Bronchiectasis is a complex and heterogeneous disease with a myriad of pulmonary and extrapulmonary etiologies. Bronchiectasis has a predominantly neutrophilic inflammatory profile. However, eosinophilic inflammation has also been documented in both the airways and the systemic circulation. Various diseases (eg, asthma, allergic bronchopulmonary aspergillosis, chronic rhinosinusitis with nasal polyps) characterized by heightened type 2 airway inflammatory responses, including blood or sputum eosinophilia, may coexist with bronchiectasis. Apart from those eosinophilic etiologies or comorbidities related to bronchiectasis, around 20% of patients with bronchiectasis have peripheral eosinophilia (at least 3% or 300 eosinophils/μL) with no identified concomitant disease (also termed "eosinophilic bronchiectasis"), whose roles have not been fully understood. The two key points regarding these observations are that eosinophils confer both bactericidal and antiviral properties against common pathogenic microorganisms that are usually detected in bronchiectasis, and that eosinophilic bronchiectasis has been associated with better therapeutic response to inhaled corticosteroids and other anti-T2 profile treatments. In this review, we summarize the most significant evidence regarding the role of eosinophils in patients with bronchiectasis, including the association of bronchiectasis with eosinophilic diseases (as etiologies or comorbidities), and existing data on eosinophilic bronchiectasis not related to eosinophilic disorders.
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http://dx.doi.org/10.1016/j.jaip.2022.10.027 | DOI Listing |
Arch Bronconeumol
January 2025
Department of Allergy and Clinical Immunology, Department of Respiratory and Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China; Guangzhou National Laboratory, Guangzhou, Guangdong, China. Electronic address:
Objectives: To investigate the microbiota and metabolome of patients with ABO compared with bronchiectasis and asthma, and determine the relevance with clinical characteristics, inflammatory endotype and exacerbation risks.
Methods: In this prospective cohort study, patients underwent comprehensive assessments, including sputum differential cell count, and sputum collection at baseline. Sputum microbiota was profiled via 16S rRNA gene sequencing and metabolome via liquid chromatography/mass spectrometry.
Chron Respir Dis
January 2025
Pulmonary Institute, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
Background: The paradigm of bronchiectasis is shifting away from its exclusive characterization as a neutrophilic condition. Patients with bronchiectasis and high eosinophil levels have been found to have a specific phenotype, but the clinical effect of eosinopenia remains unclear.
Method: A retrospective, single-center, observational study was conducted at a tertiary medical center.
J Allergy Clin Immunol Glob
February 2025
Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Background: Sensitization to mucus plugs, and bacterial colonization may coexist and relate to a refractory phenotype during follow-up in asthma with bronchiectasis and allergic bronchopulmonary aspergillosis (ABPA).
Objective: This study aimed to clarify the features of -sensitized refractory asthma with bronchiectasis and determine the refractory phenotype in this population and ABPA.
Methods: This study included cases of the oldest available -specific IgE data and chest computed tomography images from a nationwide survey of refractory asthma with bronchiectasis.
Ther Adv Pulm Crit Care Med
December 2024
Department of Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
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