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Article History

Received: 10 September 2025

Accepted: 4 January 2026

First Online: 2 April 2026

Declarations

:

: The study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the Ethics Committee of Hannover Medical School in conjunction with the Respiratory Clinic of Hannover Medical School (ethics committee approval 9170_BO_K_2020). All patients gave their written informed consent.

: Written consent for the publication of data obtained from biomaterials was obtained from each patient in the form of the DZL Broad Consent.

: Anika Habener: Receives a research grant from the German Center for Lung Research (DZL; BMBF, Federal Ministry of Education and Research) for Hannover Medical School, Hannover, Germany. Anna-Maria Dittrich: Clinical study funding from Vertex Pharmaceutical Inc. for execution of clinical studies. Money paid from the German Federal Ministry of Education and Research (German Lung Center; DZL) to institution/principal investigator for CF- and asthma-related basic and clinical research, ongoing since 2013. Money paid to institution/principal investigator for investigation of the role of innate lymphoid cells in inflammatory lung diseases as principal investigator (Priority Program 1937, 2021-2023) from the German Science Foundation. Money paid to institution/principal investigator for investigation of digital patient records as use case to predict asthma or COPD exacerbation CALM QE consortium, 2023-2027 from the German Federal Ministry of Education and Research. Received consulting fees on advice on Asthma therapy in children by a personal remuneration via c4c consortium from Novartis. Received payments from Hogrefe Publishing Company for scientific Advice for Children’s books on asthma and atopic dermatitis, editorial work for Journal: “Kindheit und Entwicklung”, personal remuneration, ongoing. Personal remuneration for participation in the 2025 telecolloquium on label extension of Elexacaftor/tezacaftor/Ivacaftor, Vertex Pharmaceuticals. Personal remuneration 2024 for an Article on Long-term effects of CFTR modulators, Vertex Pharmaceutical Inc. Payment for development and presentation of online education on CF-related topics, 2024 Vertex Pharmaceuticals. Personal remuneration for online educational presentation, StreamedUP, 2024. Personal remuneration for CF Manual, Medical Book on CF Care, Christiane-Herzog-Foundation 2022. Personal remuneration for Advisory Opinion for the Austrian Society for Rare Disease certification process, 2022. Received travel fees for an invited talk on immunotherapy in children, Paul-Ehrlich-Institute, International Paul-Ehrlich-Symposium (IPES), 2022. Member of the German CF patient advocacy board since 01/2020 (unpaid). Member of German CF Clinical Trial Network ExecCommittee since 06/2023 (unpaid). Member oft the ECFS CTN ExecCommittee since 01/2023 (unpaid). Ruth Grychtol: Received grant payments by the German Center for Lung Research (DZL; BMBF, Federal Ministry of Education and Research) to the Hannover Medical School. Received grant payment for Clinican Scientist Programme by the Else-Kröner Fresenius Foundation. Lennart Riemann: No competing interests. Bettina Corinna Fischer: No competing interests. Bin Liu: Receives grant payments from the German Center for Lung Research (DZL; BMBF, Federal Ministry of Education and Research) made to the Hannover Medical School. David DeLuca: No competing interests. Gesine Hansen: Received grant payments from the German Center for Lung Research (DZL; BMBF, Federal Ministry of Education and Research) made to the Hannover Medical School, as well as grants from German Research Foundation (DFG), EXC 2155 “RESIST”, the German Federal Ministry of Education and Research (BMBF), CHAMP (01GL1742F), Niedersachsen Vorab Foundation (INDIRA). Consulting fees from Sanofi GmbH. Lecture fee from MedUpdate, lecture fee from Abbvie. Hendrik Suhling: Received personal fees/speaker honoraria from AstraZeneca, GSK, Novartis and Sanofi, consulting fees from Astra Zeneca, GSK, Novartis, Sanofi, lecture fees from Astra Zeneca, GSK, Novartis, Sanofi. Nora Drick: Received consulting fees from Glaxo-Smith-Klein, Sanofi-Aventis, AstraZeneca, lecture fees from Glaxo-Smith-Klein, Sanofi-Aventis, AstraZeneca. Marius Hoeper: Received consulting fees from Acceleron, Actelion, AOP Health, Bayer, Ferrer, GossamerBio, Inhibikase, Janssen, Keros, MSD and Novartis.