Insights into Personalised Medicine in Bronchiectasis

Abstract

Bronchiectasis is a heterogenous disease with multiple aetiologies resulting in inflammation and dilatation of the airways with associated mucus production and chronic respiratory infection. The condition is being recognised ever more frequently as the availability of computed tomography increases. It is associated with significant morbidity and healthcare-related costs. With new understanding of the disease process, varying endotypes, identification of underlying causes and treatable traits, the management of bronchiectasis can be increasingly personalised.

Phenotype and Clinicoradiological Differences in Multifocal and Focal Bronchiectasis

“…In our study group, the patients with the asthma clinical phenotype had rhinosinusitis more frequently; the best treatment for this group is corticosteroids. The post-infective phenotype, depending on the frequency and localization of the infection itself, depends on whether a focal or diffuse form of bronchiectasis develops and was present in both groups [9]. The pathophysiology of focal bronchiectasis is usually the result of a local event, such as pneumonia [22].…”

“…For a long time, bronchiectasis was an incidental radiological finding on chest computed tomography (CT) scans. Chest CT scans are now the gold standard in establishing the diagnosis of bronchiectasis, along with its staging, localization (in one or more lobes), and complications [8,9]. Radiological criteria for existing bronchiectasis include a broncho-arterial ratio of more than one, lack of bronchial tapering, or indirect signs such as peri-bronchial thickening, pulmonary nodules, mucus plugging, mosaicism, or air-trapping [1,9].…”

“…Chest CT scans are now the gold standard in establishing the diagnosis of bronchiectasis, along with its staging, localization (in one or more lobes), and complications [8,9]. Radiological criteria for existing bronchiectasis include a broncho-arterial ratio of more than one, lack of bronchial tapering, or indirect signs such as peri-bronchial thickening, pulmonary nodules, mucus plugging, mosaicism, or air-trapping [1,9]. Thoracic scan imaging can establish the distribution pattern of bronchiectasis, supporting the severity assessment and long-term follow-up monitoring of its structural abnormalities and progression.…”