Cystic Fibrosis, CFTR Gene

Definition

An inherited disease characterized by thickened secretions due to a defect in the CFTR (cystic fibrosis transmembrane conductance regulator) gene; it affects the lungs, the pancreas and other organs.

Most common variant: p.Phe508del (F508del, c.1521_1523delCTT), the most common pathogenic variant in individuals of Northern European origin and a founder variant in many populations.

Diagnosis, two routes are used together:

MethodThreshold / Criterion
Sweat chloride test (gold standard)≥60 mmol/L → diagnostic, independently of the molecular result
30 to 59 mmol/L (intermediate value) → requires specialist evaluation
Molecular testingDetection of biallelic pathogenic variants in CFTR
Nasal potential differenceAlternative method

Important: The sweat test can establish the diagnosis independently of genetic confirmation. In other words, if the sweat chloride is ≥60 mmol/L, the diagnosis is valid even if no variant is found on genetic testing. This is related to the fact that more than 2,000 variants exist in CFTR and panels cannot cover all of them.

Inheritance

Autosomal recessive

Risks and Limitations

Carrier screening panels generally cover the most common variants; rare variants can be missed. A negative result reduces the risk but does not eliminate it (residual risk).

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