60 years of microbiological research in CF

In our 60 year history, we’ve always been committed to attracting the brightest and best young researchers to work in CF at an early stage in their career. We hope that they will stay in CF research and continue to help us improve the lives of people with CF in the future. Microbiologist Professor Jo Fothergill from Liverpool University has received funding from the Trust throughout her career, so she was the perfect person to give a plenary talk at our recent early career researcher conference. 

One in five people with CF had at least one course of intravenous treatment for a CF lung infection in the last year, was a statistic that Prof Fothergill used at the start of her talk. The data were taken from the UK CF Registry annual data report for 2023, published last month. While this is half the number of people having IV treatments five years ago, it still highlights the continued need for more research. 

Bugs that cause CF lung infections change over time and can become resistant to antimicrobial medicines such as antibiotics, meaning that they don’t work as well or no longer work at all. Further research into the lung health of people with CF, including detection and diagnosis of infections and effective treatments for them, is urgently needed. 

Decades of advances 

Prof Fothergill talked through advances in microbiology research in each decade since the Trust was established. From the 1960s to 1990s, researchers gained a detailed understanding of which bugs were causing CF lung infections and that these infections were different to infections caused in other conditions. During this time medicines such as tobramycin, which is still being used today, were developed and the introduction of inhaled antibiotics into CF care started. 

Room for more improvement in diagnosing infections 

Traditionally, lung infections have been detected and diagnosed from sputum samples. However, these have always been difficult to produce for children with CF. Many adults who are on modulators find producing sputum samples difficult too. Better ways of diagnosing infections are needed. Accelerating research to improve the detection and diagnosis of infections is an aim of the CF AMR Syndicate, an initiative managed by the Trust, Medicines Discovery Catapult and LifeArc. The Syndicate has produced a set of guidelines for new ways to diagnose lung infections. 

Living together and fighting each other 

In the last decade researchers have begun studying the combined effects of all of the bugs within the CF lung, together these bugs are known as the lung ‘microbiome’. It has led to a new way of thinking about bugs that cause infections. 

“It’s not enough to know which bugs are there, we also want to know how these bugs interact with each other. Understanding this can help us understand the best way to treat multiple infections,” said Professor Fothergill.  

Bugs within the guts 

As well CF lung infections, Prof Fothergill also talked about the bugs that live within the intestines (known as the gut ‘microbiome’). Changes in the gut microbiome might be one of the causes of gut symptoms in people with CF, alongside other things. 

Unravelling the details of what is happening when people experience different tummy and gut symptoms is the aim of our GRAMPUS-CF SRC led by Professor Alan Smyth and colleagues. If you’re interested in taking part in their studies, you can read more about how to do this on our Trials Tracker. More background about the study is on our website too. 

Best tools for the job 

Like lots of medical science, in microbiology how you do your experiments can give you different results. The use of the best lab model – or in other words the best tools for the job – is important for testing the effects of new treatments for infections. 

Prof Fothergill is passionate about having effective ways to study CF infections in the lab. Hollie is a PhD student in her lab, funded through the PIPE-CF SRC. You can read more about some of the experiments she’s doing in our ‘Inside the lab’ article from last year.  

New therapeutics  

Towards the end of her talk, Prof Fothergill talked treatments for CF lung infections. “Researchers are working on lots of different ways to treat infections. These range from medicines that improve the action of existing antibiotics, to the development of viruses that can kill bacteria, known as bacteriophage or ‘phage’.” 

Using phage as a way of treating CF lung infections is another focus of research in Prof Fothergill’s lab. She is a Hub Director of the Trailfinder-CF hub of the recently announced Translational Innovation Hub Network. You can find out more about the network on our website, or join our Instagram Live on Thursday 21 November to hear all about it.  

A big thank you to Prof Fothergill for her presentation on 60 years of CF microbiology research. You can find out more about the developments in CF research and care on our timeline.  

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