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Objectives In normal lung tissue PO 2 is highest at the top of the lung. Our aim was to examine if high O 2 tension was reflected in more ROS mediated cell destruction/inflammation and thus a reduction in functionally active neutrophil granulocytes (NG) at the top of the lung compared with the bottom, measured with 18 FDG-PET-CT-scan. We furthermore evaluate the effect of a combined treatment with per oral N-acetylcysteine (100 mg/kg/TID) and inhaled glutathione (600 mg/BID) to reduce a possible state of oxidative stress in CF lungs, measured as an increase in viable NGs. Methods Eight CF children with stable lung condition participated, age 9–14 (5F, 3M), FEV1 (120–78%). All patients were without antiinflammatory medicine 4 weeks before and to the end of the study. Five days before entering all antibiotics and N-acetylcysteine treatment was discontinued. At start patients underwent 18 FDG-PET-CT-scan, L+D, spirometry and sputum culture was taken, and after 14 days all examinations where repeated. Results NG metabolic activity was significantly increased in the lower lobes of the lungs, compared to the top. Comparing left and rigth lungs as separate compartments and including pre- and post-treatment values showed a significant difference (P<0.0001; Wilcoxon test). Post-treatment values showed a significant increase of NG metabolic activity in the lung compartments (P<0.001). Conclusion ROS in CF children impairs NG function in a concentration dependent way. Fourteen days with antioxidant treatment increased the number of functionally active NGs significantly. [ABSTRACT FROM AUTHOR]