Symptoms, risk of future exacerbations, and response to long-term macrolide treatment in bronchiectasis: an observational study.

Background: Previous studies have suggested that daily symptoms are a marker of bronchiectasis disease activity and could therefore identify patients at increased risk of exacerbation. However, international bronchiectasis guidelines recommend long-term macrolide treatment only in patients with three or more exacerbations per year. We aimed to investigate if symptoms independently predict future exacerbations and therefore identify additional responders to long-term macrolide treatment.

COVID-19 Vaccination Still Makes Sense: Insights on Pneumonia Risk and Hospitalization from a Large-Scale Study at an Academic Tertiary Center in Italy.

COVID-19 vaccines have revolutionized prevention and clinical management by reducing disease severity and mortality. However, their long-term impact on hospitalization is unclear. This retrospective study assessed whether vaccination status, timing, and number of vaccine doses influence the risk of hospitalization and COVID-19 pneumonia in a large cohort in Italy, several years after initial vaccine rollout.

in bronchiectasis.

Bronchiectasis is a chronic respiratory disease characterised by irreversible bronchial dilation, persistent productive cough and alternating periods of clinical stability and exacerbations. The distorted airways impair mucus clearance, making them susceptible to recurrent infections and chronic inflammation. is a common pathogen in bronchiectasis according to international registries.

Endotypes and Phenotypes in ILD: Is It Time to Reclassify ILD by Risk Stratification?

Interstitial lung diseases (ILD) comprise a heterogeneous group of disorders that present significant challenges in both diagnosis and management due to their varied nature, which encompasses different degrees of inflammation and fibrosis affecting lung tissue [...

Neutrophil-derived biomarkers in bronchiectasis: identifying a common therapeutic target.

Bronchiectasis is a chronic respiratory disease that can lead to a substantial decline in lung function, ultimately leading to a significantly increased risk of morbidity and mortality. Despite the increasing global impact of bronchiectasis, no specific (or licensed) treatment for the disease currently exists, with most available therapies, though beneficial, focusing on symptom management and infection control. In part, the lack of specific treatments for bronchiectasis may be due to a lack of established biomarkers for the disease.

Greater disease severity in adults with paediatric-onset adult-onset bronchiectasis: a multicenter EMBARC registry study.

Background: Young adults with paediatric- onset bronchiectasis (POBE) represent a minority of bronchiectasis patients and are poorly characterized. We aimed to compare the characteristics and severity of adults with POBE to adult-onset bronchiectasis (AOBE).

Methods: Data from four EMBARC (European Bronchiectasis Registry) centers were analyzed.

Diagnostic and prognostic trajectories of interstitial lung diseases after the multidisciplinary discussion.

Background: The 2018 guidelines on the diagnosis of idiopathic pulmonary fibrosis (IPF) conditionally recommend multidisciplinary discussion (MDD) for diagnostic decision-making. However, limited data concerning the diagnostic impact of MDD on interstitial lung diseases (ILDs) are available.

Objectives: The objective of this prospective study was to assess the impact of MDD at a tertiary referral ILD center on diagnostic trajectories, prognosis, and identification of potential treatable traits in ILD management.

Impact of long-term high-flow nasal therapy on mucus plugs in patients with bronchiectasis.

https://bit.ly/3NV39zI.

Sputum metagenomics in bronchiectasis reveals pan-European variation: an EMBARC-BRIDGE study.

Background: The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) registry shows considerable variation in culturable microbes in sputum between different European countries. The additive role of next-generation metagenomic sequencing remains unexplored and the association with antimicrobial resistomes unknown.

Methods: We used next-generation shotgun metagenomic sequencing to prospectively assess sputum from 349 individuals recruited into the EMBARC Bronchiectasis Research Involving Databases, Genomics and Endotyping (BRIDGE) study from three European regions: Northern and Western Europe, Southern Europe and the UK.

Artificial Intelligence-Generated Answers to Patients' Questions on Asthma: The Artificial Intelligence Responses on Asthma Study.

Background: Asthma is a prevalent chronic respiratory disease requiring ongoing patient education and individualized management. The increasing reliance on digital tools, particularly generative artificial intelligence (AI), to answer health-related questions has raised concerns about the accuracy, reliability, and comprehensibility of AI-generated information for people living with asthma.

Objective: To evaluate systematically the reliability, accuracy, comprehensiveness, and understandability of responses generated by three widely used artificial intelligence-based chatbots (ChatGPT, Bard, and Copilot) to common questions formulated by people with asthma.

Nosocomial lower respiratory tract infections in patients with immunosuppression: a cohort study.

Background: This post-hoc analysis of a multinational, multicenter study aimed to describe and compare clinical characteristics, microbiology, and outcomes between immunosuppressed and non-immunosuppressed patients with nosocomial lower respiratory tract infections (nLRTI). The study utilized data from the European Network for ICU-related Respiratory Infections, including 1,060 adult ICU patients diagnosed with nLRTI. Descriptive statistics were used to compare baseline characteristics and pathogen distribution between groups.

Diagnostic Management of Pediatric Bronchiectasis: A Literature Review and Clinical Examples.

Background: Bronchiectasis is an often underdiagnosed chronic respiratory disease in children and adolescents. Recent international guidelines highlighted the management of bronchiectasis in pediatric patients in comparison to adults. The purpose of this manuscript is to review the diagnostic, etiological workup and follow-up in children and adolescents with bronchiectasis, using real-life clinical cases that highlight the multidisciplinary approach required for this complex condition.

