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The immunology of bronchiectasis

Research output: Chapter in Book/Report/Conference proceedingChapter (peer-reviewed)peer-review

Abstract

Bronchiectasis is an inflammatory lung disease in which immune dysfunction is both a cause and a consequence of airway damage. The importance of understanding these concepts is underscored by the advent of immunomodulatory therapies for bronchiectasis. This chapter outlines how genetic susceptibility, autoimmune and systemic inflammatory diseases, and the lifetime exposome shape immune processes that drive disease initiation and establish the vicious vortex of mucus obstruction, infection and structural injury. We describe inflammation-driven pathology in established disease, including the central role of neutrophils, alongside eosinophils, macrophages, lymphocytes and epithelial cell injury. The increasingly recognised contribution of systemic inflammation and endothelial dysfunction is discussed, together with heterogeneous immune mechanisms and endotypes of exacerbations, and the frequent-exacerbator phenotype. Finally, we highlight emerging immuno-modulatory targets and emphasise the importance of understanding bronchiectasis immunology for earlier and more effective treatment.

Original languageEnglish
Title of host publicationBrochiectasis
EditorsJames D Chalmers, Amelia Shoemark, Stefano Aliberti, Stuart B Mazzone
Place of PublicationSheffield
PublisherEuropean Respiratory Society
Pages63-83
Number of pages21
Volume2026-March
Edition111
ISBN (Electronic)9781849842006
ISBN (Print)9781849541993
DOIs
Publication statusPublished - Mar 2026

Publication series

NameERS Monograph
PublisherEuropean Respiratory Society
ISSN (Print)2312-508X

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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