Just breathing can be difficult for cystic fibrosis patients, but new research could lead to better treatments. Currently, the best way to assess the health of the airways for CF patients is with a procedure called bronchoalveolar lavage. A thin, fiber-optic viewing scope (bronchoscope) is passed though the mouth or nose, down into the lung.

Cori Daines, M.D., Pediatric Pulmonologist with the University of Arizona College of Medicine in Tucson, AZ, says the bronchoscope allows doctors to determine how much inflammation is present and what areas of the lungs are affected. Then, a small amount of sterile saline is squirted into the airways. The fluid mixes with the mucus and is collected and sent to a lab for culture. This tells doctors what kind of bacteria (or if any) are present in the mucus, allowing more tailored treatment of symptoms.

Bronchoalveolar lavage is a relatively safe procedure. However, it’s an inpatient procedure and requires patients to be anesthetized. About five percent of patients experience complications, like cough, fever, spasms in the airways or temporary decrease in lung function.

Eric Snyder, Ph.D., Researcher with the University of Arizona College of Pharmacy, says a large number of CF patients have a genetic mutation, called Delta F508, which controls chloride production. Normally, chloride levels are associated with wetness of the tissue lining the lungs. In patients with the Delta F508 mutation, chloride levels are low, leading to less moisture production and dryness in the airways

Bronchoalveolar lavage can be used to assess chloride levels. But Snyder says the test is too invasive to use routinely. So he and his colleagues are working on a breath test to assess chloride levels in the airways.

The collection technique is similar to breathing on a cold window, which produces a temporary cloud of moisture on the glass pane. A patient breathes into a cold tube (called a breath condenser). The moisture from the exhaled air is collected in a cup at the bottom of the tube and sent for analysis. The researchers will measure the levels of three different chemical ions – chloride, sodium and potassium.

The breath test is being tested in CF patients who are already scheduled to have a bronchoalveolar lavage. The results of both tests will then be compared to determine if the breath test provides chloride measurements that are comparable to bronchoalveolar lavage.

If the breath test proves to be accurate, doctors may be able to use it to make a less invasive assessment of lung health in CF patients. Snyder says the technique may also be useful to see how the lungs respond to existing or new treatments. If you'd like more information, you can email researchers or call (520) 626-4127.