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Age-Specific Considerations in Bronchiectasis Management: Focus on Older Adults with Emphasis on Anti-inflammatory
Maria Gabriella Matera1, Vito De Novellis2, Raffaella Pagliaro3,4
1Unit of Pharmacology, Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Piazzetta Sant'Andrea delle Dame 9, 80138, Naples, Campania, Italy. mariagabriella.matera@unicampania.it.
None:
Bronchiectasis is increasingly recognized as a chronic inflammatory airway disease involving persistent immune dysregulation, recurrent infection, and progressive lung tissue damage. Older adults bear a particularly high burden of bronchiectasis, as age-related changes such as immunosenescence, multimorbidity, and polypharmacy complicate disease management in this population. Anti-inflammatory therapies are emerging as a central component of treatment strategies, reflecting the growing understanding of inflammation as a key driver of disease progression. However, applying these therapies to older populations requires considering altered pharmacokinetics and pharmacodynamics, increased susceptibility to adverse effects, and comorbid conditions. This review examines current and emerging anti-inflammatory treatments for bronchiectasis, focusing on their relevance, safety, and limitations in older patients. Attention is given to the roles of neutrophilic and type 2 inflammatory pathways, as well as the challenges of implementing precision medicine approaches for older people.
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