Irish team make cystic fibrosis discovery

THE treatment of women with a disease more prevalent here than in any other country could be helped by a major Irish scientific breakthrough.

Almost four times as many people in Ireland, per head of population, have cystic fibrosis (CF) than in other EU countries or the US. The survival rate for females with the respiratory disease, which seriously inhibits sufferers’ lung use, is much poorer than men’s and they are also more susceptible to lung infections. But researchers at the Royal College of Surgeons in Ireland (RCSI) have made an important discovery explaining this gender discrepancy.

They found the oestrogen hormone, much higher levels of which are found in women, prevents the release of a chemical signal that can help trigger white blood cells to fight infection in the lungs when cells are attacked by bacteria. Research published in 2008 showed that oestrogen can also increase the likelihood of infection but the latest findings make clear it also limits the ability to fight lung infections.

“Arising from our work, if there was some agent that could stabilise oestrogen levels in the body, it could be very effective in preventing and fighting infection,” said Dr Sanjay Chotirmall, lead author of the research paper published last month in the American Journal of Respiratory and Critical Care Medicine.

He said the harder effects of CF are noticed in female patients from the start of puberty when their bodies create more oestrogen. The 2008 study shows women’s likelihood of acquiring an infection also increases during the menstrual cycle. But the RCSI work, funded by the programme for research in third level institutions and a Molecular Medicine Ireland scientist fellowship, could improve the quality of life for female cystic fibrosis sufferers, who usually survive two to five years shorter than male counterparts.

“Our research may contribute towards... narrowing the gender gap in cystic fibrosis by identifying new potential targets for treatment such as stabilisation of oestrogen levels or more aggressively employing preventative strategies against infection during the one week of the four week menstrual cycle where oestrogen levels are at their highest,” Dr Chotirmall said.

He plans further research over the next year while on leave from the specialist registration training scheme at Beaumont Hospital, where a new outpatient facility for CF patients is to open in the coming weeks. Special facilities for CF sufferers will be provided at a 120-bed unit to be built at St Vincent’s University Hospital in Dublin. The incidence of CF in Ireland – 2.98 per 10,000 – is the world’s highest and it affects about one in every 1,600 children born here. A lung transplant unit has opened in Dublin’s Mater Hospital, with around 30 Irish CF patients awaiting double lung transplants.

As well as CF, oestrogen has been scientifically linked to the effects of asthma on female patients and is believed to have links to migraine and auto-immune conditions which are much more common among women.

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