Infections, autoimmunity and immunodeficiencies are the leading etiologies of non-cystic fibrosis bronchiectasis in adults from the southwest of Colombia.
Abstract
Introduction. Non-cystic fibrosis bronchiectasis is a complex medical condition with multiple etiologies, characterized by chronic productive cough and radiologic evidence of airway lumen dilation and wall thickening. Associated exacerbations and declining lung function contribute to increasing disability and mortality. There are no data about the prevalence of non-cystic fibrosis bronchiectasis etiologies in the Colombian population.
Objective. To investigate non-cystic fibrosis bronchiectasis etiology and clinical characteristics in adults evaluated in the southwest of Colombia.
Materials and methods. We conducted a cross-sectional, non-interventional study. Subjects diagnosed with non-cystic fibrosis bronchiectasis were referred to by their
healthcare providers and then enrolled between October 2018 and April 2021. Medical records and radiological studies were evaluated. Participants underwent laboratory tests, including complete blood count, serum immunoglobulin levels, and, in some cases, additional tests.
Results. We included 161 subjects. The average age was 50 years old, and 59% were females. Bronchiectasis etiology was identified in 84.6% of the cases. Postinfectious
(34.6%) and immune disorders (25.3%), represented by autoimmunity (13.6%) and immunodeficiency (11.7%), were the leading causes. Gender differences were noted in autoimmune (females: 18.8% versus males: 6.1%, p = 0.021) and immunodeficiency-related bronchiectasis (males: 21.2% versus females 5.2%, p = 0.002). Immunodeficiencies-associated bronchiectases were more frequent in subjects under 50 years of age, while chronic obstructive pulmonary disease-associated bronchiectases were common in subjects over 50 years of age.
Discussion. The etiologies of non-cystic fibrosis bronchiectasis in Colombia are diverse, exhibiting notable differences from other global regions. Serum immunoglobulin levels and clinical immunologist consultation should be prioritized in diagnosing patients with unclear bronchiectasis etiology, particularly those with recurrent sinopulmonary infections.
Downloads
References
Chalmers JD, Chang AB, Chotirmall SH, Dhar R, McShane PJ. Bronchiectasis. Nat Rev Dis Primers. 2018;4:1-18. https://doi.org/10.1038/s41572-018-0042-3
McShane PJ, Tino G. Bronchiectasis. Chest. 2019;155:825-33. https://doi.org/10.1016/j.chest.2018.10.027
Lesan A, Lamle AE. Short review on the diagnosis and treatment of bronchiectasis. Med Pharm Rep. 2019;92:111-6. https://doi.org/10.15386/cjmed-1060
Chalmers JD, Aliberti S, Blasi F. Management of bronchiectasis in adults. Eur Respir J. 2015;45:1446-62. https://doi.org/10.1183/09031936.00119114
O’Donnell AE. Bronchiectasis -A clinical review. N Engl J Med. 2022;387:533-45. https://doi.org/10.1056/NEJMra2202819
Dhar R, Singh S, Talwar D, Mohan M, Tripathi SK, Swarnakar R, et al. Bronchiectasis in India: Results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry. Lancet Glob Health. 2019;7:e1269-79 https://doi.org/10.1016/S2214-109X(19)30327-4
Henkle E, Chan B, Curtis JR, Aksamit TR, Daley CL, Winthrop KL. Characteristics and health-care utilization history of patients with bronchiectasis in US Medicare enrollees with prescription drug plans, 2006 to 2014. Chest. 2018;154:1311-20. https://doi.org/10.1016/j.chest.2018.07.014
