The Role of Viral Infection in Pulmonary Exacerbations of Bronchiectasis in Adults

Gao, Yong; Wei, Guan; Xu, Gang; Lin, Zhi; Tang, Yan; Lin, Zhi Min; Gao, Yang; Li, Hui Min; Zhong, Nan; Zhang, Guo Jun; Chen, Rong Chang

doi:10.1378/chest.14-1961

Cited by 130 publications

(123 citation statements)

References 35 publications

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“…It could be also possible that exacerbations may be driven by changes and/or adaptation in strains that cannot be detected by such approaches, and hence, metabolomic techniques may help. The role of viruses in triggering infective exacerbations should also be better defined [18], as well as their interaction with bacteria in both the stable state and during exacerbations. Finally, the "vicious cycle" hypothesis that characterised the physiopathology of bronchiectasis patients in the stable state does not rule out the possibility that noninfectious triggers, including indoor and outdoor air pollution, might cause exacerbations and further prospective observational studies are needed in this area [19].…”

Section: What Are the Triggers Of An Exacerbation? (Patients) What Armentioning

confidence: 99%

“…The role of NTM, between innocent colonisers or those causing chronic infection, and the predisposing factors to this need to be differentiated. There is also a paucity of data regarding the isolation of viruses and multiresistant bacteria [4,18,29]. The EMBARC registry is currently collecting susceptibility patterns of bacteria causing chronic infection in patients with bronchiectasis and these data will be crucial in planning further interventional studies on antibiotics at the European level [10].…”

Section: Consensus Statementmentioning

confidence: 99%

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Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

et al. 2016

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Bronchiectasis is a disease of renewed interest in light of an increase in prevalence and increasing burden on international healthcare systems. There are no licensed therapies, and large gaps in knowledge in terms of epidemiology, pathophysiology and therapy. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) is a European Respiratory Society (ERS) Clinical Research Collaboration, funded by ERS to promote high-quality research in bronchiectasis. The objective of this consensus statement was to define research priorities in bronchiectasis. From 2014 to 2015, EMBARC used a modified Delphi process among European bronchiectasis experts to reach a consensus on 55 key research priorities in this field. During the same period, the European Lung Foundation collected 711 questionnaires from adult patients with bronchiectasis and their carers from 22 European countries reporting important research priorities from their perspective. This consensus statement reports recommendations for bronchiectasis research after integrating both physicians and patients priorities, as well as those uniquely identified by the two groups. Priorities identified in this consensus statement provide the clearest possible roadmap towards improving our understanding of the disease and the quality of care for patients with bronchiectasis. @ERSpublications EMBARC consensus statement identifies research priorities in bronchiectasis as determined by physicians and patients

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Section: What Are the Triggers Of An Exacerbation? (Patients) What Armentioning

confidence: 99%

Section: Consensus Statementmentioning

confidence: 99%

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

et al. 2016

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“…Respiratory viral9 and fungal10 infections have also been linked to bronchiectasis disease markers, which suggests that multiple infectious agents can contribute to the pathophysiology of non-cystic fibrosis bronchiectasis. While genetic loci in genes related to inflammation and airway remodelling have been previously investigated in non-cystic fibrosis bronchiectasis,11–15 little is known regarding common genetic polymorphisms that affect microbial acquisition in patients.…”

Section: Introductionmentioning

confidence: 99%

FUT2genotype influences lung function, exacerbation frequency and airway microbiota in non-CF bronchiectasis

Taylor

Woodman

Chen

et al. 2016

Thorax

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“…Furthermore, viral infection (ie, adenovirus, coronavirus, and rhinovirus) could play crucial roles in bronchiectasis exacerbations. 26 Viral infections might also lead to enhanced bacterial virulence, resulting in augmented inflammation. It is likely that enhanced bacterial virulence, anaerobic bacterial infection, or viral-bacterial interactions also account for bronchiectasis exacerbations.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Responses, Spirometry, and Quality of Life in Subjects With Bronchiectasis Exacerbations

Guan

Gao

et al. 2015

Respir Care

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BACKGROUND: Bronchiectasis exacerbations are critical events characterized by worsened symptoms and signs (ie, cough frequency, sputum volume, malaise). Objectives: Our goal was to examine variations in airway and systemic inflammation, spirometry, and quality of life during steady state, bronchiectasis exacerbations, and convalescence (1 week following a 2-week antibiotic treatment) to determine whether potentially pathogenic microorganisms, including Pseudomonas aeruginosa, were associated with poorer conditions during bronchiectasis exacerbations. METHODS: Peripheral blood and sputum were sampled to detect inflammatory mediators and bacterial densities. Spirometry and quality of life (St George Respiratory Questionnaire [SGRQ]) were assessed during the 3 stages. RESULTS: Forty-eight subjects with bronchiectasis (43.2 ؎ 14.2 y of age) were analyzed. No notable differences in species and density of potentially pathogenic microorganisms were found during bronchiectasis exacerbations. Except for CXCL8 and tumor necrosis factor alpha (TNF-␣), serum inflammation was heightened during bronchiectasis exacerbations and recovered during convalescence. Even though sputum TNF-␣ was markedly higher during bronchiectasis exacerbations and remained heightened during convalescence, the variations in miscellaneous sputum markers were unremarkable. Bronchiectasis exacerbations were associated with notably higher SGRQ symptom and total scores, which recovered during convalescence. FVC, FEV 1 , and maximum mid-expiratory flow worsened during bronchiectasis exacerbations (median change from baseline of ؊2.2%, ؊0.8%, and ؊1.3%) and recovered during convalescence (median change from baseline of 0.6%, 0.7%, and ؊0.7%). Compared with no bacterial isolation, potentially pathogenic microorganism or P. aeruginosa isolation at baseline did not result in poorer clinical condition during bronchiectasis exacerbations. CONCLUSIONS: Bronchiectasis exacerbations are characterized by heightened inflammatory responses and poorer quality of life and spirometry, but not by increased bacterial density, which applies for subjects with and without potentially pathogenic microorganism isolation when clinically stable. (ClinicalTrials.gov registration NCT01761214.)

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The Role of Viral Infection in Pulmonary Exacerbations of Bronchiectasis in Adults

Abstract: ClinicalTrials.gov; No.: NCT01801657; www.clinicaltrials.gov.

Cited by 130 publications

References 35 publications

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

FUT2genotype influences lung function, exacerbation frequency and airway microbiota in non-CF bronchiectasis

Inflammatory Responses, Spirometry, and Quality of Life in Subjects With Bronchiectasis Exacerbations

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