Evaluation Of The Pan-microbiome and Host Immune Response in CF

Study Overview
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Brief Summary
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Investigators will examine temporal and regional dynamic changes in the microbiome of Cystic Fibrosis patients to explore microbiome features that are associated with an inflammatory phenotype. Investigators hypothesize that temporal and spatial differences in lung microbiome are associated with host inflammatory responses. While chronic and polymicrobial airway colonization are commonly recognized in cystic fibrosis (CF), it is unclear what factors of the microbial environment lead to infection with pathogenic microorganism. This is a multi center, longitudinal cohort of adult Cystic Fibrosis subjects recruit4ed from NYU and Columbia to understand how changes in the airway microbiome may affect the host inflammatory responses in Cystic Fibrosis (CF). There will be three approaches to understanding inflammatory responses; 1) a longitudinal assessment of temporal changes in the microbiome over a 6-month period of clinical stability; 2) comparison of the regional differences in airway microbiome between lung segments with more versus less disease; 3) evaluation of functional aspects of the lung microbiome.

Official Title
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Evaluation Of The Pan-microbiome and Host Immune Response in Cystic Fibrosis (CF)

Conditions
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Cystic Fibrosis (CF)

Intervention / Treatment
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* Procedure: Two-Bronchoscope Technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CF diagnosis able to produce sputum no recent (one month) exacerbation defined as physician treatment with antibiotics for ≥ 7days FEV1 ≥ 30% of predicted. Exclusion Criteria: Initiation of any new chronic therapy (e.g., ibuprofen, aerosolized rhDNase, hypertonic saline, azithromycin, tobramycin inhalation solution, aztreonam inhalation solution, ivacaftor) within 8 weeks prior to enrolment introduction of vitamins or proton pump inhibitors within 8 weeks prior to enrolment use of new investigational therapy within 4 weeks current smoker; use of oral corticosteroids Initiation of treatment or change in regimen for allergic bronchopulmonary aspergillosis or nontuberculous mycobacteria within 8 weeks. liver enzymes > 3 times the upper limit pregnancy Additional Exclusion Criteria for Bronchoscopy Subgroup (Aims 2 and 3): FEV1 < 50% of predicted. Significant cardiovascular disease defined as abnormal EKG, known or suspected coronary artery disease or congestive heart failure. Significant renal disease (Creatinine Clearance < 30%). Severe malnutrition (BMI <18kg/m2)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Stable Group<br> | Procedure: Two-Bronchoscope Technique<br>* Used to validate the use of sputum to sample the lower airway microbiome<br>|
| Rapid Decliner Group<br> | Procedure: Two-Bronchoscope Technique<br>* Used to validate the use of sputum to sample the lower airway microbiome<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Oral Inflammatory markers |  | Baseline, 6 Months | 
| Changes in Sputum Inflammatory Markers measured using research bronchoscopy |  | Baseline, 6 Months | 
| Changes in Gut Microbiome |  | Baseline, 6 Months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cystic Fibrosis (CF)