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Bronchiectasis in Adults: Aetiology and New Therapies

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 18776

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Special Issue Editors

Dr. Paul King

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Guest Editor

Monash University and Monash Medical Centre, Melbourne, Australia
Interests: lung immunity; non-typeable Haemophilus influenzae; viral–bacterial co-infection; macrophage function; phagocyte extracellular traps

Dr. Lucy Morgan

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Co-Guest Editor

Department of Respiratory Medicine, in the Concord Hospital Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia
Interests: cilia; PCD; bronchiectasis

Special Issue Information

Dear Colleagues,

Bronchiectasis is a prevalent but as of yet still not well-understood condition. It has a large number of aetiological factors, which contribute to the establishment of chronic airway infection and inflammation. There are a variety of different pathogenic processes involved that result in radiological bronchiectasis. Lung mucosal immunity is distinct from systemic immunity. The widespread availability of bronchoscopy and new techniques in the study of lung inflammation and the lung microbiome have yielded novel insights into the pathogenesis of bronchiectasis. Treatment guidelines have been established, but there is a lack of quality trials to guide clinical management. Recently, a concerted research effort has resulted in significant improvements in patient outcomes. As bronchiectasis is so heterogeneous, there is a need to develop management guidelines for different populations, e.g., indigenous groups and patients with chronic obstructive pulmonary disease. As research in bronchiectasis is an evolving area, it provides opportunities to make new discoveries about lung disease.

The aim of this Special Issue is to provide a review of the latest developments in the aetiology of adult bronchiectasis and the new developments in therapy.

Dr. Paul King
Dr. Lucy Morgan
Guest Editors

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Keywords

aetiology
prevalence
disease in indigenous populations
mucociliary function
lung inflammation
diagnosis and CT scanning
role of antibiotics in treatment
vaccination and immune therapies

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Published Papers (6 papers)

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Editorial

Jump to: Research

3 pages, 188 KiB

Open AccessEditorial

Bronchiectasis in Adults: Aetiology and New Therapies

by Paul T. King and Lucy Morgan

J. Clin. Med. 2022, 11(19), 5957; https://doi.org/10.3390/jcm11195957 - 9 Oct 2022

Cited by 1 | Viewed by 1526

Abstract

Bronchiectasis is emerging as a global health issue, and this is reflected by a series of registries that were established worldwide [...] Full article

(This article belongs to the Special Issue Bronchiectasis in Adults: Aetiology and New Therapies)

Research

Jump to: Editorial

18 pages, 1856 KiB

Open AccessArticle

Profile of Clinical and Analytical Parameters in Bronchiectasis Patients during the COVID-19 Pandemic: A One-Year Follow-Up Pilot Study

by Liyun Qin, Filipe Gonçalves-Carvalho, Yingchen Xia, Jianhua Zha, Mireia Admetlló, José María Maiques, Sandra Esteban-Cucó, Xavier Duran, Alicia Marín and Esther Barreiro

J. Clin. Med. 2022, 11(6), 1727; https://doi.org/10.3390/jcm11061727 - 21 Mar 2022

Cited by 3 | Viewed by 2501

Abstract

Whether the COVID-19 pandemic may have modified the clinical planning and course in bronchiectasis patients remains to be fully elucidated. We hypothesized that the COVID-19 pandemic may have influenced the management and clinical outcomes of bronchiectasis patients who were followed up for 12 months. In bronchiectasis patients (n = 30, 23 females, 66 years), lung function testing, disease severity [FEV₁, age, colonization, radiological extension, dyspnea (FACED), exacerbation (EFACED)] and dyspnea scores, exacerbation numbers and hospitalizations, body composition, sputum microbiology, and blood analytical biomarkers were determined at baseline and after a one-year follow-up. Compared to baseline (n = 27, three patients dropped out), in bronchiectasis patients, a significant increase in FACED and EFACED scores, number of exacerbations, and erythrocyte sedimentation rate (ESR) was observed, while FEV₁, ceruloplasmin, IgE, IgG, IgG aspergillus, IgM, and IgA significantly decreased. Patients presenting colonization by Pseudomonas aeruginosa (PA) remained unchanged (27%) during follow-up. In bronchiectasis patients, FEV₁ declined only after a one-year follow-up along with increased exacerbation numbers and disease severity scores, but not hospitalizations. However, a significant decrease in acute phase-reactants and immunoglobulins was observed at the one-year follow-up compared to baseline. Despite the relatively small cohort, the reported findings suggest that lung function impairment may not rely entirely on the patients’ inflammatory status. Full article

