title: Ivacaftor in a young boy with the rare gating mutation S549R--use of lung clearance index to track progress: a case report.
abstract: BACKGROUND
  Ivacaftor acts as a potentiator of the cystic fibrosis transmembrane conductance regulator (CFTR) and increases the transepithelial chloride transport of CFTR in 9 of 10 known gating mutations causing cystic fibrosis. S549R is a rare gating mutation considered to be less sensitive to potentiators than all other gating mutations.
  
  
  METHODS
  We report our first experience with ivacaftor in an 8-year-old boy with the rare S549R gating mutation. Besides subjective clinical improvements, the sweat chloride level and the lung clearance index decreased impressively within a few weeks of treatment while forced expiratory volume in the first second values remained in normal range.
  
  
  CONCLUSIONS
  We emphasize the value of measuring small airway function by lung clearance index as an outcome measure for new interventions targeting the correction of the CFTR defect at an age before traditional lung function parameters start to deteriorate.
authors.affiliation: Division of Intensive Care and Pulmonology, University Children's Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, CH-4056, Basel, Switzerland. nina.lenherr@ukbb.ch.
authors.forename: Nina
authors.initials: N
authors.lastname: Lenherr
authors.affiliation: Division of Intensive Care and Pulmonology, University Children's Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, CH-4056, Basel, Switzerland. marco.lura@ukbb.ch.
authors.forename: Marco
authors.initials: M
authors.lastname: Lurà
authors.affiliation: Division of Intensive Care and Pulmonology, University Children's Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, CH-4056, Basel, Switzerland. daniel.trachsel@ukbb.ch.
authors.forename: Daniel
authors.initials: D
authors.lastname: Trachsel
authors.affiliation: Division of Intensive Care and Pulmonology, University Children's Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, CH-4056, Basel, Switzerland. philipp.latzin@ukbb.ch.
authors.forename: Philipp
authors.initials: P
authors.lastname: Latzin
authors.affiliation: Division of Intensive Care and Pulmonology, University Children's Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, CH-4056, Basel, Switzerland. juerg.hammer@ukbb.ch.
authors.forename: Juerg
authors.initials: J
authors.lastname: Hammer
mesh_terms: D000627:Aminophenols / Q000627:therapeutic use*; D001944:Breath Tests; D002648:Child; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics*; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D009154:Mutation; D009584:Nitrogen / Q000032:analysis; D015363:Quinolones / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000627:Aminophenols; C505032:CFTR protein, human; D015363:Quinolones; D019005:Cystic Fibrosis Transmembrane Conductance Regulator; C545203:ivacaftor; D009584:Nitrogen