists, without other information. We hypothesized that with minimal training non-specialists could perform similarly to specialist physicians in the diagnosis of cystic lung disease. Methods: 72 cystic lung disease cases and 25 cystic lung disease mimics were obtained from three sources: 1) a prospective acquired diffuse lung disease registry, 2) a retrospective search of medical records and 3) teaching files. Cases were anonymized, randomized and interpreted by 7 diffuse lung disease specialists and 15 non-specialist radiologists and pulmonologists. Clinical information other than age and sex was not provided. Prior to interpretation, non-specialists viewed a short PDF training document explaining cystic lung disease interpretation. Results: Correct first choice diagnosis of 85%-88% may be achieved by high-performing specialist readers and 71%-80% by non-specialists and lower-performing specialists, with mean accuracies in the diagnosis of LAM (91%, p < 0.0001), BHD (93%, p < 0.0001), PLCH (89%, p < 0.0001) and LIP (92%, p < 0.0001). A strategy based on cyst appearance: simple cysts (LAM), peri-septal cysts (BHD), bizarre-shaped cysts (PLCH) and vascular indented cysts (LIP) gave non-specialists accuracies of 90% (p < 0.0001), 94% (p < 0.0001), 92% (p < 0.0001) and 88% (p < 0.0001), respectively, for these diagnoses. Cystic lung abnormalities caused by diseases other than LAM, BHD, PLCH and LIP are rarely accurately diagnosed by imaging alone. Conclusion: With specific but limited training, non-specialist physicians can diagnose cystic lung diseases from CT appearance alone with similar accuracy to specialists, correctly identifying approximately 75% of cases.

The association between type 2 diabetes and pulmonary cavitation revealed among IGRA-positive tuberculosis patients.

The co-occurrence of tuberculosis (TB) and diabetes mellitus (DM) presents a significant obstacle to TB eradication. Pulmonary cavitation can occur in severe cases of TB, particularly in patients with DM. From 1 May 2014 through 30 June 2019, we conducted a cross-sectional study of 1,658 smear- or culture-confirmed pulmonary TB (PTB) patients at the Second Department of Pulmonary Medicine and Tuberculosis, Shenzhen, China. A total of 861 participants who satisfied the criteria (chest CT scan for cavitation, interferon-gamma release assay (IGRA), diagnosis of diabetes mellitus), with the median age of 36.7 years, 63.6% of male, 79.7% IGRA positive, 13.8% with diabetes, and 40.8% with pulmonary cavitation, were included in the study. The association between diabetes and pulmonary cavitation was confirmed in these TB patients (adjusted OR, 2.54; 95% CI, 1.66-3.94; p < 0.001). No associations were observed between diabetes and IGRA, as well as between lung cavitary and IGRA. Based on the criteria of IGRA+/-, pulmonary cavitation+/-, and DM+/-, the further analysis with univariate and multivariate logistic regression were conducted in six subgroups. The significant association between diabetes and pulmonary cavitation was further confirmed in the IGRA+ subgroup (adjusted OR, 3.07; 95% CI, 1.86-5.16; p < 0.001) but not observed in IGRA- individuals. This observation suggests that different immunological mechanisms of pulmonary cavitary/DM may be employed in IGRA+ TB patients from IGRA- TB patients.

ХІРУРГІЧНЕ ЛІКУВАННЯ РІДКІСНИХ ЛЕГЕНЕВИХ УСКЛАДНЕНЬ ВИКЛИКАНИХ COVID-19: КЛІНІЧНИЙ ВИПАДОК ГІГАНТСЬКОЇ НЕСПРАВЖНЬОЇ КІСТИ ЛЕГЕНІ, УСКЛАДНЕНОЇ ГЕМАТОМОЮ

A lung cyst is a pathologic cavity filled with air or fluid content. According to the morphological structure, lung cysts are divided into true and false. The former are always congenital, while false lung cysts are acquired. In the population, lung cysts are found in patients of both sexes equally often. According to statistics, about 76 people per 1000 people have a history of lung cysts. With the onset of the COVID-19 pandemic, the widespread use of chest computed tomography (CT) has made it possible to identify a number of pulmonary pathologies, including rare complications of this viral infection. According to the literature, the incidence of pulmonary cysts in the studied patients was 9.0 %. The authors suggest that COVID-19 causes cyst formation in the lungs due to ischemic damage to the parenchyma or vascular occlusion, pulmonary fibrosis. Another cause is blockage of bronchioles by mucus and mucus plugs, accompanied by excessive alveolar distension and, as a result, rupture of the alveolar septum with subsequent formation of small cysts. The article presents our own experience of surgical treatment of rare pulmonary complications caused by COVID-19, namely false giant lung cyst complicated by hematoma. Conclusions. COVID-19 is a relatively new and poorly understood viral lung disease, and therefore each report of its atypical or complicated course will contribute to the systematization of knowledge about this pathology. Key words: COVID-19, VATS, hematoma, cyst, computed tomography

Effect of persistent malnutrition on pulmonary tuberculosis treatment: A cross-sectional study in Weifang, China.