(This article belongs to the Special Issue Bronchiectasis in Adults: Aetiology and New Therapies)

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11 pages, 460 KiB

Open AccessArticle

The Perceptions of Telehealth Physiotherapy for People with Bronchiectasis during a Global Pandemic—A Qualitative Study

by Annemarie L. Lee, Louise Tilley, Susy Baenziger, Ryan Hoy and Ian Glaspole

J. Clin. Med. 2022, 11(5), 1315; https://doi.org/10.3390/jcm11051315 - 27 Feb 2022

Cited by 4 | Viewed by 2420

Abstract

Physiotherapy is a core component of management for people with bronchiectasis and has predominantly been delivered in an in-person consultative format. With the global pandemic, a telehealth physiotherapy model of service evolved, but the perceptions and experiences from the consumer perspective of this service have not been evaluated. Participants who had a diagnosis of bronchiectasis and received a minimum of two telehealth physiotherapy sessions during the months of March 2020 to December 2020 at a private hospital were invited to take part in a semistructured interview. Interview transcripts were coded independently, with themes established by consensus from two researchers. In total, nine participants completed interviews (age range 44 to 83 years, 67% male), with four themes identified. Themes were initial mixed opinions and acceptance of telehealth physiotherapy as an alternate model, ease of use and limitations to the telehealth platform, enablers and barriers to physiotherapy service provision, and preferences for future models of telehealth physiotherapy beyond a pandemic. In the event of the continuation of telehealth physiotherapy services for people with bronchiectasis, the perceptions and experiences outlined by consumers could be applied to inform future modification of this model of service. Full article

(This article belongs to the Special Issue Bronchiectasis in Adults: Aetiology and New Therapies)

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9 pages, 529 KiB

Open AccessArticle

Clinical Characteristics of Patients with Post-Tuberculosis Bronchiectasis: Findings from the KMBARC Registry

by Hayoung Choi, Hyun Lee, Seung Won Ra, Hyun Kuk Kim, Jae Seung Lee, Soo-Jung Um, Sang-Heon Kim, Yeon-Mok Oh, Yong-Soo Kwon and on behalf of the KMBARC

J. Clin. Med. 2021, 10(19), 4542; https://doi.org/10.3390/jcm10194542 - 30 Sep 2021

Cited by 17 | Viewed by 2922

Abstract

The clinical characteristics of patients with post-tuberculosis (TB) bronchiectasis have not been well evaluated. We enrolled 598 patients with bronchiectasis who participated in the Korean prospective bronchiectasis registry and compared the characteristics of post-TB bronchiectasis (19.7%) with post-infectious (19.6%), idiopathic (40.8%), and other (19.9%) bronchiectasis. The patients with post-TB bronchiectasis had a lower body mass index, higher rate of chronic obstructive pulmonary disease, and lower rate of asthma than those in the other groups. The patients with post-TB bronchiectasis had more upper lobe involvement, more severe radiological extent, and worse lung function than those in the other groups. Long-acting muscarinic antagonist/long-acting ß agonist use and mucolytics were more commonly used in the patients with post-TB bronchiectasis than those in the other groups, while inhaled corticosteroid/long-acting ß agonist was less commonly used. There were no significant intergroup differences in bronchiectasis severity scores except for FACED, the number of exacerbations, and quality of life. Post-TB bronchiectasis is characterised by reduced lung function and higher rates of mucolytic use when compared with other bronchiectasis; thus, adequate bronchodilator use and airway clearance techniques may alleviate symptom burden in this population. Full article

(This article belongs to the Special Issue Bronchiectasis in Adults: Aetiology and New Therapies)

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16 pages, 2578 KiB

Open AccessArticle

Do Redox Balance and Inflammatory Events Take Place in Mild Bronchiectasis? A Hint to Clinical Implications

by Liyun Qin, Maria Guitart, Mireia Admetlló, Sandra Esteban-Cucó, José María Maiques, Yingchen Xia, Jianhua Zha, Santiago Carbullanca, Xavier Duran, Xuejie Wang and Esther Barreiro

