Is bronchiectasis really a disease?

The definition of a disease requires that distinguishing signs and symptoms are present that are common, and that the constellation of signs and symptoms differentiate the condition from other causes. In bronchiectasis, anatomical changes, airways inflammation and airway infection are the distinguis...

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Bibliographic Details
Published in:European respiratory review Vol. 29; no. 155; p. 190051
Main Authors: Shteinberg, Michal, Flume, Patrick A., Chalmers, James D.
Format: Journal Article
Language:English
Published: England European Respiratory Society 31.03.2020
Subjects:
Bronchiectasis - classification
Bronchiectasis - diagnosis
Bronchiectasis - physiopathology
Bronchiectasis - therapy
Humans
Phenotype
Predictive Value of Tests
Series
Terminology as Topic
Treatment Outcome
ISSN:0905-9180, 1600-0617, 1600-0617
Online Access:Get full text
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Summary:The definition of a disease requires that distinguishing signs and symptoms are present that are common, and that the constellation of signs and symptoms differentiate the condition from other causes. In bronchiectasis, anatomical changes, airways inflammation and airway infection are the distinguishing features that are common to this disease. However, bronchiectasis is a heterogenous disease: signs and symptoms are shared with other airway diseases, there are multiple aetiologies and certain phenotypes of bronchiectasis have distinct clinical and laboratory features that are not common to all people with bronchiectasis. Furthermore, response to therapeutic interventions in clinical trials is not uniform. The concept of bronchiectasis as a treatable trait has been suggested, but this may be too restrictive in view of the heterogeneity of bronchiectasis. It is our opinion that bronchiectasis should be defined as a disease in its own right, but one that shares several pathophysiological features and “treatable traits” with other airway diseases. These traits define the large heterogeneity in the pathogenesis and clinical features and suggest a more targeted approach to therapy.
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ISSN:0905-9180
1600-0617
1600-0617
DOI:10.1183/16000617.0051-2019