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Cystic fibrosis-related diabetes is associated with reduced airway microbial diversity

Diemer, Stefanie LU ; Kozjek, Katja LU and Påhlman, Lisa LU orcid (2026) In Respiratory Research 27. p.1-9
Abstract
Background
Cystic fibrosis (CF) is a genetic disorder characterized by chronic airway inflammation and lung function decline. CF-related diabetes (CFRD) is the main extrapulmonary complication and it is tightly linked to an impaired lung function, but the underlying mechanisms behind these observations are incompletely understood. In the present study, we aimed to compare airway microbiome compositions between pwCF with and without CFRD.

Methods
Sputum samples from pwCF with and without CFRD were analysed for inflammatory cytokines using MesoScale assays and total bacterial load using quantitative PCR of the 16s rRNA gene. Bacterial sputum microbiomes were analysed with 16s rRNA sequencing and characterized based on... (More)
Background
Cystic fibrosis (CF) is a genetic disorder characterized by chronic airway inflammation and lung function decline. CF-related diabetes (CFRD) is the main extrapulmonary complication and it is tightly linked to an impaired lung function, but the underlying mechanisms behind these observations are incompletely understood. In the present study, we aimed to compare airway microbiome compositions between pwCF with and without CFRD.

Methods
Sputum samples from pwCF with and without CFRD were analysed for inflammatory cytokines using MesoScale assays and total bacterial load using quantitative PCR of the 16s rRNA gene. Bacterial sputum microbiomes were analysed with 16s rRNA sequencing and characterized based on richness and evenness. Bray-Curtis was used to determine the distance in microbiome compositions between samples.

Results
Forty-four pwCF were included, of which 59% were diagnosed with CFRD. The CFRD group had significantly lower lung function and elevated sputum levels of IL-1β compared to pwCF without CFRD. The CFRD sputum microbiome was characterized by reduced bacterial diversity, but this association was attenuated after adjusting for lung function. The distance in microbiome composition did not differ between groups. Abiotrophia, Anaeroglobus and Escherichia-Shigella were significantly enriched in the CFRD group, while Neisseria, Prevotella and Streptococcus were more abundant in pwCF without CFRD.

Conclusion
CFRD is associated with impaired lung function, elevated airway inflammation, and a sputum microbiome characterized by reduced bacterial diversity and a more dysbiotic composition. The decreased microbial diversity observed in pwCF with CFRD was predominantly driven by impaired lung function rather than by CFRD itself. (Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Respiratory Research
volume
27
article number
106
pages
1 - 9
publisher
BioMed Central (BMC)
external identifiers
  • pmid:41749281
  • scopus:105031960127
ISSN
1465-993X
DOI
10.1186/s12931-026-03598-2
language
English
LU publication?
yes
id
e63b1a56-42e6-4489-988f-66a967183454
date added to LUP
2026-04-10 09:33:41
date last changed
2026-04-11 04:00:50
@article{e63b1a56-42e6-4489-988f-66a967183454,
  abstract     = {{Background<br/>Cystic fibrosis (CF) is a genetic disorder characterized by chronic airway inflammation and lung function decline. CF-related diabetes (CFRD) is the main extrapulmonary complication and it is tightly linked to an impaired lung function, but the underlying mechanisms behind these observations are incompletely understood. In the present study, we aimed to compare airway microbiome compositions between pwCF with and without CFRD.<br/><br/>Methods<br/>Sputum samples from pwCF with and without CFRD were analysed for inflammatory cytokines using MesoScale assays and total bacterial load using quantitative PCR of the 16s rRNA gene. Bacterial sputum microbiomes were analysed with 16s rRNA sequencing and characterized based on richness and evenness. Bray-Curtis was used to determine the distance in microbiome compositions between samples.<br/><br/>Results<br/>Forty-four pwCF were included, of which 59% were diagnosed with CFRD. The CFRD group had significantly lower lung function and elevated sputum levels of IL-1β compared to pwCF without CFRD. The CFRD sputum microbiome was characterized by reduced bacterial diversity, but this association was attenuated after adjusting for lung function. The distance in microbiome composition did not differ between groups. Abiotrophia, Anaeroglobus and Escherichia-Shigella were significantly enriched in the CFRD group, while Neisseria, Prevotella and Streptococcus were more abundant in pwCF without CFRD.<br/><br/>Conclusion<br/>CFRD is associated with impaired lung function, elevated airway inflammation, and a sputum microbiome characterized by reduced bacterial diversity and a more dysbiotic composition. The decreased microbial diversity observed in pwCF with CFRD was predominantly driven by impaired lung function rather than by CFRD itself.}},
  author       = {{Diemer, Stefanie and Kozjek, Katja and Påhlman, Lisa}},
  issn         = {{1465-993X}},
  language     = {{eng}},
  pages        = {{1--9}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Respiratory Research}},
  title        = {{Cystic fibrosis-related diabetes is associated with reduced airway microbial diversity}},
  url          = {{http://dx.doi.org/10.1186/s12931-026-03598-2}},
  doi          = {{10.1186/s12931-026-03598-2}},
  volume       = {{27}},
  year         = {{2026}},
}