What is Bronchiectasis?
Bronchiectasis is a chronic lung condition when the airways/bronchi (tubes that carry air in and out of the lung) are widened, inflamed, and often scarred. This damage can happen in one or many parts of the lung or in both lungs [1, 2].
In bronchiectasis, the mucus that normally helps us clear dust, germs, and other small particles we inhale gets thick and difficult to clear by coughing. This leads to inflammation and frequent infections that result in flare-ups (exacerbations) and more damage to the airways.
Is There a Cure for Bronchiectasis?
Although there is no cure for bronchiectasis at this time, there are treatments that will help you breathe better, clear your lungs of mucus, and prevent flare ups. You and your caregivers can work with your healthcare provider to put together a treatment plan and find tools to help you manage your condition.
GAAPP is a Proud Member of the World Bronchiectasis Day Collaborative Effort that Brought the Bronchiectasis “World” Together on
July 1st 2022
You will find evidence-based resources provided by international bronchiectasis experts and patient advocacy organizations available in several languages on the World Bronchiectasis Day webpage.
It includes lots of information about diagnosis, airway clearance, patient support groups, and treatments.
We highly recommend the educational “basic information sheet” on bronchiectasis which is available in multiple languages here.
In 2023, GAAPP recorded an educational webinar on bronchiectasis you can find here. Our speakers from around the globe included Lauren Dunlap, a patient advocate (US), Ashok Gupta, MD (India), Ghulam Mustafa, MD (Pakistan), and Tonya Winders, MBA (CEO of GAAPP).
This multidisciplinary group of two healthcare practitioners and two patient advocates discussed the following topics:
- World-view perspectives from allergy/immunology and pulmonology specialists in the diagnosis, epidemiology, therapeutic endpoints, and advancements in treatment for non-CF bronchiectasis (NCFB).
- Overlapping conditions often associated with NCFB (e.g., immune deficiencies, infections).
- Disease management and lifestyle factors that are involved from a patient’s perspective when choosing treatment options and stigmas associated with the diagnosis.
What are Common Symptoms of Bronchiectasis and How is it Diagnosed?
People experience different symptoms depending on their type of disease [1, 2].
- Cough that lasts a long time (chronic cough) with or without phlegm
- Sputum/phlegm production
- Loss of sleep due to coughing
- Shortness of breath (breathlessness)
- Frequent lung infections that require treatment (flare ups/exacerbations)
- Unexplained weight loss and/or chest pain
- Fever and/or chills
The most definitive way to diagnose bronchiectasis is using a lung imaging (radiology) test called computerized tomography (CT). Scans can be used to show the presence of enlarged airways and inflammation or scarring typical of bronchiectasis. If you experience symptoms, your healthcare provider will send you for this test.
Additional tests may include cultures of your airway mucus to test for germs (bacteria, fungi, or mycobacteria) to see if you need treatment with antibiotics.
What are the Causes of (or Risk Factors for) Bronchiectasis?
There are many possible causes of bronchiectasis, including pre-existing medical conditions that are often called co-morbidities, as well as genetic, auto-immune, and infection-related causes. [3] Treatment depends on the type of bronchiectasis you have.
Bronchiectasis was originally called a “rare disease,” but with more research and increased awareness that led to better diagnosis, it is now accepted as the third most common lung disease in the world after asthma and COPD, [1] affecting many adults and children.
Severe infections
- Tuberculosis (TB) and pneumonia are the most common causes in the world [4] especially in Asian countries such as India. [5]
- NTM lung disease is a rare condition caused by an infection with non-tuberculous mycobacteria. [14]
Genetic disorders
- Primary ciliary dyskinesia (PCD) patients often get the condition early in life and require special diagnosis and treatment. [6]
- Alpha-1 antitrypsin deficiency (genetic COPD) requires genetic testing to diagnose. Specialized treatment (augmentation therapy) is available in some countries. [3]
- Cystic fibrosis is often diagnosed in children using genetic testing and requires specialized treatments. [15]
- Primary immunodeficiency and other autoimmune conditions that require specialized diagnosis and treatment. [3]
Asthma
Asthma is often found as a comorbidity in bronchiectasis [7] and studies have shown that people with asthma and bronchiectasis respond well to inhaled corticosteroid treatment. [8]
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) often co-exists [9, 10] with bronchiectasis and they share many symptoms resulting from obstruction of the airways, but these are two separate conditions.
Chronic rhinosinusitis
Chronic rhinosinusitis (inflammation of the sinuses, hollow cavities in the head) is thought to be related to a type of inflammation called eosinophilic bronchiectasis. [11, 12]
Gastrointestinal reflux disease
Gastrointestinal reflux disease (GERD/GORD) is aspiration of gastric material into the lung; this is thought to be a risk for several lung conditions. [13]
World Bronchiectasis Day Webinar YouTube Playlist
Engaging Patients in Global Bronchiectasis Research
GAAPP brought together an expert in her field and a patient ambassador in conversation. Listen to Dr. Michal Shteinberg, M.D., PhD. And Ninon Farber as they discuss Ninon’s journey through her struggle with bronchiectasis and the value she found in participating in research. Find out how you as a patient can engage in research.