Ringshausen FC, De Roux A, Diel R, Hohmann D, Welte T, Rademacher J. Bronchiectasis in Germany: A population-based estimation of disease prevalence. Eur Respir J. 2015;46:1805-7. https://doi.org/10.1183/13993003.00954-2015
Sánchez-Muñoz G, López-de Andrés A, Jiménez-García R, Carrasco-Garrido P, Hernández-Barrera V, Pedraza-Serrano F, et al. Time trends in hospital admissions for bronchiectasis: Analysis of the Spanish National Hospital discharge data (2004 to 2013). PLoS ONE. 2016;11:1-15. https://doi.org/10.1371/journal.pone.0162282
Lin J-L, Xu J-F, Qu J-M. Bronchiectasis in China. Ann Am Thorac Soc. 2016;13:609-16. https://doi.org/10.1513/AnnalsATS.201511-740PS
Lonni S, Chalmers JD, Goeminne PC, McDonnell MJ, Dimakou K, De Soyza A, et al. Etiology of non-cystic fibrosis bronchiectasis in adults and its correlation to disease severity. Ann Am Thorac Soc. 2015;12:1764-70. https://doi.org/10.1513/AnnalsATS.201507-472OC
Aksamit TR, O’Donnell AE, Barker A, Olivier KN, Winthrop KL, Daniels MLA, et al. Adult patients with bronchiectasis: A first look at the US Bronchiectasis Research Registry. Chest. 2017;151:982-92. https://doi.org/10.1016/j.chest.2016.10.055
McShane PJ, Naureckas ET, Strek ME. Bronchiectasis in a diverse US population: Effects of ethnicity on etiology and sputum culture. Chest. 2012;142:159-67. https://doi.org/10.1378/chest.11-1024
Huang HY, Chung FT, Lo CY, Lin HC, Huang YT, Yeh CH, et al. Etiology and characteristics of patients with bronchiectasis in Taiwan: A cohort study from 2002 to 2016. BMC Pulm Med. 2020;20:1-11. https://doi.org/10.1186/s12890-020-1080-7
Pasteur MC, Bilton D, Hill AT, on behalf of the British Thoracic Society Bronchiectasis (non-CF) Guideline Group. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010;65(Suppl.1): i1-58. https://doi.org/10.1136/thx.2010.136119
Hill AT, Sullivan AL, Chalmers JD, De Soyza A, Stuart-Elborn J, Andres-Floto R, et al. British Thoracic Society Guideline for bronchiectasis in adults. Thorax. 2019;74(Suppl.1):1-69. https://doi.org/10.1136/thoraxjnl-2018-212463
Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26:948-68. https://doi.org/10.1183/09031936.05.00035205
Agustí A, Celli BR, Criner GJ, Halpin D, Anzueto A, Barnes P, et al. Global Initiative for chronic obstructive lung disease 2023 Report: GOLD Executive Summary. Eur Respir J. 2023;61:1-26. https://doi.org/10.1183/13993003.00239-2023
Reddel HK, Bacharier LB, Bateman ED, Brightling CE, Brusselle GG, Buhl R, et al. Global Initiative for Asthma Strategy 2021: Executive summary and rationale for key changes. Eur Respir J. 2022;59:1-25. https://doi.org/10.1183/13993003.02730-2021
Agarwal R, Maskey D, Aggarwal AN, Saikia B, Garg M, Gupta D, et al. Diagnostic performance of various tests and criteria employed in allergic bronchopulmonary aspergillosis: A latent class analysis. PLoS ONE. 2013;8:1-7. https://doi.org/10.1371/journal.pone.0061105
Bousfiha A, Jeddane L, Picard C, Al-Herz W, Ailal F, Chatila T, et al. Human inborn errors of immunity: 2019 Update of the IUIS phenotypical classification. J Clin Immunol. 2020;40:66-81. https://doi.org/10.1007/s10875-020-00758-x
