Bronchiectasis: An In-Depth Review of Pathogenesis, Diagnostic Approaches, And Management Strategies

Bronchiectasis is a chronic and heterogeneous respiratory disorder marked by permanent dilatation of the bronchi, recurrent infections, and persistent airway inflammation. Once considered a neglected disease, its prevalence is now recognized as rising globally, posing significant challenges to patient quality of life and healthcare systems. The condition arises from a vicious cycle of impaired mucociliary clearance, microbial colonization, and neutrophil-driven inflammation, with various underlying causes ranging from post-infectious damage to immune deficiencies and comorbid conditions. High-resolution computed tomography remains the gold standard for diagnosis, offering detailed visualization of airway dilatation and structural abnormalities. Current management relies mainly on airway clearance techniques, antibiotic therapy for chronic bacterial infection, and control of exacerbations, with surgery considered only in selected cases. Despite these measures, there is no approved disease-modifying treatment for bronchiectasis. This review summarizes the current knowledge of the pathogenesis, diagnostic challenges, and therapeutic strategies for bronchiectasis