Potential adverse effects of hypoxia in CF
| Adverse effect | |
|---|---|
| Pulmonary circulation | Increased pulmonary artery pressures related to levels of sleep and exercise hypoxaemia17 |
| Lung inflammation | Up-regulated cytokine expression19 with increased neutrophil chemoattraction, neutrophilic inflammation, and resultant parenchymal lung damage |
| Bacterial profile in the CF lung | Enhanced P aeruginosa growth in biofilms20 with increased antibiotic resistance28 |
| Possible increased S aureus virulence30 | |
| Exercise ability | Limited exercise ability due to effects on pulmonary vasculature and also lung inflammation and bacterial colonisation. Reduced exercise ability sets up “vicious circle” (fig 1) |
| Muscle strength | Reduced skeletal muscle mass29 |
| Quality of life | Potential adverse effects on quality of life, including maintenance of school or work attendance7 |
| Poor sleep quality18 | |
| Endothelium | Endothelial dysfunction31 |
| (CFTR trafficking) | Reduced CFTR protein trafficking shown in vitro under hypoxic conditions in a non-CF cell line32 |
| Effects not documented in a CF cell line |