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Pulmonary Literature Review and Complex Case Prese ...
Update Non CF Bronchiectasis and NTM Lung Disease ...
Update Non CF Bronchiectasis and NTM Lung Disease Addrizzo Harris
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Pdf Summary
The document is an extensive literature review on bronchiectasis and non-tuberculous mycobacterial (NTM) lung disease, prepared by Dr. Doreen J. Addrizzo-Harris. It highlights significant advancements and ongoing research in the treatment and understanding of these conditions. A central focus is the pathogenesis of bronchiectasis, describing a cycle where airway dysfunction leads to inflammation and further tissue damage, creating a "vicious cycle" or "vicious vortex."<br /><br />The review describes the roles of neutrophils in bronchiectasis, noting their contribution to inflammation and tissue damage. It discusses the novel oral treatment brensocatib, which targets neutrophilic inflammation by inhibiting dipeptidyl peptidase 1 (DPP1). In a phase 2 trial, brensocatib showed prolonged time to first exacerbation and reduced neutrophil elastase activity in bronchiectasis patients. The review mentions the upcoming phase 3 ASPEN trial to further study brensocatib's efficacy.<br /><br />In exploring pathogenic mechanisms, the document remarks on studies examining inflammatory and microbial characteristics of exacerbations in bronchiectasis. It mentions trials like the AIRLEAF study on the Cathepsin C inhibitor BI 1291583, focusing on its potential to reduce exacerbations.<br /><br />Emerging treatments for NTM lung disease are also discussed, including repurposing older antimicrobials and the potential therapeutic use of mycobacteriophages. The document touches on the ongoing and planned clinical trials aiming to evaluate new treatment options and the development of guidelines for clinical practice in managing these diseases.<br /><br />Additionally, the literature review provides insight into various editorial perspectives, highlighting global efforts to improve the diagnosis, treatment, and understanding of bronchiectasis and related lung diseases, emphasizing the need for patient-centered care and innovative research approaches.
Keywords
bronchiectasis
non-tuberculous mycobacterial
NTM lung disease
brensocatib
neutrophils
DPP1 inhibitor
mycobacteriophages
AIRLEAF study
ASPEN trial
patient-centered care
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