A Breath of Fresh Air: Novel Treatments That Address the Inflammatory Component of Non-Cystic Fibrosis Bronchiectasis

Non-cystic fibrosis bronchiectasis (NCFBE) is a heterogenous and increasingly prevalent chronic pulmonary disease that is associated with high morbidity and mortality. It is characterized by irreversibly damaged and dilated bronchi, and has a broad spectrum of clinical presentations, ranging from asymptomatic radiological changes detected incidentally to chronic sputum production and recurrent exacerbations. There are numerous etiologies that can induce or contribute to the pathophysiological processes that result in NCFBE. The concomitant presence of chronic obstructive pulmonary disease increases the use of healthcare resources and is associated with poorer health. Optimal management of NCFBE requires an individualized approach. Effective therapies surrounding each component of the pathophysiological processes (ie, inflammation, infection, mucociliary clearance) may be required to disrupt the “vicious cycle” to achieve desirable outcomes. Currently, there are no therapies approved by the US Food and Drug Administration for the treatment of NCFBE, but research and development of novel targeted agents are ongoing, including those that target neutrophilic inflammation.