[Precise etiological diagnosis of bronchiectasis: value and challenges from routine screening to precision...

Bronchiectasis is a chronic airway disease characterized by structural destruction of the airways and impaired mucus clearance, with various and intricate causes. Precise etiological diagnosis is crucial for targeted management. The release of the 2021 Expert Consensus on the Diagnosis and Management of Adult Bronchiectasis promoted the standardization of care in China, while the 2024 Expert Consensus on the Etiological Diagnosis of Adult Bronchiectasis emphasizes the critical significance of identifying underlying causes. However, clinical practice still faces challenges,including a low incidence of etiological diagnosis and constraints in detection methodologies. Based on the clinical value of etiological investigation, this article analyzes practical difficulties and corresponding strategies, proposing the establishment of an integrated "etiology-treatable trait" diagnostic model. It also emphasizes the need to develop a localized diagnostic framework by leveraging data from the Bronchiectasis-China (BE-China). Future multicenter collaboration and standardized clinical pathways are expected to facilitate the establishment of individualized intervention options for the Chinese population, ultimately enhancing the long-term outcomes for patients with bronchiectasis.