Respiratory viruses in stable bronchiectasis: A multicenter evaluation in Northern Italy

Bronchiectasis is a chronic respiratory disease defined by the radiological appearance of abnormal bronchial dilations in association with a clinical syndrome of cough, daily sputum production and frequent exacerbations [ [1] Aliberti S. Goeminne P.C. O'Donnell A.E. Aksamit T.R. Al-Jahdali H. Barker A.F. Blasi F. Boersma W.G. Crichton M.L. De Soyza A. Dimakou K.E. Elborn S.J. Feldman C. Tiddens H. Haworth C.S. Hill A.T. Loebinger M.R. Martinez-Garcia M.A. Meerburg J.J. Menendez R. Morgan L.C. Murris M.S. Polverino E. Ringshausen F.C. Shteinberg M. Sverzellati N. Tino G. Torres A. Vandendriessche T. Vendrell M. Welte T. Wilson R. Wong C.A. Chalmers J.D. Criteria and definitions for the radiological and clinical diagnosis of bronchiectasis in adults for use in clinical trials: international consensus recommendations. Lancet Respir. Med. 2022 Mar; 10: 298-306 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar ]. Chronic infection with different bacteria plays a crucial role in the vicious cycle of bronchiectasis characterized by a persistent local inflammation, a worsening of bronchial anatomy and a reduction of the mucociliary clearance [ [2] Gramegna A. Amati F. Terranova L. Sotgiu G. Tarsia P. Miglietta D. Calderazzo M.A. Aliberti S. Blasi F. Neutrophil elastase in bronchiectasis. Respir. Res. 2017 Dec 19; 18: 211 Crossref PubMed Scopus (63) Google Scholar , [3] Araújo D. Shteinberg M. Aliberti S. Goeminne P.C. Hill A.T. Fardon T.C. Obradovic D. Stone G. Trautmann M. Davis A. Dimakou K. Polverino E. De Soyza A. McDonnell M.J. Chalmers J.D. The independent contribution of Pseudomonas aeruginosa infection to long-term clinical outcomes in bronchiectasis. Eur. Respir. J. 2018 Jan 31; 51 Crossref Scopus (128) Google Scholar ]. While a possible pathogenic role in bronchiectasis has been also identified for other pathogens, evidence on viral infection is still scarce [ [4] Amati F. Simonetta E. Gramegna A. et al. The biology of pulmonary exacerbations in bronchiectasis. Eur. Respir. Rev. 2019; 28 (Published 2019 Nov 20)190055https://doi.org/10.1183/16000617.0055-2019 Crossref PubMed Scopus (29) Google Scholar , [5] Bonaiti G. Pesci A. Marruchella A. Lapadula G. Gori A. Aliberti S. Nontuberculous mycobacteria in noncystic fibrosis bronchiectasis. BioMed Res. Int. 2015; 2015197950 Crossref PubMed Scopus (56) Google Scholar ]. Respiratory viruses in adults with bronchiectasis have been evaluated in two different cohorts of patients in China and Australia [ [6] Gao Y.H. Guan W.J. Xu G. Lin Z.Y. Tang Y. Lin Z.M. Gao Y. Li H.M. Zhong N.S. Zhang G.J. ChenRC The role of viral infection in pulmonary exacerbations of bronchiectasis in adults: a prospective study. Chest. 2015 Jun; 147: 1635-1643 Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar , [7] Mitchell A.B. Mourad B. Buddle L. Peters M.J. Oliver B.G.G. Morgan L.C. Viruses in bronchiectasis: a pilot study to explore the presence of community acquired respiratory viruses in stable patients and during acute exacerbations. BMC Pulm. Med. 2018 May 22; 18: 84 Crossref PubMed Scopus (22) Google Scholar ]. No data are currently available on the impact of respiratory viruses in a European cohort of adults with bronchiectasis while possible differences with findings reported from other continents might exist.