# Therapies for bronchiectasis: mechanisms and potential effects

**Authors:** Long Yu, Hong-rui Zhu, Xue-hang Jin, Jin Ding, Ting Jin

PMC · DOI: 10.3389/fimmu.2026.1735598 · Frontiers in Immunology · 2026-02-18

## TL;DR

This paper reviews new therapies for bronchiectasis, focusing on their mechanisms and potential effects to improve treatment options.

## Contribution

The paper provides a detailed review of emerging therapies and emphasizes the need for precision medicine in bronchiectasis treatment.

## Key findings

- Current therapies for bronchiectasis have limited evidence of efficacy.
- Emerging therapies focus on anti-inflammatory, mucociliary clearance, and anti-infectious effects.
- Future efforts should prioritize patient stratification and precision medicine approaches.

## Abstract

Bronchiectasis is a complex and heterogeneous disease, and our current understanding of its pathophysiological mechanisms remains in its infancy. Currently, few specifically approved treatments for non-cystic fibrosis bronchiectasis are applied globally, and most guideline-recommended therapies have limited evidence of efficacy. Consequently, the development of new treatment methods is particularly urgent. To gain insight into new drugs under clinical development for adults with bronchiectasis, we conducted a review of the scientific literature and clinical trial registries. In this review, we discuss in detail the mechanisms and potential effects of these emerging therapies, which focus on their anti-inflammatory effects, enhancement of mucociliary clearance, and anti-infectious effects. Clinical research has revealed significant variability among patients, suggesting the need for a multidisciplinary and comprehensive approach. Future efforts should focus on patient stratification using biomarkers and clinical assessments, with an emphasis on precision medicine. Furthermore, it is essential to develop new antibiotics, innovative neutrophil-targeted therapies, and effective mucus-clearing agents to alleviate patient disease burden and minimize the risk of exacerbations.

## Linked entities

- **Diseases:** bronchiectasis (MONDO:0004822), cystic fibrosis (MONDO:0009061)

