The overlap between bronchiectasis and chronic airway diseases: state of the art and future directions.

Bronchiectasis is a clinical and radiological diagnosis associated with cough, sputum production and recurrent respiratory infections. The clinical presentation inevitably overlaps with other respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD). In addition, 4-72% of patients with severe COPD are found to have radiological bronchiectasis on computed tomography, with similar frequencies (20-30%) now being reported in cohorts with severe or uncontrolled asthma. Co-diagnosis of bronchiectasis with another airway disease is associated with increased lung inflammation, frequent exacerbations, worse lung function and higher mortality. In addition, many patients with all three disorders have chronic rhinosinusitis and upper airway disease, resulting in a complex "mixed airway" phenotype.The management of asthma, bronchiectasis, COPD and upper airway diseases has traditionally been outlined in separate guidelines for each individual disorder. Recognition that the majority of patients have one or more overlapping pathologies requires that we re-evaluate how we treat airway disease. The concept of treatable traits promotes a holistic, pathophysiology-based approach to treatment rather than a syndromic approach and may be more appropriate for patients with overlapping features.Here, we review the current clinical definition, diagnosis, management and future directions for the overlap between bronchiectasis and other airway diseases.

Polverino E ，Dimakou K ，Hurst J ，Martinez-Garcia MA ，Miravitlles M ，Paggiaro P ，Shteinberg M ，Aliberti S ，Chalmers JD ... -  《-》

Airway disease: similarities and differences between asthma, COPD and bronchiectasis.

Athanazio R 《-》

Management of airway mucus hypersecretion in chronic airway inflammatory disease: Chinese expert consensus (English edition).

Shen Y ，Huang S ，Kang J ，Lin J ，Lai K ，Sun Y ，Xiao W ，Yang L ，Yao W ，Cai S ，Huang K ，Wen F ... -  《International Journal of Chronic Obstructive Pulmonary Disease》

Clinical characteristics of patients with chronic obstructive pulmonary disease with comorbid bronchiectasis: a systemic review and meta-analysis.

Ni Y ，Shi G ，Yu Y ，Hao J ，Chen T ，Song H ... -  《International Journal of Chronic Obstructive Pulmonary Disease》

Practical tips in bronchiectasis for Primary Care.

Bronchiectasis is the third most common chronic inflammatory airway disease, after chronic obstructive pulmonary disease (COPD) and asthma with a prevalence clearly underestimated probably because of its clinical similitudes with other chronic airway diseases. Bronchiectasis can be caused by a dozen of pulmonary and extra-pulmonary diseases and a variable number and severity of exacerbations can appear throughout its natural history, usually with an infectious profile. The dilation of the airway and the inflammation/infection is their radiological and pathophysiological hallmarks. Primary Care should play an important play in many aspects of the bronchiectasis assessment. In this article, we will try to offer a series of important concepts and practical tips on some key aspects of the diagnosis and management of bronchiectasis in Primary Care: clinical suspicion, diagnostic methods, severity assessment, overlap with asthma and COPD and microbiological and therapeutic aspects.

Martinez-Garcia MA ，Garcia-Ortega A ，Oscullo G 《npj Primary Care Respiratory Medicine》