THE HUMAN gut microbiota consists of a diverse array of microbial species that play a crucial role in immune regulation, metabolism, and overall physiological function. Alterations in gut microbiota composition are linked to various diseases, making it a key area of research. The gut microbiota begins to establish itself at birth, undergoing significant developmental changes throughout early life. By the age of three to five years, these changes typically stabilise into an adult-like microbiome. However, disruptions in this maturation process can negatively impact health, as seen in malnourished children who exhibit delayed gut microbiota development, leading to growth and immune function deficiencies.
Cystic fibrosis (CF) is a genetic disorder caused by mutations in the CFTR gene, leading to impaired chloride ion transport across cell membranes. While CF is most commonly associated with lung complications, it also affects the gastrointestinal system, resulting in chronic inflammation and gut microbiota imbalances. From birth, individuals with CF experience nutritional deficits due to pancreatic insufficiency, contributing to altered microbiota composition. Studies indicate that both infants and adults with CF have increased levels of Proteobacteria and reduced levels of Bacteroidetes, changes that persist over time. Factors such as frequent antibiotic use, pancreatic enzyme replacement therapy, and dietary modifications further influence gut microbiota composition. However, research in germ-free mouse models suggests that CFTR dysfunction alone can drive significant microbial alterations.
A recent study aimed to better understand microbiota development in CF by analysing faecal samples from infants with CF over three years. Findings revealed that microbiota maturation in CF is delayed, preventing the establishment of a stable, adult-like community. A key observation was the enrichment of oral-derived bacterial taxa, which has also been linked to antibiotic usage. Additionally, individuals with CF exhibited reduced levels of short-chain fatty acid (SCFA)-producing bacteria, which are essential for maintaining gut health and immune function.
These findings suggest that microbiota alterations in CF may contribute to systemic inflammation and disease progression. Future research should explore targeted dietary interventions and probiotic therapies aimed at restoring microbiota balance. Understanding the relationship between gut microbiota and CF could pave the way for novel therapeutic strategies to improve patient outcomes.
Katie Wright, EMJ
Reference
Verster AJ et al. Persistent delay in maturation of the developing gut microbiota in infants with cystic fibrosis. mBio. 2025;DOI:10.1128/mbio.03420-24.
