Basic, translational and clinical aspects of bronchiectasis in adults

James D. Chalmers, Stuart Elborn, Catherine M. Greene (Lead / Corresponding author)

    Research output: Contribution to journalArticlepeer-review

    9 Citations (Scopus)
    20 Downloads (Pure)

    Abstract

    Bronchiectasis is a common progressive respiratory disease with recognisable radiological abnormalities and a clinical syndrome of cough, sputum production and recurrent respiratory infections. Inflammatory cell infiltration into the lung, in particular neutrophils, is central to the pathophysiology of bronchiectasis. Herein we explore the roles and relationships between infection, inflammation and mucociliary clearance dysfunction in the establishment and progression of bronchiectasis. Microbial and host-mediated damage are important processes underpinning bronchiectasis and the relative contribution of proteases, cytokines and inflammatory mediators to the propagation of inflammation is presented. We also discuss the emerging concept of inflammatory endotypes, defined by the presence of neutrophilic and eosinophilic inflammation, and explore the role of inflammation as a treatable trait. Current treatment for bronchiectasis focuses on treatment of underlying causes, enhancing mucociliary clearance, controlling infection and preventing and treating complications. Data on airway clearance approaches via exercise and mucoactive drugs, pharmacotherapy with macrolides to decrease exacerbations and the usefulness of inhaled antibiotics and bronchodilators are discussed, finishing with a look to the future where new therapies targeting host-mediated immune dysfunction hold promise.

    Original languageEnglish
    Article number230015
    Number of pages14
    JournalEuropean Respiratory Review
    Volume32
    Issue number168
    Early online date7 Jun 2023
    DOIs
    Publication statusPublished - 30 Jun 2023

    Keywords

    • Humans
    • Adult
    • Bronchiectasis/diagnosis
    • Inflammation
    • Cough
    • Anti-Bacterial Agents/therapeutic use
    • Macrolides/therapeutic use

    ASJC Scopus subject areas

    • Pulmonary and Respiratory Medicine

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