Malnutrition is associated with pulmonary tuberculosis (PTB). The aim of this study is to investigate the association between persistent malnutrition and the effect of PTB treatment. A total of 915 PTB patients were included. Baseline demographic information, anthropometry, and nutritional indicators were measured. The treatment effect was assessed by combinations of clinical manifestations, sputum smear, chest computerized tomography, gastrointestinal symptoms, and the indexes of liver function. Persistent malnutrition was considered when one or more indicators of malnutrition were lower than the reference standards in two tests on admission and after one month of treatment. Clinical symptom score (TB score) was used to assess the clinical manifestations. The generalized estimating equation (GEE) was used to assess the associations. In GEE analyses, patients with underweight had a higher incidence of TB score >3 (OR=2.95; 95% CI, 2.28-3.82) and lung cavitation (OR=1.36; 95% CI, 1.05-1.76). Hypoproteinemia was associated with a higher risk of TB score >3 (OR=2.73; 95% CI, 2.08-3.59) and sputum positive (OR=2.69; 95% CI, 2.08-3.49). Anemia was associated with a higher risk of TB score >3 (OR=1.73; 95% CI, 1.33-2.26), lung cavitation (OR=1.39; 95% CI, 1.19-1.63), and sputum positive (OR=2.23; 95% CI, 1.72-2.88). Lymphocytopenia was associated with a higher risk of gastrointestinal adverse reactions (OR=1.47; 95% CI, 1.17-1.83). Persistent malnutrition within one month of treatment can adversely affect anti-tuberculosis treatment. Nutritional status during anti-tuberculosis treatment should be continuously monitored.

Surgical treatment and outcome of the hydatid cyst: A study from a tertiary care center in Nepal

Introduction: Hydatid cyst is commonly encountered in Nepal with different clinical presentation. Surgery is the treatment of choice. For H. cyst of lung, beside standard thoracotomy Video assisted Thoracoscopy Surery (VATS) has equally good outcome.Method: This was a retrospective, descriptive study of duration of 5 years from 2017 to 2021, conducted in Department of General Surgery of Bir Hospital, National Academy of Medical Sciences, Nepal. Result: Out of 43 patients (age 14 – 63years), most common presenting symptom was cough (48.84%), 16.28% were asymptomatic. Patients were treated with standard thoracotomy (72.09%) and VATS (11.63%) with commonest complication of pneumothorax (6.98%), recurrence in (2.33%) having mortality of (2.33%).Conclusion: H. cyst is commonly encounter in Nepal. Surgery is the treatment of choice. For the treatment of the pulmonary H.cyst VATS is safe having good result.

A Rare Case of Isolated Hydatid Cyst in Right Lung in a Pediatric Patient

Abstract The parasite Echinococcus granulosus is the source of the disease hydatid cyst, which primarily affects the liver but can also affect other parts of the body. This case involves a seven-year-old boy who had fever and cough for 15 days which was identified as a case of isolated hydatid cyst of the right lung following examination and further testing. The child received albendazole preoperatively, then had the hydatid cyst removed with enucleation. After receiving advice to continue taking Praziquantel and Albendazole for another three months, the boy was discharged. If untreated, hydatid cysts of the lung can lead to serious problems like cyst rupture, pneumothorax, and infection and could pose a life-threatening risk. In order to identify hydatid cyst as early as possible, a comprehensive history and examination are crucial, and treatment should begin.

Hitna medicinska stanja tokom komercijalnih letova avionom - "Ima li lekara u avionu?"

Almost four billion passengers travel aboard commercial airliners every year. Last year In-flight medical emergencies (IMEs) were relatively common and occurred in a complex environment with limited medical resources. More recent data shows that IMEs occur in one passenger for every 604 flights or 24-130 IMEs for every one million passengers, more often in people over 70 years old. Due to the drop in barometric pressure, there are specific conditions in the aircraft passenger cabin that can affect the occurrence of IMEs. Most importantly it is hypobaric hypoxia, which can lead to the development of hypoxia-related symptoms in chronic patients with respiratory, cardiovascular, and hematological diseases. With reduced barometric pressure gases in body cavities and medical equipment can expand by 30%, this can lead to IMEs in recently operated patients (wound dehiscence, bleeding), middle ear and sinus diseases, subocclusions, and lung problems (pulmonary bulla). Other factors that contribute to the occurrence of IMEs are limited movement (deep vein thrombosis), dry and cold air (dehydration), jet lag, turbulence, and psychological stress. IMEs most commonly involve syncope or near-syncope (32.7%), gastrointestinal (14.8%), respiratory (10.1%), and cardiovascular (7.0%) symptoms. Because of ethical, and in some countries also legal responsibilities, doctor-passengers are a great help in the treatment of IMEs. Emergency landing of the aircraft when an IME occurs happens in an estimated 4.4% of cases. Knowing the influence of the specific ambient conditions in the plane on physiological processes in the body is of great importance for determining the absolute and relative contraindications for flying by plane. Doctor-passengers have an important role in the treatment of IMEs. This work aims to introduce us to the specific ambient conditions in the aircraft cabin and their influence on the physiology of the human body, the most common IMEs that occur under the influence of those conditions, the role of the doctorpassenger as well as the absolute and relative contraindications for flying by plane.