Neutrophilic inflammation in bronchiectasis.

Noncystic fibrosis bronchiectasis, hereafter referred to as bronchiectasis, is a chronic, progressive lung disease that can affect people of all ages. Patients with clinically significant bronchiectasis have chronic cough and sputum production, as well as recurrent respiratory infections, fatigue and impaired health-related quality of life. The pathophysiology of bronchiectasis has been described as a vicious vortex of chronic inflammation, recurring airway infection, impaired mucociliary clearance and progressive lung damage that promotes the development and progression of the disease.

Use of inhaled corticosteroids in bronchiectasis: data from the European Bronchiectasis Registry (EMBARC).

Introduction: Current bronchiectasis guidelines advise against the use of inhaled corticosteroids (ICS) except in patients with associated asthma, allergic bronchopulmonary aspergillosis (ABPA) and/or chronic obstructive pulmonary disease (COPD). This study aimed to describe the use of ICS in patients with bronchiectasis across Europe.

Methods: Patients with bronchiectasis were enrolled into the European Bronchiectasis Registry from 2015 to 2022.

Vaccination Strategies in Respiratory Diseases: Recommendation from AIPO-ITS/ETS, SIMIT, SIP/IRS, and SItI.

Background: Chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease, and bronchiectasis, are significant global health concerns associated with recurrent exacerbations, hospitalization, and increased mortality. Preventive strategies, particularly vaccination, play a crucial role in managing these diseases by reducing infection-related exacerbations and stabilizing lung function.

Summary: This review summarizes the recommendations provided by four major Italian scientific societies on vaccination against key respiratory pathogens, including respiratory syncytial virus, influenza, SARS-CoV-2, Streptococcus pneumoniae, and varicella zoster virus, which pose serious risks to individuals with chronic respiratory conditions.

Factors Associated with Mortality in Nosocomial Lower Respiratory Tract Infections: An ENIRRI Analysis.

: Nosocomial lower respiratory tract infections (nLRTIs) are associated with unfavorable clinical outcomes and significant healthcare costs. nLRTIs include hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and other ICU-acquired pneumonia phenotypes. While risk factors for mortality in these infections are critical to guide preventive strategies, it remains unclear whether they vary based on their requirement of invasive mechanical ventilation (IMV) at any point during the hospitalization.

Broad Immunomodulatory Effects of the Dipeptidyl-peptidase-1 Inhibitor Brensocatib in Bronchiectasis: Data from the Phase 2, Double-Blind, Placebo-controlled WILLOW Trial.

Rationale: In the WILLOW trial, the Dipeptidyl peptidase-1 inhibitor brensocatib reduced neutrophil serine protease (NSP) activity and prolonged time to first exacerbation in patients with bronchiectasis.

Objectives: We hypothesized that, by reducing NSPs, brensocatib would affect antimicrobial peptides, mucins, and cytokines throughout the inflammatory cascade.

Methods: The WILLOW trial was a phase 2 randomized trial of brensocatib (10mg and 25mg) versus placebo.

Occluding mucous airway plugs in patients with obstructive lung diseases: a new treatable trait?

https://bit.ly/4gyJHFW.

Epidemiology and Resistance Profiles of Bacteria Isolated From Blood Samples in Septic Patients at Emergency Department Admission: A 6-Year Single Centre Retrospective Analysis From Northern Italy.

Objective: This study aimed to investigate the microbiological and clinical heterogeneity of community-onset bloodstream infections (BSIs) and identify features to support targeted empirical antibiotic therapy in the Emergency Department (ED).

Methods: Clinical and microbiological data from 992 BSI cases (1,135 isolates) diagnosed within 24 h of ED admission at IRCCS Humanitas Research Hospital, Milan, Italy (January 2015-June 2022), were analysed. Drug resistance was interpreted using EUCAST-2023.

Immunodeficiencies and CFTR dysfunction: results from a systematic screening in a cohort of adults with cystic fibrosis and CFTR-related disorders.

Background: Immunodeficiencies (IDs) are conditions caused by immune system dysfunctions which predispose to chronic infections. Cystic fibrosis (CF) patients are characterized by the presence of bronchiectasis filled with hyper-viscous secretions that constitute the ideal environment for infections. Although CF and IDs might share similarities in the pathophysiological mechanism of bronchiectasis development, they each offer different treatment options.

A worldwide look into long COVID-19 management: an END-COVID survey.

Background: Long COVID is a heterogeneous clinical syndrome characterised by a variety of reported symptoms and signs. Its clinical management is expected to differ significantly worldwide.

Methods: A survey-based study investigating long COVID-related standard operating procedures (SOPs) has been conducted by the European Respiratory Society (ERS) END-COVID clinical research collaboration with the support of other international societies (ALAT, APSR, CHEST, ESCMID and PATS).

Clinical Efficacy of Serum Antiglycopeptidolipid Core IgA Antibody Test for Screening Nontuberculous Mycobacterial Pulmonary Disease in Bronchiectasis: A European Multicenter Cohort Study.

Background: The serum antiglycopeptidolipid core IgA antibody test has been proposed as a diagnostic tool for Mycobacterium avium complex pulmonary diseases. Cross-reactivity with other nontuberculous mycobacteria (NTM), including Mycobacterium abscessus, indicates that it may have a role as a broader screening test for nontuberculous mycobacterial pulmonary disease (NTM-PD). NTM-PD is believed to be underdiagnosed in patients with bronchiectasis.