The precision medicine era of bronchiectasis

Abstract

Bronchiectasis, originating from the Greek words bronkhia (“airway”) and ektasis (“distortion”), is a permanent, irreversible airway dilatation described in 1819 by René Laennec (1) (Figure 1A). Key work by Sir William Osler followed in the late 1800s, and Osler’s biography details his battle with frequent severe chest infections, with some believing that Osler himself died of complications from undiagnosed bronchiectasis (2). Fast forward 100 years, when radiology, antibiotics, and physiotherapy were incorporated into the identification, assessment, and treatment of bronchiectasis. Since the turn of the century, we have seen the first clinical guidelines to drive care, advances in genomics, and the emergence of international registries, targeted therapeutics, and a pipeline of clinical trials focused on inhaled antibiotics, mucolytics and newer antiinflammatory approaches to treat disease.