## Full-text entities

- **Genes:** PDE4A (phosphodiesterase 4A) [NCBI Gene 5141] {aka DPDE2, PDE4, PDE46}, MUC5B (mucin 5B, oligomeric mucus/gel-forming) [NCBI Gene 727897] {aka MG1, MUC-5B, MUC5, MUC9}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, CXCL1 (C-X-C motif chemokine ligand 1) [NCBI Gene 2919] {aka FSP, GRO1, GROa, MGSA, MGSA-a, NAP-3}, PRTN3 (proteinase 3) [NCBI Gene 5657] {aka ACPA, AGP7, C-ANCA, CANCA, MBN, MBT}, CTSC (cathepsin C) [NCBI Gene 1075] {aka CPPI, DPP-I, DPP1, DPPI, HMS, JP}, CSF2 (colony stimulating factor 2) [NCBI Gene 1437] {aka CSF, GMCSF}, CXCR2 (C-X-C motif chemokine receptor 2) [NCBI Gene 3579] {aka CD182, CDw128b, CMKAR2, IL8R2, IL8RA, IL8RB}, SERPINA1 (serpin family A member 1) [NCBI Gene 5265] {aka A1A, A1AT, AAT, PI, PI1, PRO2275}, ELANE (elastase, neutrophil expressed) [NCBI Gene 1991] {aka ELA2, GE, HLE, HNE, NE, PMN-E}, EDN1 (endothelin 1) [NCBI Gene 1906] {aka ARCND3, ET1, HDLCQ7, PPET1, QME}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, CXCR1 (C-X-C motif chemokine receptor 1) [NCBI Gene 3577] {aka C-C, C-C-CKR-1, CD128, CD181, CDw128a, CKR-1}, MUC5AC (mucin 5AC, oligomeric mucus/gel-forming) [NCBI Gene 4586] {aka MUC5, TBM, leB, mucin}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, CFTR (CF transmembrane conductance regulator) [NCBI Gene 1080] {aka ABC35, ABCC7, CF, CFTR/MRP, MRP7, TNR-CFTR}, CTSG (cathepsin G) [NCBI Gene 1511] {aka CATG, CG}
- **Diseases:** respiratory diseases (MESH:D012140), Bronchiectasis (MESH:D001987), bacterial colonization (MESH:D015179), PA infection (MESH:D011552), chronic sinusitis (MESH:D012852), eosinophil depletion (MESH:D017681), mycobacterial infections (MESH:D009165), lung infections (MESH:D012141), disease (MESH:D004194), Inflammatory (MESH:D007249), bronchial fibrosis (MESH:D005355), rheumatoid arthritis (MESH:D001172), epithelial dysfunction (MESH:D009375), common variable immunodeficiency (MESH:D017074), alpha-1 antitrypsin deficiency (MESH:D019896), cough (MESH:D003371), airway disruption and dysfunction (MESH:D019958), CF (MESH:D003550), asthma (MESH:D001249), allergic bronchopulmonary aspergillosis (MESH:D001229), decreased lung function (MESH:D055370), eosinophilia (MESH:D004802), mucus clearance (MESH:C565366), dyspnea (MESH:D004417), infected (MESH:D007239), idiopathic (MESH:D002311), NTM-PD (MESH:D008171), COVID-19 (MESH:D000086382), chronic bronchitis (MESH:D029481), hypertrophy (MESH:D006984), Sjogren's syndrome (MESH:D012859), COPD (MESH:D029424), systemic (MESH:D015619), tuberculosis (MESH:D014376), Mucociliary dysfunction (MESH:D006331), pneumonia (MESH:D011014), primary ciliary dyskinesia (MESH:D002925), bacterial infections (MESH:D001424), Mounier-Kuhn syndrome (MESH:D014137), autoimmune diseases (MESH:D001327), inflammatory bowel disease (MESH:D015212), nasal polyps (MESH:D009298), infectious (MESH:D003141), human immunodeficiency virus infection (MESH:D015658), damage to the airways (MESH:D000402), fungal infections (MESH:D009181), Genetic disorders (MESH:D030342), immune deficiency syndromes (MESH:D000081207)
- **Chemicals:** atorvastatin (MESH:D000069059), aztreonam (MESH:D001398), leukotriene B4 (MESH:D007975), sodium (MESH:D012964), Anti (-), benralizumab (MESH:C571386), Azithromycin (MESH:D017963), saline (MESH:D012965), ciprofloxacin (MESH:D002939), bicarbonate (MESH:D001639), theophylline (MESH:D013806), formoterol (MESH:D000068759), beclomethasone (MESH:D001507), macrolide (MESH:D018942), carbapenem (MESH:D015780), ceftazidime (MESH:D002442), Brensocatib (MESH:C000619932), S-1226 (MESH:C000718177), Roflumilast (MESH:C424423), carbocisteine (MESH:D002233), water (MESH:D014867), CO2 (MESH:D002245), glutathione (MESH:D005978), PFOB (MESH:D005466), mannitol (MESH:D008353), BAY85-8501 (MESH:C000606490), budesonide (MESH:D019819), tiotropium (MESH:D000069447), reactive oxygen species (MESH:D017382), AZD9668 (MESH:C568080), tobramycin (MESH:D014031), ascorbic acid (MESH:D001205), gentamicin (MESH:D005839), AZD5069 (MESH:C000597960), POL6014 (MESH:C000718548)
- **Species:** Haemophilus influenzae (species) [taxon 727], Klebsiella pneumoniae (species) [taxon 573], Homo sapiens (human, species) [taxon 9606], Staphylococcus aureus (species) [taxon 1280], Pseudomonas aeruginosa (species) [taxon 287], Streptococcus pyogenes (species) [taxon 1314], Streptococcus pneumoniae (species) [taxon 1313]

## Full text

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## Figures

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## References

111 references — full list in the complete paper: https://tomesphere.com/paper/PMC12956706/full.md

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Source: https://tomesphere.com/paper/PMC12956706