PT  - JOURNAL ARTICLE
AU  - Thomas Pembridge
AU  - James D. Chalmers
TI  - Precision medicine in bronchiectasis
AID  - 10.1183/20734735.0119-2021
DP  - 2021 Dec 01
TA  - Breathe
PG  - 210119
VI  - 17
IP  - 4
4099  - http://breathe.ersjournals.com/content/17/4/210119.short
4100  - http://breathe.ersjournals.com/content/17/4/210119.full
SO  - Breathe2021 Dec 01; 17
AB  - Bronchiectasis, due to its highly heterogenous nature, requires an individualised approach to therapy. Patients experience symptoms and exacerbations driven by a combination of impaired mucociliary clearance, airway inflammation and airway infection. Treatment of bronchiectasis aims to enhance airway clearance and to address the underlying causes of inflammation and infection susceptibility. Bronchiectasis has multiple causes and so the pathophysiology leading to individual symptoms and exacerbations are different between individuals. Standardised investigations are recommended by international guidelines to identify the underlying causes of bronchiectasis. The process of identifying the underlying biology within an individual is called “endotyping” and is an emerging concept across chronic diseases. Endotypes that have a specific treatment are referred to as “treatable traits” and a treatable traits approach to managing patients with bronchiectasis in a holistic and evidence-based manner is the key to improved outcomes. Bronchiectasis is an area of intense research. Endotyping allows identification of subsets of patients to allow medicines to be tested differently in the future where trials, rather than trying to achieve a “one size fits all” solution, can test efficacy in subsets of patients where the treatment is most likely to be efficacious.Bronchiectasis, due to its highly heterogenous nature, requires an individualised approach to therapy. Treatment targets symptoms and exacerbations by aiming to improve mucociliary clearance and to reduce airway inflammation and airway infection. https://bit.ly/3ite4B2