What Is Chronic Bronchitis? Causes, Symptoms, Diagnosis, Treatment, and Prevention

Key Areas Of Research And Emerging Therapies In Bronchiectasis Treatment

Dr Metersky provides his closing thoughts, highlighting key points of emphasis surrounding bronchiectasis care and the future of its treatment landscape.

This is a video synopsis/summary of an Insights involving Mark Metersky, MD, FCCP, on emerging bronchiectasis research and key takeaways.

Many new experimental bronchiectasis therapies are under investigation with increased pharmaceutical industry interest. One medication class is dipeptidyl-peptidase (DPP-1) inhibitors which block neutrophil serine protease activation (like neutrophil elastase) without impairing other neutrophil functions. Neutrophil elastase directly causes bronchiectasis inflammation and tissue damage. A DPP-1 inhibitor phase 2 trial demonstrated reduced exacerbations. Multiple similar agents are under study.

Research into bronchiectasis endotypes (underlying characteristics) also shows promise for precision therapy approaches. About 20% of bronchiectasis patients have eosinophil-predominant inflammation. Some case reports suggest possible benefits from asthma biologic medications in this subgroup. Also, the historical practice of avoiding inhaled corticosteroids due to infection risks like nontuberculous mycobacteria is being reevaluated given the potential advantages of treating eosinophilic inflammation.

Another emerging endotype is primary ciliary dyskinesia (PCD) among adults with bronchiectasis, found to be around 10% rather than the previous estimate of 1% to 2%. Biotechnology investigations target whether improving ciliary function in PCD bronchiectasis could improve outcomes. Additionally, significant percentages of noncystic fibrosis bronchiectasis patients have single mutant cystic fibrosis transmembrane conductance regulator (CFTR) genes. Early CFTR modulator research is underway for such heterozygotes.

In summary, key points are that bronchiectasis remains underdiagnosed with an average of 5- to 10-year delays from symptom onset, often initially misattributed to asthma or chronic obstructive pulmonary disease. Clinicians should maintain a low threshold for CT diagnostic imaging given bronchiectasis treatment benefits. Though incurable, evidence-based supportive treatments significantly improve symptoms and quality of life for many patients. Exciting near-future targeted therapies seem probable given expanding pharmaceutical interest and research.

Video synopsis is AI-generated and reviewed by AJMC® editorial staff.

New Treatment For Skin Cancer

A treatment developed in Australia for recurrent skin cancer is likely to save hundreds of people from losing their limbs.

Doctors in Britain have now learned the new technique, which involves infusing large amounts of liquid chemotherapy under the skin to kill the cancer tumours as they spread.

The technique is called isolated limb infusion (ILI) and has proved very effective in Sydney, where hundreds of patients have been treated.

When skin cancer is initially diagnosed, it is usually just one tumour. Around 80 per cent of patients have no recurrence, but when melanoma returns it tends to come back in clusters in a small area.

Because malignant melanoma can become extremely aggressive, spreading quickly and threatening the life of the patient, those with recurrent malignant melanoma on their limbs often face amputation.

ILI involves temporarily cutting off the blood supply to the lower limb by use of a tourniquet, which prevents the highly toxic cancer chemicals reaching the rest of the body.

Then, for an hour, while under general anaesthetic, a litre of chemotherapy drugs is pumped under the skin through an artery in the groin or upper arm. The drugs are then flushed out of the limb, but the residue continues to work through the body tissue.

Eleanor Ogden, a 72-year- old grandmother from Church Aston, Shropshire, has become the first person in Europe to undergo the treatment at Birmingham University Hospital.

Consultant dermatologist Jerry Marsden went to Sydney to study the technique.

'I had the treatment about six weeks ago and it seems to be working,' said Mrs Ogden. 'There was no pain and I didn't feel sick or sleepy.'

Dr Marsden said the new technique will benefit those getting repeated cancers, like Mrs Ogden, as it widens their treatment options.

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Breakthrough Blood Test Predicts Schizophrenia Risk, Best Treatments

Scientists say they have developed a breakthrough new blood test for schizophrenia — a chronic brain disorder that often causes delusions, hallucinations and disorganized speech.

The test, featured Thursday in Molecular Psychiatry, is said to evaluate a person's risk for developing schizophrenia and identify the most effective treatment for that individual by analyzing biomarkers in their blood.

"Schizophrenia is hard to diagnose, especially early on, and matching people to the right treatment from the beginning is very important," Dr. Alexander Niculescu, the senior author of the Indiana University School of Medicine study, said in a statement.

"Psychosis usually manifests in young adulthood — a prime period of life," Niculescu continued. "Stress and drugs, including marijuana, are precipitating factors on a background of genetic vulnerability. If left unchecked, psychosis leads to accumulating biological damage, social damage and psychological damage."

As many as 3.5 million Americans have been diagnosed with schizophrenia, which often presents between the late teen years and early 30s, statistics show.

Scientists say they have developed a breakthrough new blood test for schizophrenia — a chronic brain disorder that often causes delusions, hallucinations and disorganized speech. Angellodeco – stock.Adobe.Com

Researchers tested the blood of psychiatric patients they followed for over a decade and identified biomarkers that were predictive of extreme hallucinations and delusions and psychiatric hospitalizations related to these symptoms.

They then studied which biomarkers would be best treated by certain medications.

As many as 3.5 million Americans have been diagnosed with schizophrenia, which often presents between the late teen years and early 30s, statistics show. Angellodeco – stock.Adobe.Com

"Fortunately, biologically some of the existing medications work quite well if initiated early in the right patients," Niculescu explained.

"Social support is also paramount, and once that and medications are in place, psychological support and therapy can help as well," he continued. "There is still plenty left to understand and apply about cognition and its abnormalities, but there is reason for optimism in this era of emerging precision psychiatry."

The test is anticipated to be commercially available later this year.

Previous research has shown that fingerprint images may also have potential as predictors of schizophrenia.

A 2022 study used a machine learning-based process known as a convolutional neural network to find abnormalities in the fingerprints of people known to have schizophrenia.

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