International Journal of Respiratory Medicine

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (629)348-3199

Short Communication - International Journal of Respiratory Medicine (2023) Volume 8, Issue 4

The role of inflammation and oxidative stress in cystic fibrosis lung disease

Cardenas Horati *

Department of Medical Sciences, University of Rzeszow, Warzywna 1a, Rzeszow, Poland

*Corresponding Author:
Cardenas Horati
Department of Medical Sciences
University of Rzeszow
Warzywna 1a, Rzeszow, Poland

Received: 19-Jul-2023, Manuscript No. AAIJRM-23-109327; Editor assigned: 21-Jul-2023, PreQC No. AAIJRM-23-109327(PQ); Reviewed: 04-Aug-2023, QC No. AAIJRM-23-109327; Revised: 08-Aug-2023, Manuscript No. AAIJRM-23-109327(R); Published: 14-Aug-2023, DOI: 10.35841/aaijrm-8.4.157

Citation: Horati C. The role of inflammation and oxidative stress in cystic fibrosis lung disease. Int J Respir Med. 2023; 8(4):157

Visit for more related articles at International Journal of Respiratory Medicine


Cystic Fibrosis (CF) is a life-threatening genetic disorder primarily affecting the respiratory and digestive systems. The hallmark of CF is a defective Cystic Fibrosis Trans membrane conductance Regulator (CFTR) protein, leading to impaired ion transport across cell membranes. The lung is the most severely affected organ, with chronic airway inflammation and oxidative stress playing pivotal roles in the progression of CF lung disease. This article delves into the intricate relationship between inflammation, oxidative stress and CF lung disease, highlighting their contributions to disease pathogenesis and potential therapeutic targets [1].


In CF patients, the absence or dysfunction of CFTR results in abnormal Mucociliary clearance, leading to the accumulation of thick and sticky mucus in the airways. The stagnation of mucus creates an ideal environment for bacterial colonization and infection, which triggers an excessive inflammatory response. Immune cells, primarily neutrophils and macrophages, infiltrate the lungs and release pro-inflammatory cytokines, such as interleukins (IL-1β, IL-6 and IL-8) and tumor necrosis factor-alpha (TNF-α).


Chronic inflammation leads to tissue damage, recruitment of more immune cells and structural changes in the airways. Furthermore, the inflammatory response perpetuates a vicious cycle of mucus accumulation, bacterial infection and tissue destruction, ultimately resulting in the progressive decline of lung function [2].


Oxidative stress arises from an imbalance between reactive oxygen species (ROS) production and the antioxidant defence system. In CF, the abnormal inflammatory response and bacterial infection contribute to an excessive production of ROS by activated immune cells, especially neutrophils. The compromised antioxidant defence, coupled with a limited capacity to clear ROS due to CFTR dysfunction, further exacerbates oxidative stress in the lungs. ROS can damage lipids, proteins and DNA, causing cellular dysfunction and apoptosis. The lung epithelium, in particular, is susceptible to oxidative damage, leading to impaired barrier function and increased susceptibility to infections [3].


Synergy between inflammation and oxidative stress

In CF lung disease, inflammation and oxidative stress work in synergy, each amplifying the detrimental effects of the other. Pro-inflammatory cytokines can stimulate the production of ROS, while ROS, in turn, can activate signalling pathways that promote inflammation. The release of damage-associated molecular patterns (DAMPs) during cell death and tissue damage also contributes to inflammation and further ROS production.


One of the central players linking inflammation and oxidative stress in CF is nuclear factor-kappa B (NF-kB). NF-kB is a transcription factor that regulates the expression of various pro-inflammatory genes. ROS can activate NF-kB, leading to increased cytokine production and perpetuation of the inflammatory response. Additionally, NF-kB activation can enhance the expression of NADPH oxidases, the main enzymes responsible for ROS production in immune cells. The chronic and deregulated inflammatory response, coupled with sustained oxidative stress, is the driving force behind the progressive lung damage observed in CF patients. The continuous cycle of inflammation, ROS production and tissue damage results in bronchiectasis, airway remodelling and fibrosis, ultimately leading to respiratory failure.


Moreover, chronic bacterial colonization and recurrent infections, partly caused by impaired mucus clearance, lead to more pronounced inflammation and oxidative stress. The prolonged exposure to bacterial products and inflammatory mediators further exacerbates lung pathology [4].


Understanding the interplay between inflammation and oxidative stress has opened up potential therapeutic avenues for managing CF lung disease. Targeting key inflammatory mediators, such as IL-8 or TNF-α, has been explored as a means to reduce excessive inflammation. Furthermore, antioxidant therapies aimed at restoring the redox balance in the lungs have shown promise in preclinical studies.


CFTR modulator therapies, which directly target the underlying defect in CF, have demonstrated significant improvements in lung function and reduced exacerbations. These therapies may also have indirect anti-inflammatory and antioxidant effects by improving Mucociliary clearance and reducing bacterial colonization [[5].



In conclusion, inflammation and oxidative stress are critical components of CF lung disease pathogenesis. Their interplay creates a detrimental feedback loop that drives progressive lung damage. Targeting these processes represents a promising approach to alleviate CF lung disease and improve the quality of life for individuals affected by this debilitating genetic disorder. As research continues, advancements in understanding the complex interactions between inflammations, oxidative stress and CF lung disease may pave the way for more effective therapeutic strategies in the future.



  1. Di Gioia S, Daniello V, Conese M. Extracellular Vesicles’ Role in the Pathophysiology and as Biomarkers in Cystic Fibrosis and COPD. Int J Mol Sci. 2022;24(1):228.
  2. Indexed at, Google Scholar, Cross Ref

  3. Montuschi P, Kharitonov SA, Ciabattoni G, et al. Exhaled 8-isoprostane as a new non-invasive biomarker of oxidative stress in cystic fibrosis. 2000;55(3):205-9.
  4. Indexed at, Google Scholar, Cross Ref

  5. Spicuzza L, Parisi GF, Tardino L, et al. Exhaled markers of antioxidant activity and oxidative stress in stable cystic fibrosis patients with moderate lung disease. J Breath Res. 2018;12(2):026010.
  6. Indexed at, Google Scholar, Cross Ref

  7. Voynow JA, Zheng S, Kummarapurugu AB. Glycosaminoglycans as multifunctional anti-elastase and anti-inflammatory drugs in cystic fibrosis lung disease. Front Pharmacol. 2020;11:1011.
  8. Indexed at, Google Scholar, Cross Ref

  9. Zuniga JA, Garcia AA, Fordyce J, et al. Predictors of Flu Vaccination for Persons Living With HIV in Central Texas. J Assoc Nurses AIDS. 2019;30(5):593-7.

Indexed at, Google Scholar, Cross Ref

Get the App