Evidence map›Paper›PMID 41158477›Full record

ArticleERJ open research2025

The response of rare CFTR mutations to specific modulator combinations.

Noemie Stanleigh, Michal Gur, Michal Shteinberg, Aryeh Weiss, Naama Sebbag-Sznajder, Deborah Duran, Myriam Grunewald, Liron Birimberg-Schwartz, Lea Pevzner, Ronen Bar-Yoseph and 4 more

Abstract read
In one paragraph

Article in ERJ open research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Noemie StanleighDepartment of Genetics, the Hebrew University of Jerusalem, Jerusalem, Israel.ORCID https://orcid.org/0000-0001-9526-2246
Michal GurPediatric Pulmonary Institute and CF Centre, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Michal ShteinbergRappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.ORCID https://orcid.org/0000-0002-0432-3398
Aryeh WeissFaculty of Engineering, Bar-Ilan University, Ramat-Gan, Israel.
Naama Sebbag-SznajderHadassah Organoid Centre, The Hadassah Medical Organization, Jerusalem, Israel.
Deborah DuranHadassah Organoid Centre, The Hadassah Medical Organization, Jerusalem, Israel.
Myriam GrunewaldHadassah Organoid Centre, The Hadassah Medical Organization, Jerusalem, Israel.
Liron Birimberg-SchwartzHadassah Organoid Centre, The Hadassah Medical Organization, Jerusalem, Israel.ORCID https://orcid.org/0000-0001-9014-3686
Lea PevznerDepartment of Genetics, the Hebrew University of Jerusalem, Jerusalem, Israel.
Ronen Bar-YosephPediatric Pulmonary Institute and CF Centre, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Jeffrey M BeekmanDepartment of Paediatric Respiratory Medicine, Wilhelmina Children's Hospital, University Medical Centre, Utrecht University, Utrecht, The Netherlands.
Eitan KeremCF Centre, Hadassah Hebrew University Medical Centre, Jerusalem, Israel.ORCID https://orcid.org/0000-0002-4635-386X
Michael WilschanskiCF Centre, Hadassah Hebrew University Medical Centre, Jerusalem, Israel.
Batsheva KeremDepartment of Genetics, the Hebrew University of Jerusalem, Jerusalem, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The combination of the cystic fibrosis transmembrane conductance regulator (CFTR) modulators elexacaftor (VX-445)-tezacaftor (VX-661)-ivacaftor (VX-770) (ETI) enables the effective rescue of CFTR function in people with the F508del mutation and 177 other US Food and Drug Administration-approved alleles. However, the effect of modulator combination treatment on many rare CFTR mutations is mostly unknown. Furthermore, rare CFTR mutations may not require all ETI components to reach maximal correction. This can be studied in intestinal organoids derived from patients carrying rare mutations. Methods: Intestinal organoids were generated from six patients carrying the Q1100P and/or K163E alleles, not receiving ETI. Measurements of the response to ETI or combination of its components were performed in three-dimensional organoids by forskolin-induced swelling and in two-dimensional monolayers by short-circuit current. Based on these results, patients initiated off-label ETI treatment. Clinical data before and after treatment were collected. Results: Functional measurements showed that both mutations are responsive to ETI. The results further showed that VX-445 had a dramatic effect on K163E function. Both Q1100P and K163E mutations achieved clinically significant CFTR activity levels with VX-661+VX-445, without benefit from VX-770. Following these results patients initiated off-label ETI treatment, resulting in significant and sustained clinical improvements, in all patients, in lung function (forced expiratory volume in 1 s and lung clearance index), body mass index and sweat chloride. Conclusion: Our results support that CFTR function measurements in patient-derived intestinal organoids carrying rare CFTR alleles can detect potential responders to modulator treatment and serve as the basis for drug approval by health providers. Furthermore, this approach allows for patient-specific optimisation of modulator combinations, minimising unnecessary exposure to ineffective treatments.

Identifiers

PMID41158477
PMCPMC12557413

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.