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Staphylococcus aureus , one of the earliest and most persistent pathogens found in the lungs of people with CF, has been shown to adapt to the lung environment by increasing pro-inflammatory cytokine secretion (e.g., TNF-α or IL-8, involved in the mucin secretion pathway) through upregulating staphylococcal protein A (Spa) (Ramond et al., 2022)

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In individuals with symptomatic B 12 deficiency despite normal dietary B 12 intake, B 12 malabsorption is the most likely cause and should guide parenteral therapy