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Abstract
Introduction: Recent research has confirmed the increasing burden of bronchiectasis, in affluent and developing countries. Bronchiectasis, the destruction and dilation of airways, is due to a variety of causes and is characterised by a self-perpetuating cycle of airway inflammation, infection and obstruction that results in substantial morbidity and mortality. Improved therapies that address these three components, and the diseases that both cause and result from bronchiectasis are required.
Areas covered: In this review, we update our previous summary of the clinical features, pathophysiology and epidemiology of bronchiectasis among adults and children, highlighting the most recent advances in therapeutics. We discuss current treatment strategies and then identify key goals for future research on the causes and treatments of a variety of types of bronchiectasis.
Expert opinion: Bronchiectasis remains an orphan disease with respect to the development of new therapies. There has been progress in the recognition and studies but further research is now required on the pathogenesis, prevention, and treatment of bronchiectasis in order to decrease its high burden. Such advances will require a concerted, global effort to coordinate studies of both the pathophysiology and potential treatments of this heterogeneous, chronic disease that affects people of all ages and demographics.
Declaration of interest
A Chang and H Smith-Vaughan have a current research grant from Glaxo-Smith-Kline to report the influence of PHiD-CV on the lower airway microbiology of children with bronchiectasis. A Chang is supported by a National Health and Medical Research (NHMRC) practitioner fellowship (1058213) and the work from this paper by NHMRC grants 1019834, 1040830. H Smith-Vaughan is supported by a NHMRC career development fellowship (1024175). LR Hoffman is supported by a National Institutes of Health (USA) Independent Scientist Award (K02HL105543). Dr Robyn Marsh is supported by a NHMRC early career fellowship (1034703). The authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.