The biology of pulmonary exacerbations in bronchiectasis
Bronchiectasis is a heterogeneous chronic disease. Heterogeneity characterises bronchiectasis not only in the stable state but also during exacerbations, despite evidence on clinical and biological aspects of bronchiectasis, exacerbations still remain poorly understood. Although the scientific commu...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2019-11-01
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| Series: | European Respiratory Review |
| Online Access: | http://err.ersjournals.com/content/28/154/190055.full |
| _version_ | 1818308228919853056 |
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| author | Francesco Amati Edoardo Simonetta Andrea Gramegna Paolo Tarsia Martina Contarini Francesco Blasi Stefano Aliberti |
| author_facet | Francesco Amati Edoardo Simonetta Andrea Gramegna Paolo Tarsia Martina Contarini Francesco Blasi Stefano Aliberti |
| author_sort | Francesco Amati |
| collection | DOAJ |
| description | Bronchiectasis is a heterogeneous chronic disease. Heterogeneity characterises bronchiectasis not only in the stable state but also during exacerbations, despite evidence on clinical and biological aspects of bronchiectasis, exacerbations still remain poorly understood. Although the scientific community recognises that bacterial infection is a cornerstone in the development of bronchiectasis, there is a lack of data regarding other trigger factors for exacerbations. In addition, a huge amount of data suggest a primary role of neutrophils in the stable state and exacerbation of bronchiectasis, but the inflammatory reaction involves many other additional pathways. Cole's vicious cycle hypothesis illustrates how airway dysfunction, airway inflammation, infection and structural damage are linked. The introduction of the concept of a “vicious vortex” stresses the complexity of the relationships between the components of the cycle. In this model of disease, exacerbations work as a catalyst, accelerating the progression of disease. The roles of microbiology and inflammation need to be considered as closely linked and will need to be investigated in different ways to collect samples. Clinical and translational research is of paramount importance to achieve a better comprehension of the pathophysiology of bronchiectasis, microbiology and inflammation both in the stable state and during exacerbations. |
| first_indexed | 2024-12-13T07:10:57Z |
| format | Article |
| id | doaj.art-640566e6abff410b8dc60563331fe35c |
| institution | Directory Open Access Journal |
| issn | 0905-9180 1600-0617 |
| language | English |
| last_indexed | 2024-12-13T07:10:57Z |
| publishDate | 2019-11-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj.art-640566e6abff410b8dc60563331fe35c2022-12-21T23:55:40ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172019-11-012815410.1183/16000617.0055-20190055-2019The biology of pulmonary exacerbations in bronchiectasisFrancesco Amati0Edoardo Simonetta1Andrea Gramegna2Paolo Tarsia3Martina Contarini4Francesco Blasi5Stefano Aliberti6 Dept of Pathophysiology and Transplantation, University of Milan, Milan, Italy Dept of Pathophysiology and Transplantation, University of Milan, Milan, Italy Dept of Pathophysiology and Transplantation, University of Milan, Milan, Italy Dept of Pathophysiology and Transplantation, University of Milan, Milan, Italy Dept of Pathophysiology and Transplantation, University of Milan, Milan, Italy Dept of Pathophysiology and Transplantation, University of Milan, Milan, Italy Dept of Pathophysiology and Transplantation, University of Milan, Milan, Italy Bronchiectasis is a heterogeneous chronic disease. Heterogeneity characterises bronchiectasis not only in the stable state but also during exacerbations, despite evidence on clinical and biological aspects of bronchiectasis, exacerbations still remain poorly understood. Although the scientific community recognises that bacterial infection is a cornerstone in the development of bronchiectasis, there is a lack of data regarding other trigger factors for exacerbations. In addition, a huge amount of data suggest a primary role of neutrophils in the stable state and exacerbation of bronchiectasis, but the inflammatory reaction involves many other additional pathways. Cole's vicious cycle hypothesis illustrates how airway dysfunction, airway inflammation, infection and structural damage are linked. The introduction of the concept of a “vicious vortex” stresses the complexity of the relationships between the components of the cycle. In this model of disease, exacerbations work as a catalyst, accelerating the progression of disease. The roles of microbiology and inflammation need to be considered as closely linked and will need to be investigated in different ways to collect samples. Clinical and translational research is of paramount importance to achieve a better comprehension of the pathophysiology of bronchiectasis, microbiology and inflammation both in the stable state and during exacerbations.http://err.ersjournals.com/content/28/154/190055.full |
| spellingShingle | Francesco Amati Edoardo Simonetta Andrea Gramegna Paolo Tarsia Martina Contarini Francesco Blasi Stefano Aliberti The biology of pulmonary exacerbations in bronchiectasis European Respiratory Review |
| title | The biology of pulmonary exacerbations in bronchiectasis |
| title_full | The biology of pulmonary exacerbations in bronchiectasis |
| title_fullStr | The biology of pulmonary exacerbations in bronchiectasis |
| title_full_unstemmed | The biology of pulmonary exacerbations in bronchiectasis |
| title_short | The biology of pulmonary exacerbations in bronchiectasis |
| title_sort | biology of pulmonary exacerbations in bronchiectasis |
| url | http://err.ersjournals.com/content/28/154/190055.full |
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