Redox Profile, Inflammatory and Cardiac Autonomic Nervous Activity of Children and Adolescents With Cystic Fibrosis

Cystic fibrosis (CF) is a genetic disease in which oxidative stress, chronic inflammation, and autonomic imbalance drive the pathophysiology; however, their interplay in children and adolescents with CF remains unclear. This study aimed to compare the cardiometabolic profile of children and adolescents with CF and healthy controls, and to investigate associations between heart rate variability (HRV), Forced Expiratory Volume in the first second (FEV₁), oxidative stress, and inflammation.

This cross-sectional study included 12 patients with CF and 12 healthy controls (5-18 years). Were analyzed for oxidative stress markers (total antioxidant capacity-CAOx, malondialdehyde-MDA), and inflammatory (hs-CRP, IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-γ, and TNF-α). HRV was assessed using a Bluetooth heart rate monitor.

Mean age was similar between groups (CF: 11.7 ± 4.5 years vs. CONT: 12.5 ± 4.2 years, p = 0.68). Mean FEV₁ in the CF group was 78.7%. CF group, MDA was significantly elevated (CF: 3.8 ± 1.4 μM vs. CONT: 2.8 ± 0.3 μM, p = 0.03), while CAOx was lower (CF: 33.0% ± 4.3% vs. CONT: 45.3% ± 13.6%, p = 0.01); CRP (CF: 4.6 ± 5.67 mg/L vs. CONT: 0.6 ± 0.7 mg/L, p = 0.03), IL-6 (CF: 53.0 ± 47.37 pg/mL vs. CONT: 25.1 ± 43.8 pg/mL, p = 0.02), and IL-17 (CF: 89.3 ± 53.37 pg/mL vs. CONT: 41.4 ± 42.5 pg/mL, p = 0.03) were significantly elevated; Time-domain variables were lower: SDNN (CF: 52 ± 24 ms vs. CONT: 88 ± 31 ms, p = 0.04), RMSSD (CF: 41 ± 21 ms vs. CONT: 68 ± 34 ms, p = 0.02), pNN50 (CF: 20% ± 16.3% vs. CONT: 35% ± 19.1%, p = 0.03); in the frequency domain, only low frequency (LF) was lower (CF: 1061 ± 1335 ms² vs. CONT: 2979 ± 4896 ms², p = 0.04).

Children and adolescents with CF exhibit increased oxidative stress, systemic inflammation, and reduced sympathetic and parasympathetic activity, as well as associations among lung function, HRV, and antioxidant capacity.