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Bronchiectasis: Current Concepts in Pathogenesis, Immunology, and Microbiology
Rosemary J Boyton1,2, Daniel M Altmann3
1Lung Immunology Group, Department of Medicine, Imperial College London, London W12 0NN, United Kingdom;
Annual Review of Pathology
|March 17, 2016
Summary
Bronchiectasis involves chronic lung inflammation and infection, leading to irreversible airway widening. Susceptibility arises from a complex interplay of genetics, immune issues, and environmental factors.
Area of Science:
- Pulmonology
- Immunology
- Microbiology
Background:
- Bronchiectasis is characterized by persistent lung inflammation and recurrent infections.
- It results in irreversible bronchial dilatation due to diverse underlying causes.
- This condition involves an interplay of immunogenetic susceptibility, immune dysregulation, bacterial infection, and lung damage.
Purpose of the Study:
- To explore the complex etiology of bronchiectasis.
- To highlight the relationship between lung microbiota and microbial-pathogen interactions.
- To understand the role of genetic and environmental factors in disease susceptibility.
Main Methods:
- Review of recent studies on lung microbiota and microbial-pathogen niches.
- Analysis of the role of interleukin-17-driven neutrophilia.
- Examination of associations with autoimmune diseases and primary immune deficiencies.
Main Results:
- Damaged epithelium impairs mucus clearance, facilitating bacterial infections.
- Common pathogens include Pseudomonas aeruginosa, Haemophilus, Aspergillus fumigatus, and nontuberculous mycobacteria.
- Bronchiectasis is linked to immune dysregulation conditions like CVID, PAPD, and HIES.
Conclusions:
- Bronchiectasis results from a multifactorial etiology involving genetic predisposition and environmental influences.
- Understanding the lung microbiota and immune responses is crucial for managing the disease.
- Geographic and ethnic variations suggest a significant role for genetics and environment.
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