Characteristics and outcome of pneumothorax, pneumomediastinum, and subcutaneous emphysema in COVID-19 patients

Background: Pneumothorax, pneumomediastinum, and subcutaneous emphysema are few of fatal complications noted in patients with COVID-19 pneumonia. Various studies have shown prevalence of pneumothorax ranging between 1% and 2% in COVID-19 pneumonia. Materials and methods: A total of 10 inpatients admitted with COVID-19 disease confirmed by RT-PCR test who developed pneumothorax, pneumomediastinum, and subcutaneous emphysema during hospital stay by sequential sampling method were included in the study. Demographic data, duration of hospital stay, underlying comorbidities, predisposing factors, radiographic characteristics, and mode of oxygen delivery were collected and analyzed. Results: In our study, mean age group of patient who developed pneumothorax, pneumomediastinum, and subcutaneous emphysema was 39.8 years. Male to female ratio was 9:1. Mean time duration of onset of pneumothorax, pneumomediastinum, and subcutaneous emphysema from the day of hospitalization was 17.3 (8–30) days. Nine patients were on NIV (non-invasive ventilation) while one patient was on NRBM. Right sided involvement was noted in five patients, three had left sided involvement, and two patients had bilateral pneumothorax. Five patients had pneumomediastinum and subcutaneous emphysema along with pneumothorax. All patients received antivirals (Inj. Remdesivir), systemic steroids along with other supportive treatment. Except for one patient, all patients who developed pneumothorax, pneumomediastinum, and subcutaneous emphysema succumbed. All patients’ chest radiograph was consistent with COVID-19 pneumonia. One patient had pulmonary cyst on Computerized Tomography (CT) thorax which was done post intercostal drainage of pneumothorax. Mean time of death after development of pneumothorax, pneumomediastinum, subcutaneous emphysema was 4.3 days. Comorbidities observed were bronchial asthma, obesity, and status post Caesarian section. Conclusion: Development of pulmonary barotrauma in COVID-19 patients is associated with high mortality. Presence of pulmonary cyst, prexisting bronchial asthma, obesity, systemic steroids are possible poor determinants.

Cathepsin K: both a likely biomarker and a new therapeutic target in lymphangioleiomyomatosis?

Lymphangioleiomyomatosis (LAM) is a rare disease which is characterized by cystic lung destruction and lymphangiomas, and is associated with a high risk of osteoporosis-related bone fractures. Its diagnosis is based on pulmonary anatomopathological criteria combined with chest computed tomography. VEGF-D is the only serum diagnostic biomarker used in clinic, while inhibition of the mTOR pathway by rapamycin is currently the only reference therapy for LAM. Human cathepsin K (CatK), a potent collagenase predominantly found in osteoclasts, is considered as a valuable target for anti-osteoporosis and bone cancer therapy. Recently, CatK, which is overexpressed in lung cysts, was proposed as a putative LAM biomarker. Moreover, CatK may take part in the LAM pathophysiology by participating in pulmonary cystic destruction and bone degradation. Accordingly, targeting of collagenolytic activity of CatK by exosite-binding inhibitors in combination with mTOR inhibition could represent an innovative therapeutic option in reducing lung destruction in LAM.

Engineering in vitro models of cystic fibrosis lung disease using neutrophil extracellular trap inspired biomaterials.

Cystic fibrosis (CF) is a muco-obstructive lung disease where inflammatory responses due to chronic infection result in the accumulation of neutrophil extracellular traps (NETs) in the airways. NETs are web-like complexes comprised mainly of decondensed chromatin that function to capture and kill bacteria. Prior studies have established excess release of NETs in CF airways increases viscoelasticity of mucus secretions and reduces mucociliary clearance. Despite the pivotal role of NETs in CF disease pathogenesis, current in vitro models of this disease do not account for their contribution. Motivated by this, we developed a new approach to study the pathobiological effects of NETs in CF by combining synthetic NET-like biomaterials, composed of DNA and histones, with an in vitro human airway epithelial cell culture model. To determine the impact of synthetic NETs on airway clearance function, we incorporated synthetic NETs into mucin hydrogels and cell culture derived airway mucus to assess their rheological and transport properties. We found that the addition of synthetic NETs significantly increases mucin hydrogel viscoelasticity. As a result, mucociliary transport in vitro was significantly reduced with the addition of mucus containing synthetic NETs. Given the prevalence of bacterial infection in the CF lung, we also evaluated the growth of Pseudomonas aeruginosa in mucus with or without synthetic NETs. We found mucus containing synthetic NETs promoted microcolony growth and prolonged bacterial survival. Together, this work establishes a new biomaterial enabled approach to study innate immunity mediated airway dysfunction in CF.