Pathogenesis and clinical management of chronic multilobar segmental bronchial stenosis: a literature review

Chronic multilobar segmental bronchial stenosis (CMBS) represents a chronic airway inflammatory disorder characterized by fibrotic narrowing of multiple lobar and segmental bronchi. Its pathogenesis is closely associated with chronic exposure to biomass smoke and tuberculosis infection. CMBS demonstrates high morbidity and poor prognosis, representing a condition of growing clinical significance. However, its underlying pathophysiological mechanisms remain incompletely elucidated. Epidemiological studies reveal a notably higher disease prevalence in developing countries, with particular susceptibility observed in female populations and tuberculosis-endemic cohorts. The pathogenic cascade involves an "inflammatory-oxidative damage-fibrosis" axis, wherein biomass smoke induces airway remodeling through epigenetic reprogramming and mitochondrial dysfunction. Characteristic clinical manifestations include obstructive ventilatory impairment accompanied by pulmonary hypertension. Current therapeutic strategies predominantly rely on bronchodilators and antitubercular agents, yet fail to reverse established fibrotic lesions. Future directions necessitate coordinated public health interventions for early disease detection, deeper exploration of molecular mechanisms, and the development of targeted therapeutics.