English Version
Hebrew Version
2023 Webinar:
In the context of the 2nd World Bronchiectasis Day, which the global community celebrated on 1 July 2023,and GAAPP created a unique educational webinar. Our speakers from around the globe include Lauren Dunlap, PACS (US), Ashok Gupta, MD (India), Ghulam Mustafa, MD (Pakistan), and Tonya Winders, MBA (president of GAAPP). The healthcare practitioners and patient advocates discuss the world-view perspectives from allergy/immunology and pulmonology specialists in the diagnosis, epidemiology, therapeutic endpoints, and advancements in treatment for non-cf bronchiectasis as well as disease management and lifestyle factors are involved from a patient’s perspective when choosing treatment options and stigmas associated with the diagnosis.
References
- Barbosa M, Chalmers JD. Bronchiectasis. Presse Med. Published online September 30, 2023. doi:10.1016/j.lpm.2023.104174.
- Macfarlane L, Kumar K, Scoones T, Jones A, Loebinger MR, Lord R. Diagnosis and management of non-cystic fibrosis bronchiectasis. Clin Med (Lond). 2021;21(6):e571-e577. doi:10.7861/clinmed.2021-0651
- Martins M, Keir HR, Chalmers JD. Endotypes in bronchiectasis: moving towards precision medicine. A narrative review. Pulmonology. 2023;29(6):505-517. doi:10.1016/j.pulmoe.2023.03.004
- Chandrasekaran R, Mac Aogáin M, Chalmers JD, Elborn SJ, Chotirmall SH. Geographic variation in the etiology, epidemiology and microbiology of bronchiectasis. BMC Pulm Med. 2018;18(1):83. Published 2018 May 22. doi:10.1186/s12890-018-0638-0.
- Dhar R, Singh S, Talwar D, et al. Clinical outcomes of bronchiectasis in India: data from the EMBARC/Respiratory Research Network of India registry. Eur Respir J. 2023;61(1):2200611. Published 2023 Jan 6. doi:10.1183/13993003.00611-2022.
- Kos R, Goutaki M, Kobbernagel HE, et al. A BEAT-PCD consensus statement: a core outcome set for pulmonary disease interventions in primary ciliary dyskinesia. ERJ Open Res. 2024;10(1):00115-2023. Published 2024 Jan 8. doi:10.1183/23120541.00115-2023
- Polverino E, Dimakou K, Traversi L, et al. Bronchiectasis and asthma: Data from The European Bronchiectasis Registry (EMBARC). J Allergy Clin Immunol. Published online February 22, 2024. doi:10.1016/j.jaci.2024.01.027.
- Cordeiro R, Choi H, Haworth CS, Chalmers JD. The efficacy and safety of inhaled antibiotics for the treatment of bronchiectasis in adults: Updated systematic review and meta-analysis. Chest. Published online February 1, 2024. doi:10.1016/j.chest.2024.01.045.
- Polverino E, De Soyza A, Dimakou K, et al. The Association Between Bronchiectasis and Chronic Obstructive Pulmonary Disease: Data from the European Bronchiectasis Registry (EMBARC). Am J Respir Crit Care Med. Published online January 25, 2024. doi:10.1164/rccm.202309-1614OC.
- Martinez-Garcia MA, Miravitlles M. Bronchiectasis in COPD patients: more than a comorbidity? [published correction appears in Int J Chron Obstruct Pulmon Dis. 2019 Jan 18;14:245]. Int J Chron Obstruct Pulmon Dis. 2017;12:1401-1411. Published 2017 May 11. doi:10.2147/COPD.S132961
- Shteinberg M, Chalmers JD, Narayana JK, et al. Bronchiectasis with Chronic Rhinosinusitis Is Associated with Eosinophilic Airway Inflammation and Is Distinct from Asthma. Ann Am Thorac Soc. Published online January 9, 2024. doi:10.1513/AnnalsATS.202306-551OC.
- Guan WJ, Oscullo G, He MZ, Xu DY, Gómez-Olivas JD, Martinez-Garcia MA. Significance and Potential Role of Eosinophils in Non-Cystic Fibrosis Bronchiectasis. J Allergy Clin Immunol Pract. 2023 Apr;11(4):1089-1099. doi: 10.1016/j.jaip.2022.10.027. Epub 2022 Oct 30. PMID: 36323380.
- Durazzo M, Lupi G, Cicerchia F, et al. Extra-Esophageal Presentation of Gastroesophageal Reflux Disease: 2020 Update. J Clin Med. 2020;9(8):2559. Published 2020 Aug 7. doi:10.3390/jcm908255.
- Henkle E, Aksamit TR, Barker AF, et al. Pharmacotherapy for Non-Cystic Fibrosis Bronchiectasis: Results From an NTM Info & Research Patient Survey and the Bronchiectasis and NTM Research Registry. Chest. 2017;152(6):1120-1127. doi:10.1016/j.chest.2017.04.167.
- Bell SC, Mall MA, Gutierrez H, et al. The future of cystic fibrosis care: a global perspective. [published correction appears in Lancet Respir Med. 2019 Dec;7(12):e40]. Lancet Respir Med. 2020;8(1):65-124. doi:10.1016/S2213-2600(19)30337-6.