Bronchiectasis (BE)
BE: a risk factor for NTM that is underpinned by inflammation
A recent meta-analysis indicated that patients with BE were more than 20 times more likely to contract NTM-pulmonary disease (NTM-PD) than the general population.[1]
Once NTM infection is established many patients experience significant deterioration in lung health, quality of life and life expectancy.[2,3] Inflammation, impaired mucociliary clearance and infection form a self-perpetuating vicious vortex in BE [4] which results in a perfect breeding ground in the lung for infection with NTM.[5]
Persistent inflammation damages the lung’s structural integrity, facilitates chronic infection and impairs mucociliary clearance.[4] These actions further upregulate inflammation leading to a self-perpetuating cycle of damage.[4]
Key resources on the role of inflammation in BE
Video
The role of inflammation in the vicious vortex of bronchiectasis - Is it time to re-evaluate?
Duration: 54 mins
Recording of webinar on the role of Inflammation in the vicious vortex of Bronchiectasis with Prof. Stefano Aliberti, Dr Holly Keir and Dr Pieter Geominne that took place on 8th of June 2023
Video
The role of neutrophilic inflammation in bronchiectasis
Duration: 50 mins
Professor James D Chalmers
Lecture given during WBNC 2022 conference in Prague exploring the role of inflammation in bronchiectasis
BE is characterised by exacerbations caused by neutrophilic inflammation; the levels of neutrophilic inflammation correlate with exacerbation frequency, lung damage and BE severity. [6,7]
The pathogenesis of bronchiectasis
The vicious vortex, adapted from Flume et al. [5]
Consider and treat bronchiectasis, being aware of the role of inflammation.[8]
References
- Loebinger MR, et al. Chest 2023 (in press)
- Kwak N, et al. BMC Pulm Med 2020;20:293
- Marras TK, et al. Emerg Infect Dis 2017;23:468–76
- Adjemian J, et al. Am J Respir Crit Care Med 2012;185:881–6.
- Flume PA, et al. Lancet 2018;392:880-90.
- Chalmers JD, et al. Am J Respir Crit Care Med, 2017;195:1384-1393
- Keir HR, et al. Lancet Respir Med, 2021;9:873-884
- Keir HR, et al. Semin Respir Crit Care Med 2021;42:499–512.
Job code: MED-EU7-00099 Date: August 2023
Professor Stefano Aliberti
Chief of Respiratory Unit
Italy
Stefano Aliberti is Chief of Respiratory Unit at Humanitas Research Hospital, Milan, Italy.
He specialises in respiratory infectious diseases, including bronchiectasis and pneumonia.
He is Founder and Co-chair of The European Bronchiectasis Registry (EMBARC) and Work Package Leader of the European Respiratory Society (ERS) Clinical Research Collaboration (EMBARC 2) for Clinical Trials Support and Feasibility.
He is Director of the Italian Registry of Adults with non-cystic fibrosis bronchiectasis (IRIDE), the Italian Registry on Pulmonary Non-tuberculous Mycobacteria (IRENE) and Director of the bronchiectasis and NTM Program at the Policlinico University Hospital in Milan, Italy.
Stefano Aliberti is also Chair of the ERS END-COVID Clinical Research Collaboration and Associate Editor (chest infections) for Chest.
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