Viral Infections in Young CF Patients Linked to Disease Pathogens and Flares in Study

In a new study, researchers at Columbia University Medical Center found that viral infections were associated with pulmonary exacerbations in pediatric patients with cystic fibrosis (CF). They also theorized that viruses might impact the respiratory microbiome, leading to the worsening of clinical outcomes during flares.

Results of the study, “Viral Infections and Their Impact on the Respiratory Microbiome in Pediatric Patients with Cystic Fibrosis,” were recently presented at the 2016 American Academy of Allergy, Asthma & Immunology Annual Meeting in Los Angeles, California.

Viral infection is known to negatively impacts the clinical status of patients with CF, but its effect on the respiratory microbiome, the variety of microbes found in the lungs and airways, is not established.

The research team assessed the possible changes in the lung microbiome of pediatric CF patients during periods of wellness and exacerbation, with a focus on the impact of viral infections. Researchers collected swab, sputum, bronchoalveolar lavage, and oropharyngeal samples from 102 people under age 22, at baseline and exacerbation states. With these samples, researchers performed Illumina sequencing, and standard techniques for bacterial and viral detection.

From the 380 samples collected, 301 were found to be negative for virus presence, while 73 were positive, most commonly with the rhinovirus/enterovirus and coronavirus. Researchers found a positive correlation between the presence of viruses and a higher prevalence of traditional CF pathogens. Despite finding some evidence of changes in the amount of microbiota bacteria in virus-positive samples when compared with virus-negative ones, researchers found no association between viral infections and the patient’s clinical status or lung function.

Despite the lack of strong evidence, researchers suggested that the detection of viruses in CF patients may predict subsequent infection with more common CF pathogens. They also suggested that such viruses could be associated with subtle changes in the microbiome, but further research is needed to confirm this hypothesis.

“Our research suggests that in pediatric patients with [cystic fibrosis], viral infections are associated with pulmonary exacerbations and changes in respiratory microbial communities may be part of the underlying mechanism,” concluded the study’s lead author, Gina T. Coscia, MD, in a press release.