What type of gene mutation is cystic fibrosis deletion?

A gene is the basic unit of heredity. Genes are responsible for the physical characteristics that each person has (like eye color, facial features, and many health conditions). Each gene occupies a certain location on a chromosome (a thread-like material that is located in the nucleus of every single cell in the body). Chromosomes come in 23 pairs, and each chromosome carries thousands of genes.

What happens?

Each gene has a specific role in determining how a person's body is put together and how it functions. The role of a gene is determined by its individual DNA code (deoxyribonucleic acid, the chemical coding for a gene). DNA is made up of four building blocks called bases. These bases are joined in a specific order for each gene. When a change occurs in the arrangement of the bases, it can cause the gene not to work properly.

What are genetic disorders?

A structural gene change which can cause a disease or a birth defect is called a mutation. Genes are inherited in pairs, with one gene inherited from each parent to make the pair. Cystic fibrosis occurs when both genes in the pair have a mutation. A person with cystic fibrosis inherits one CF gene from each parent. Cystic fibrosis is a genetic disorder caused by inheriting a pair of genes that are mutated or not working properly.

The Cystic Fibrosis Gene

Everyone inherits two copies of the CFTR (cystic fibrosis transmembrane conductance regulator) gene. However, some of the inherited copies are mutations. To date, over 700 mutations of the CFTR gene have been identified. A person with CF inherits two mutated copies of the CFTR gene. These mutations can either be homozygous, the same, or heterozygous, different mutations. The most common mutation is delta F508, accounting for approximately 70% of all mutations. Those homozygous for this mutation tend to be pancreatic insufficient.

What Does the Mutation Do?

The CFTR gene is a protein that functions as a chloride channel. A chloride channel helps maintain the proper balance of salt and water within a cell. A mutation in CFTR causes a dysfunction of the salt and water balance. This causes dehydration of the secretions (thick mucous) and excessive loss of salt in sweat.

What is a carrier?

A carrier is a person who only has one copy of the mutated gene. The parents of a child with CF each carry one CF gene and one normal gene. They have no symptoms and no disease.

How does CF occur?

When each of the parents contributes a gene to their child, they could pass on either their CF gene or their non-CF gene. Each pregnancy could result in one of three outcomes:

People have cystic fibrosis (CF) because they have inherited a faulty gene from both of their parents. Find out more about the CF gene, genotypes and the different mutations that people with CF have.

  • People who have CF are born with it. It can't be caught or developed.

    If you are not born with CF you will never have it, but you could be a CF gene carrier.

    One in 25 people carry the CF gene. For someone to be born with CF, both parents must carry the faulty gene. If both parents have the gene, there is a 25% chance the child will have CF. If both parents carry the gene there is also a 50% chance of the child being a gene carrier but not having CF and a 25% chance they will not have the CF gene.

    Nowadays, all babies are offered a screening test when they are five days old. Because of this, most people with CF are diagnosed at birth. However, some people with CF are not diagnosed until later in life.

    Find out more about diagnosis

  • Everyone with CF will have two faulty or ‘mutated’ CF genes.

    These mutations may also be known as 'variants'.

    There are over 2,000 known mutations that can cause CF.

    The two genes could be the same mutation, or you could have two different ones. The specific mutations and combination you have is known as your ‘genotype’. 

    Your genotype and other factors will dictate how severe the condition is for you, and which organs in the body are most affected.

    It’s important to know which mutations you have, as it might affect what kind of treatments you can have. Research is underway into medicines that work for people with specific CF genotypes, as well as treatments that will work for everyone with CF ('genotype agnostic' treatments).

  • Genes instruct the body on how to make proteins and where to send them in cells in order for them to work. CF mutations affect the body’s ability to make or direct the CFTR protein, which helps salt and water move into and out of cells. You can find out more about how CF affects the body here.

  • The mutations that cause CF can be split into five different categories depending on how they affect the CFTR protein.

    The first three classes generally lead to complete loss of CFTR function and a more severe form of the disease. The last two classes cause a milder reduction in function.

    Class I – shortened protein

    Around 7% of people with cystic fibrosis in Europe have this type of mutation, which results in a shortened CFTR protein.

    Class II – protein fails to reach membrane

    Around 85% of people with cystic fibrosis in Europe have this type of mutation, which results in the CFTR protein not being transported to the surface of the cells in which it is required. The most common of this type of mutation is F508del.

    Class III – protein cannot be regulated

    Less than 3% of people with cystic fibrosis in Europe have this type of mutation. The CFTR protein forms a channel in the cell surface – in people with this mutation the gate at the end of the channel doesn’t open and close at the right times.

    Class IV – reduced chloride conductance

    Less than 3% of people with cystic fibrosis in Europe have this type of mutation, which changes the shape of the protein channel so that chloride cannot move easily in and out of the cells.

    Class V – reduced protein levels

    Less than 3% of people with cystic fibrosis in Europe have this type of mutation, which results in a reduction in the amount of CFTR protein produced by the cells.

  • CFTR2 provides information about specific variants in the CF gene.

    You must accept the site usage agreements before using the site.

    You can enter your genetic variants to find information about:

    • sweat chloride in people with your genotype
    • lung function in people with your genotype
    • pancreatic insufficiency in people with your genotype
    • P. aeruginosa infection rate in people with your genotype

    This information is not a substitute for information from your CF team. It's only a representation of the average health outcomes of people with your genotype, and cannot account for individual experience.

    Visit CFTR2

Our page on how people with cystic fibrosis are diagnosed with the condition also includes information on newborn screening, carrier testing and late diagnosis.

Find out more about medication, exercise, nutrition, transplant and transition on our treatment page.

Explore our interactive body to find out all about the different ways CF affects the body, from the lungs and digestive system to the bones and the reproductive system.

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When CFTR is defective other channels, including the outwardly rectifying chloride channel (ORCC), the epithelial sodium channel (ENaC), a potassium channel known as ROMK1 and a chloride/bicarbonate exchanger, do not work properly. In addition, other chloride channels present on the surface of epithelial cells may be affected in the CF airways. These “alternative” chloride channels have been proposed as a therapeutic target to enhance chloride transport.

The ORCC is found on the surface of many epithelial cells. Normal CFTR facilitates the transport of adenosine triphosphate (ATP), an energy-carrying molecule, to the outside of the cell, activating ORCC. It is unknown whether CFTR itself or an associated channel actually transports the ATP. However, the mutant CFTR is not able to perform the function of transporting ATP.

The ENaC, a sodium channel found on the surface of epithelial cells, is made up of four subunits: two alpha, one beta and one gamma. Each subunit consists of two transmembrane helices. CFTR also influences the function of ENaC in the lung by decreasing its activity, however, the mechanism by which this occurs is unclear.

As suggested by its name, the chloride/bicarbonate exchanger transports one bicarbonate molecule out the cell for every chloride that it transports into the cell. The chloride is derived from the efflux of chloride through CFTR. Therefore, if CFTR is not functional the activity of this channel will be greatly reduced.

Several other chloride channels are present on the cell surface. The one that may be most influenced by CFTR is the CaCC or calcium-activated chloride channel. The exact protein that creates this channel has yet to be defined. However, it is known that the channel is modulated by the P2Y2 receptor which is activated by ATP. Therefore, the activity of this channel could be influenced by decreased ATP associated with mutant CFTR..

What type of gene mutation is cystic fibrosis deletion?

CFTR regulates the function of other ion channels located within the cell membrane.