Basic, translational and clinical aspects of bronchiectasis in adults
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...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2023-06-01
|
| Series: | European Respiratory Review |
| Online Access: | http://err.ersjournals.com/content/32/168/230015.full |
| _version_ | 1797793393321967616 |
|---|---|
| author | James D. Chalmers Stuart Elborn Catherine M. Greene |
| author_facet | James D. Chalmers Stuart Elborn Catherine M. Greene |
| author_sort | James D. Chalmers |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-13T02:46:38Z |
| format | Article |
| id | doaj.art-aec85d244a084cd9a3e79ec7a8623e40 |
| institution | Directory Open Access Journal |
| issn | 0905-9180 1600-0617 |
| language | English |
| last_indexed | 2024-03-13T02:46:38Z |
| publishDate | 2023-06-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj.art-aec85d244a084cd9a3e79ec7a8623e402023-06-28T15:28:52ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172023-06-013216810.1183/16000617.0015-20230015-2023Basic, translational and clinical aspects of bronchiectasis in adultsJames D. Chalmers0Stuart Elborn1Catherine M. Greene2 School of Medicine, University of Dundee, Dundee, UK School of Medicine, Dentistry and Biomedical Sciences, Belfast, UK Lung Biology Group, Department of Clinical Microbiology, RCSI University of Medicine and Heath Sciences, Education and Research Centre, Beaumont Hospital, Dublin, Ireland 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.http://err.ersjournals.com/content/32/168/230015.full |
| spellingShingle | James D. Chalmers Stuart Elborn Catherine M. Greene Basic, translational and clinical aspects of bronchiectasis in adults European Respiratory Review |
| title | Basic, translational and clinical aspects of bronchiectasis in adults |
| title_full | Basic, translational and clinical aspects of bronchiectasis in adults |
| title_fullStr | Basic, translational and clinical aspects of bronchiectasis in adults |
| title_full_unstemmed | Basic, translational and clinical aspects of bronchiectasis in adults |
| title_short | Basic, translational and clinical aspects of bronchiectasis in adults |
| title_sort | basic translational and clinical aspects of bronchiectasis in adults |
| url | http://err.ersjournals.com/content/32/168/230015.full |
| work_keys_str_mv | AT jamesdchalmers basictranslationalandclinicalaspectsofbronchiectasisinadults AT stuartelborn basictranslationalandclinicalaspectsofbronchiectasisinadults AT catherinemgreene basictranslationalandclinicalaspectsofbronchiectasisinadults |