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Phenotyping Bronchiectasis Frequent Exacerbator: A Single Centre Retrospective Cluster Analysis.

Francesco Rocco Bertuccio1,2, Nicola Baio3, Simone Montini1,2

  • 1Unit of Respiratory Disease, Cardiothoracic and Vascular Department, IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.

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|September 27, 2025
PubMed
Summary

This study identified four distinct phenotypes in frequent exacerbator bronchiectasis patients, revealing significant heterogeneity. Tailoring treatments based on these phenotypes and their treatable traits can personalize management and improve patient outcomes.

Keywords:
clinical outcomesmultivariate analysesnon-cystic fibrosis bronchiectasisphenotypic clusters

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Area of Science:

  • Pulmonology
  • Clinical Phenotyping
  • Precision Medicine

Background:

  • Bronchiectasis is a chronic respiratory disease with progressive lung damage.
  • Frequent exacerbators experience accelerated decline and reduced quality of life.
  • Identifying distinct phenotypes and treatable traits is crucial for optimizing management.

Purpose of the Study:

  • To identify distinct phenotypes and treatable traits in frequent exacerbator bronchiectasis patients.
  • To guide personalized management strategies for improved patient outcomes.

Main Methods:

  • Analysis of 56 frequent exacerbator bronchiectasis patients.
  • Utilized 21 clinical variables including PFTs, imaging, and microbiology.
  • Applied hierarchical clustering and k-means algorithms for subgroup identification.

Main Results:

  • Four distinct clusters were identified: mild idiopathic, rheumatological/NTM-associated, mild post-infective, and severe chronic infection.
  • The severe cluster showed high Pseudomonas aeruginosa colonization and advanced structural damage.
  • Clusters differed in etiology, disease severity, and microbiological profiles.

Conclusions:

  • Bronchiectasis frequent exacerbators exhibit significant heterogeneity.
  • Phenotype-specific interventions and treatable traits management are essential.
  • Precision medicine approaches can improve outcomes in bronchiectasis care.