The biology of pulmonary exacerbations in bronchiectasis.
Journal
European respiratory review : an official journal of the European Respiratory Society
ISSN: 1600-0617
Titre abrégé: Eur Respir Rev
Pays: England
ID NLM: 9111391
Informations de publication
Date de publication:
31 Dec 2019
31 Dec 2019
Historique:
received:
19
05
2019
accepted:
11
06
2019
entrez:
22
11
2019
pubmed:
22
11
2019
medline:
30
5
2020
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 31748420
pii: 28/154/190055
doi: 10.1183/16000617.0055-2019
pmc: PMC9488527
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright ©ERS 2019.
Déclaration de conflit d'intérêts
Conflict of interest: F. Amati has nothing to disclose. Conflict of interest: E. Simonetta has nothing to disclose. Conflict of interest: A. Gramegna has nothing to disclose. Conflict of interest: P. Tarsia has nothing to disclose. Conflict of interest: M. Contarini has nothing to disclose. Conflict of interest: F. Blasi reports personal fees from AstraZeneca, Guidotti, Menarini, Novartis and Teva, grants from Bayer, and grants and personal fees from Chiesi, Grifols, GSK, Insmed, Pfizer and Zambon, outside the submitted work. Conflict of interest: S. Aliberti reports grants and personal fees from Bayer Healthcare, Aradigm Corporation, Grifols, Chiesi, and INSMED, and personal fees from AstraZeneca, Basilea, Zambon, Novartis, Raptor, Actavis UK Ltd and Horizon, outside the submitted work.
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