Lucas JS, Barbato A, Collins SA, Goutaki M, Behan L, Caudri D, et al. European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia. Eur Respir J. 2017;49:1-25. https://doi.org/10.1183/13993003.01090-2016
National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease and dyspepsia in adults: Investigation and management CG184. NICE. 2014. p.1-29. Accesed: March 10, 2022. Available at: https://www.nice.org.uk/guidance/cg184
Chalmers JD, Goeminne P, Aliberti S, McDonnell MJ, Lonni S, Davidson J, et al. The Bronchiectasis Severity Index. An international derivation and validation study. Am J Respir Crit Care Med. 2014;189:576-85. https://doi.org/10.1164/rccm.201309-1575OC
Gao Y-H, Guan W-J, Liu S-X, Wang L, Cui J-J, Chen R-C, et al. Aetiology of bronchiectasis in adults: A systematic literature review. Respirology. 2016;21:1376-83. https://doi.org/10.1111/resp.12832
Leal RKR, Salles R, Costa W, Acar Silva J, Torres GR. The profile of adult patients with bronchiectasis at State University of Rio de Janeiro, Brazil. Am J Respir Crit Care Med. 2014;189:A6252. https//doi.org/10.1164/ ajrccm-conference.2014.189.1
Chakaya J, Khan M, Ntoumi F, Aklillu E, Fatima R, Mwaba P, et al. Global Tuberculosis Report 2020 - Reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis. 2021;113:S7-12. https://doi.org/10.1016/j.ijid.2021.02.107
World Health Organization. WHO global lists of high burden countries for tuberculosis (TB), TB/HIV and multidrug/rifampicin-resistant TB (MDR/RR-TB), 2021-2025: background document. Accessed: March 10, 2022. Available at: https://iris.who.int/bitstream/handle/10665/341980/9789240029439-eng.pdf?sequence=1&isAllowed=y
Instituto Nacional de Salud, Colombia. Protocolo de vigilancia en salud pública de tuberculosis. Version 6. Accessed: March 10, 2022. Available at: https://www.ins.gov.co/buscador-eventos/Lineamientos/Pro_Tuberculosis%202022.pdf
Ko JM, Kim KJ, Park SH, Park HJ. Bronchiectasis in active tuberculosis. Acta Radiol. 2013;54:412-7. https://doi.org/10.1177/0284185113475796
Ratnatunga CN, Lutzky VP, Kupz A, Doolan DL, Reid DW, Field M, et al. The rise of nontuberculosis mycobacterial lung disease. Front Immunol. 2020;11:1-12. https://doi.org/10.3389/FIMMU.2020.00303
Néel A, Espitia-Thibault A, Arrigoni PP, Volteau C, Rimbert M, Masseau A, et al. Bronchiectasis is highly prevalent in anti-MPO ANCA-associated vasculitis and is associated with a distinct disease presentation. Semin Arthritis Rheum. 2018;48:70-6. https://doi.org/10.1016/j.semarthrit.2017.12.002
Martin LW, Prisco LC, Huang W, McDermott G, Shadick NA, Doyle TJ, et al. Prevalence and risk factors of bronchiectasis in rheumatoid arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. 2021;51:1067-80. https://doi.org/10.1016/j.semarthrit.2021.08.005
Chalmers JD, Polverino E, Crichton ML, Ringshausen FC, De Soyza A, Vendrell M, et al. Bronchiectasis in Europe: Data on disease characteristics from the European Bronchiectasis registry (EMBARC). Lancet Respir Med. 2023;11:637-49. https://doi.org/10.1016/s2213-2600(23)00093-0
Goussault H, Salvator H, Catherinot E, Chabi M-L, Tcherakian C, Chabrol A, et al. Primary immunodeficiency-related bronchiectasis in adults: Comparison with bronchiectasis of other etiologies in a French reference center. Respir Res. 2019;20. https://doi.org/10.1186/s12931-019-1242-4
