Correlation of Inflammatory Markers and Radiological Findings in Stable Bronchiectasis Patients With Exacerbation Phenotype

Bronchiectasis, also referred to as non-cystic fibrosis (non-CF) bronchiectasis, is a chronic respiratory disease defined by abnormal and irreversible dilatation of the bronchi (1). Dilatation of the bronchial lumen predisposes to infection (2). Recurrent infection and airway inflammation leads to tissue damage and inflammation that leads to excess mucus production and delayed mucociliary clearance, predisposing the patient to recurrent and chronic infections (3). This in turn creates a cycle of further tissue damage and infection (4), leading to recurrent exacerbations, hospitalizations and loss of lung function. Non-CF bronchiectasis patients who experience frequent exacerbations (≥2 per year) represent a high-risk group with accelerated disease progression.Bronchiectasis has become a major health concern due to its increasing prevalence and associated healthcare costs (5). The disease can be caused by many different etiologies, which may be causative, synergistic, or coincidental, depending on the manner in which they interact and it is clinically characterized by a variety of symptoms, including cough, sputum production and airway infection, and can often present with recurrent exacerbations (6). An exacerbation is generally defined as a sustained clinical deterioration characterized by an increase in symptoms, which may include increased cough, increased sputum volume or change in consistency, increased sputum purulence (color change), increased breathlessness and/or reduced exercise tolerance, increased fatigue and/or malaise, hemoptysis for at least 48 h requiring a change in treatment. Recurrent exacerbations are related to elevated systemic and airway inflammation, deterioration of lung function and progression of the disease(7). In addition to known etiologies of bronchiectasis, several other diseases may occur at any stage of bronchiectasis and are likely major contributors to increased hospitalizations, healthcare utilization and socioeconomic costs. These include cardiovascular disorders, gastro-oesophageal reflux disease (GORD), psychological illnesses, pulmonary hypertension, cognitive impairment, and lung, oesophageal and hematological malignancies (8-9).