Cystic fibrosis (CF) is the most common, lethal genetic disease among the Caucasian population. The leading cause of mortality is recurrent acute exacerbations resulting in chronic airway inflammation and subsequent downward progression of pulmonary function. Traditionally, these periods of clinical deterioration have been associated with several principal pathogens. However, a growing body of literature has demonstrated a polymicrobial lower respiratory community compromised of facultative and obligate anaerobes. Despite the understanding of a complex bacterial milieu in CF patient airways, specific roles of anaerobes in disease progression have not been established. In this paper, we first present a brief review of the anaerobic microorganisms that have been identified within CF lower respiratory airways. Next, we discuss the potential contribution of these organisms to CF disease progression, in part by pathogenic potential and also through synergistic interaction with principal pathogens. Finally, we propose a variety of clinical scenarios in which these anaerobic organisms indirectly facilitate principal CF pathogens by modulating host defense and contribute to treatment failure by antibiotic inactivation. These mechanisms may affect patient clinical outcomes and contribute to further disease progression.

中文翻译：

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囊性纤维化气道中厌氧菌的潜在贡献

囊性纤维化 (CF) 是高加索人群中最常见的致命遗传疾病。死亡的主要原因是反复急性加重，导致慢性气道炎症和随后的肺功能下降。传统上，这些临床恶化时期与几种主要病原体有关。然而，越来越多的文献表明，多种微生物下呼吸道群落受到兼性和专性厌氧菌的影响。尽管了解 CF 患者气道中复杂的细菌环境，但尚未确定厌氧菌在疾病进展中的具体作用。在本文中，我们首先简要回顾了在 CF 下呼吸道内已鉴定的厌氧微生物。下一个，我们讨论了这些生物体对 CF 疾病进展的潜在贡献，部分是通过致病潜力以及与主要病原体的协同相互作用。最后，我们提出了多种临床方案，其中这些厌氧生物通过调节宿主防御间接促进主要 CF 病原体，并通过抗生素灭活导致治疗失败。这些机制可能会影响患者的临床结果并导致进一步的疾病进展。我们提出了多种临床方案，其中这些厌氧生物通过调节宿主防御间接促进主要 CF 病原体，并通过抗生素灭活导致治疗失败。这些机制可能会影响患者的临床结果并导致进一步的疾病进展。我们提出了多种临床方案，其中这些厌氧生物通过调节宿主防御间接促进主要 CF 病原体，并通过抗生素灭活导致治疗失败。这些机制可能会影响患者的临床结果并导致进一步的疾病进展。