Zea-Vera AF, Chacón MA, Parra B. Antibody deficiencies with normal IgG in adults with noncystic fibrosis bronchiectasis or recurrent pneumonia: Cross-sectional study. Colomb Med (Cali). 2022;53:e2014832. https://doi.org/10.25100/cm.v53i2.4832
Pasteur MC, Helliwell SM, Houghton SJ, Webb SC, Foweraker JE, Coulden RA, et al. An investigation into causative factors in patients with bronchiectasis. Am J Respir Crit Care Med. 2000;162:1277-84. https://doi.org/10.1164/ajrccm.162.4.9906120
Shoemark A, Ozerovitch L, Wilson R. Aetiology in adult patients with bronchiectasis. Respir Med. 2007;101:1163-70. https://doi.org/10.1016/j.rmed.2006.11.008
Wall LA, Wisner EL, Gipson KS, Sorensen RU. Bronchiectasis in primary antibody deficiencies: A multidisciplinary approach. Front Immunol. 2020;11:1-15. https://doi.org/10.3389/fimmu.2020.00522
Chandrasekaran R, Mac Aogáin M, Chalmers JD, Elborn SJ, Chotirmall SH. Geographic variation in the aetiology, epidemiology and microbiology of bronchiectasis. BMC Pulm Med. 2018;18:1-14. https://doi.org/10.1186/S12890-018-0638-0
Some similar items:
- Juan Gabriel Bueno-Sánchez, Jairo René Martínez-Morales, Elena E. Stashenko, Wellman Ribón, Anti-tubercular activity of eleven aromatic and medicinal plants occurring in Colombia , Biomedica: Vol. 29 No. 1 (2009)
- María Consuelo Garzón, Dailyn Yorledy Angée, Claudia Llerena, Dora Leticia Orjuela, Jorge Ernesto Victoria, Surveillance of Mycobacterium tuberculosis resistance to antituberculosis drugs , Biomedica: Vol. 28 No. 3 (2008)
- Diego Chaves, Andrea Sandoval, Luis Rodríguez, Juan C. García, Silvia Restrepo, María Mercedes Zambrano, Comparative analysis of six Mycobacterium tuberculosis complex genomes , Biomedica: Vol. 30 No. 1 (2010)
- María Imaz, Sonia Allassia, Mónica Aranibar, Alba Gunia, Susana Poggi, Ana Togneri, Lidia Wolff, Group of Implementation of Fluorescence, Performance of LED fluorescence microscopy for the detection of acid-fast bacilli from respiratory samples in peripheral laboratories in Argentina , Biomedica: Vol. 37 No. 2 (2017)
- Diana Castaño, Mauricio Rojas, Alterations in recruitment and activation of Rab proteins during mycobacterial infection , Biomedica: Vol. 30 No. 2 (2010)
- Adriana Rojas-Villarraga, Carlos Andrés Agudelo, Ricardo Pineda-Tamayo, Alvaro Porras, Gustavo Matute, Juan Manuel Anaya, Tuberculosis in patientes treated with tumor necrosis factor alpha antagonists living in an endemic area. Is the risk worthwhile? , Biomedica: Vol. 27 No. 2 (2007)
- Francisco Cuervo, Luis F. Giraldo, Alirio Bastidas, Carlos Vélez, Maria R. Forero, Fibrinogen-thrombin as bridge therapy in massive hemoptysis , Biomedica: Vol. 33 No. 1 (2013)
- Alvaro Javier ldrovo, Notes on the onset of a pulmonary tuberculosis epidemic in Bogotá (1870-1920) , Biomedica: Vol. 21 No. 3 (2001)
- Ivohne Fernanda Corrales, Jorge Alberto Cortés, María Lucía Mesa, Graciela Zamora, Sternal osteomyelitis and scrofuloderma due to BCG vaccination. , Biomedica: Vol. 23 No. 2 (2003)
- Alvaro Javier Idrovo, Historical, social and epidemiological roots of tuberculosis in Bogotá, Colombia. , Biomedica: Vol. 24 No. 4 (2004)
Copyright (c) 2024 Biomedica
This work is licensed under a Creative Commons Attribution 4.0 International License.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
Funding data
-
Takeda Science Foundation
Grant numbers IIR-BXT-COL-001923/ IISR-2017-104214