J. Clin. Med. 2021, 10(19), 4534; https://doi.org/10.3390/jcm10194534 - 30 Sep 2021

Cited by 6 | Viewed by 2149

Abstract

We hypothesized that in mild bronchiectasis patients, increased systemic inflammation and redox imbalance may take place and correlate with clinical parameters. In plasma samples from patients with very mild bronchiectasis, inflammatory cells and molecules and redox balance parameters were analyzed. In the patients, lung function and exercise capacity, nutritional status, bacterial colonization, and radiological extension were assessed. Correlations between biological and clinical variables were determined. Compared to healthy controls, levels of acute phase reactants, neutrophils, IgG, IgA, myeloperoxidase, protein oxidation, and GSH increased and lung function and exercise capacity were mildly reduced. GSH levels were even greater in ex-smoker and Pseudomona-colonized patients. Furthermore, radiological extension inversely correlated with airway obstruction and, disease severity, and positively correlated with neutrophil numbers in mild bronchiectasis patients with no nutritional abnormalities. In stable patients with mild bronchiectasis, several important inflammatory and oxidative stress events take place in plasma. These findings suggest that the extension of bronchiectasis probably plays a role in the development of redox imbalance and systemic inflammation in patients with mild bronchiectasis. These results have therapeutic implications in the management of bronchiectasis patients. Full article

(This article belongs to the Special Issue Bronchiectasis in Adults: Aetiology and New Therapies)

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12 pages, 745 KiB

Open AccessArticle

Computed Tomography in Adults with Bronchiectasis and Nontuberculous Mycobacterial Pulmonary Disease: Typical Imaging Findings

by Sabine Dettmer, Felix C. Ringshausen, Jan Fuge, Hannah Louise Maske, Tobias Welte, Frank Wacker and Jessica Rademacher

J. Clin. Med. 2021, 10(12), 2736; https://doi.org/10.3390/jcm10122736 - 21 Jun 2021

Cited by 10 | Viewed by 6277

Abstract

Among patients with bronchiectasis, nontuberculous mycobacterial pulmonary disease (NTM-PD) ranged between 1 and 6% and it is suspected that its prevalence is underestimated. Our aim was to evaluate differences in computed tomography (CT) features in patients with bronchiectasis, with and without NTM-PD, in order to facilitate earlier diagnosis in the future. In addition, we evaluated longitudinal changes after successful NTM-PD treatment. One hundred and twenty-eight CTs performed in adults with bronchiectasis were scored for the involvement, type, and lobar distribution of bronchiectasis, bronchial dilatation, and bronchial wall thickening according to Reiff. In addition, associated findings, such as mucus plugging, tree-in-bud, consolidations, ground-glass opacities, interlobular thickening, intralobular lines, cavities, and atelectasis, were registered. Patients with NTM-PD (n = 36), as defined by ATS/IDSA diagnostic criteria, were compared to bronchiectasis patients without NTM-PD (n = 92). In twelve patients with an available consecutive CT scan after microbiological cure of NTM-PD imaging findings were also scored according to Kim and compared in the course. In patients with NTM-PD, there was a higher prevalence of bronchiectasis in the middle lobes (p < 0.001), extended bronchiolitis (p = 0.032) and more small and large nodules (p < 0.001). Furthermore, cavities turned out to be larger (p = 0.038), and walls thickened (p = 0.019) and extended (p = 0.016). Patients without NTM more often showed peripheral ground-glass opacities (0.003) and interstitial changes (p = 0.001). CT findings decreased after successful NTM-PD treatment in the follow-up CT; however, without statistical significance for most features (p = 0.056), but bronchiolitis was the only significantly reduced score item (p = 0.043). CT patterns in patients with bronchiectasis and NTM-PD differ from those of patients with bronchiectasis without NTM-PD, although the findings are non-specific radiological features. Follow-up CT findings after microbiological cure differed interindividual regarding the decline in imaging features. Our findings may help practitioners to identify NTM-PD in patients with bronchiectasis. Further research is needed regarding the use of CT as a potential imaging biomarker for the evaluation of treatment response. Full article

(This article belongs to the Special Issue Bronchiectasis in Adults: Aetiology and New Therapies)

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