Bronchiectasis and Emphysema
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Pulmonologist, Director of 5th Pulmonary department, “Sotiria” Chest Hospital, Athens, Greece
Pulmonologist, 5th Pulmonary department, “Sotiria” Chest Hospital, Athens, Greece
Pulmonologist, 6th Pulmonary department, “Sotiria” Chest Hospital, Athens, Greece
Katerina Dimakou   

152 Mesogion Ave., 11527 Athens, Greece
Pneumon 2016;29(4):334–337
Emphysema is the predominant component in alpha1-Antitrypsin (α1-AT) Deficiency, but the prevalence and impact of bronchiectasis is greater than previously recognized. Bronchiectasis is more common and severe where emphysema is seen and may add to the severity of the disease and worse health status. The pathogenetic association between bronchiectasis and emphysema is not well defined. Whether bronchiectasis take advantage of the α1-AT augmentation therapy remains unknown. The coexistence of emphysema and bronchiectasis in COPD patients is nor rare. Bronchiectasis could have an impact on disease course over and above the effects of emphysema. From the other side, the presence of emphysema in bronchiectasis is common and may contribute to the severity of airways obstruction. Emphysema may represent a risk factor of mortality in patients with bronchiectasis.
Martínez-García MA, de la Rosa Carrillo D, Soler-Cataluña JJ, et al. Prognostic value of bronchiectasis in patients with moderate-to-severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2013;187:823-31.
Parr DG, Guest PG, Reynolds JH, et al. Prevalence and impact of bronchiectasis in alpha-1 antitrypsin defi ciency. Am J Respir Crit Care Med 2007; 176:1215–21.
Dowson LJ, Guest PJ, MA and Stockley RA. The relationship of chronic sputum expectoration to physiologic, radiologic, and health status characteristics in α1-Antitrypsin Deficiency (PiZ)*. Chest 2002;122:1247-55.
Strange Charlie Airway Disease in Alpha-1 Antitrypsin Defi ciency. COPD 2013;10(Suppl 1):68–73.
McElvaney NG, Stoller JK, Buist AS, et al. Baseline characteristics of enrollees in the National Heart, Lung and Blood Institute Registry of alpha-1 antitrypsin deficiency. Alpha-1 Antitrypsin Deficiency Registry Study Group. Chest 1997; 111:394–403.
King MA, Stone JA, Diaz PT, Mueller CF, Becker WJ, Gadek JE. a1-Alpha-1 antitrypsin deficiency: evaluation of bronchiectasis with CT. Radiology 1996;199:137–41.
Stockley RA, Hill AT, Hill SL, et al. Bronchial inflammation:its relationship to colonizing microbial load and alpha-1 antitrypsin defi ciency. Chest 2000;117:291S–3S.
Lieberman J. Augmentation therapy reduces frequency of lung infections in antitrypsin defi ciency: a new hypothesis with supporting data. Chest 2000; 118:1480–5.
Fugimoto K, Kitagughi Y, Kubo K, Honda T. Clinical analysis of chronic obstructive pulmonary disease phenotypes classified using high-resolution computed tomography. Respirology 2006;11:731–40.
Gatheral T, Kumar N, Sansom B, et al. COPD-related bronchiectasis; independent impact on disease course and outcomes COPD 2014;11:605-14.
Loubeyre P, Paret M, Revel D, Wiesendanger T, Brune J. Thinsection CT detection of emphysema associated with bronchiectasis and correlation with pulmonary function tests*. CHEST 1996; 109:360-5.
Loebinger MR, Wells AU, Hansell DM, et al. Mortality in bronchiectasis: A long-term study assessing the factors influencing survival. Eur Respir J 2009;34:843–9.
Goeminne PC, Nawrot TS, Ruttens D, Seys S, Dupont LJ. Mortality in non-cystic fibrosis bronchiectasis: A prospective cohort analysis. Respir Med 2014;108:287–96.
Tang X, Bi J, Yang D, et al. Emphysema is an independent risk factor for 5-year mortality in patients with bronchiectasis. The Clinical Respiratory Journal (2016) • ISSN 1752-6981.