The course of pulmonary disease in cystic fibrosis is variable. There are controversial data on the impact of the type of mutation on the cystic fibrosis transmembrane conductance regulator (CFTR) gene on the course of pulmonary disease in CF. Since selected mutations of the CFTR gene appear to be associated with relatively mild disease, this study addressed the question whether the course of pulmonary disease in CF patients colonized with P. aeruginosa is influenced by the frequency of the DeltaF 508 mutation. For this study, we assessed FVC and FEV1 in 127 CF patients who attended regularly the Munich CF Center over a mean period of 43 +/- 16 (SD) months. Of these 127 patients, 69 (54.3%) were homozygous for the DeltaF 508 mutation, 42 (33.1%) were compound heterozygous for the DeltaF 508 mutation, and 16 (12.6%) did not carry the DeltaF 508 mutation on either chromosome. In homozygotes 59 (85.5%) out of 69 CF-patients were colonized with P. aeruginosa as compared with 27 (64.3%) out of 42 in heterozygotes (p <0.05). The mean age of onset of P. aeruginosa colonization was 11.0 years, and there was no difference between the three groups. The mean FVC and FEV1 values did not differ significantly between the three genotype groups when P. aeruginosa infection was disregarded. However, when only P. aeruginosa colonized patients were compared FVC and FEV1 values were lower in heterozygotes than in the other two groups both at the beginning and at the end of the study. These findings indicate that the course of pulmonary disease in CF patients is at least partially influenced by the frequency of the DeltaF 508 mutation.