Understanding Bronchiectasis and MACI was diagnosed with two lung conditions--bronchiectasis (BE) and a Mycobacterium Avium Complex lung infection (MAC-LD).  Not long ago, both were considered rare. Today, thanks to better medical education and the widespread use of high-resolution CT scans, BE is being diagnosed more often. MAC, however, remains less common. These bacteria are present everywhere in our environment, but in most people they do not cause disease. The “Chicken or the Egg” QuestionWhen someone is diagnosed with both bronchiectasis and a MAC infection, doctors often describe it as a “chicken or the egg” scenario. Did the lung damage from bronchiectasis create an environment that allowed MAC to thrive, or did MAC infection trigger the development of BE? Risk Factors and Root CausesClues sometimes come from a person’s medical and lifestyle history. Pneumonia or chronic bronchitis, for example, can scar the lungs and lead to BE. In other cases, genetic factors may play a role. Occasionally, identifying these underlying conditions opens the door to targeted treatment. How My Story UnfoldedAlthough nothing is certain in my situation, I likely developed bronchiectasis after a severe pulmonary infection in my mid-50s. That inflammation may have made my lungs more vulnerable to MAC. And because MAC is everywhere—in soil, water, and air—exposure is difficult to avoid. For instance, during the years my husband and I lived upstate, I kept a large flower garden and regularly spread mulch. MAC thrives in mulch, which can easily become airborne and inhaled. Clearing a MAC Infection Through Self-CareFortunately, I was able to clear the MAC infection with a strong commitment to airway clearance, regular exercise, maintaining a healthy weight, and consistent stress management. These daily practices gave my body the best chance to heal and stay resilient. Why I Focus on Bronchiectasis in My BookIn my book, The BE CLEAR Method to Living with Bronchiectasis, I briefly share my “double-whammy” experience but focus primarily on bronchiectasis. That was intentional—many people with BE will never develop MAC or other Nontuberculous Mycobacterial (NTM) infections. Reducing Risk in Everyday LifeStill, it’s important to talk about practical prevention. Simple steps, like wetting soil before gardening and wearing a mask while working outdoors, can reduce exposure and give peace of mind to those who want to be proactive. Build Your Own Bronchiectasis Self-Care PlanIf you would like help putting together a daily self-care management program, I can support you. As an experienced health educator and coach, I’ve worked with hundreds of individuals to create personalized plans that fit their lifestyle—covering airway clearance routines, exercise, nutrition, stress management, and long-term wellness strategies.
Together, we can build a program that helps you feel more in control of your health and confident in your day-to-day life.
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The past several days have been nothing short of inspiring for the bronchiectasis and NTM community.  Between new research updates, clinical insights, and groundbreaking treatment news, we have so much to be hopeful about! It all began with a powerful video from Dr. Charles Daley of National Jewish Health, who was speaking with a patient group in Florida. His focus? The newly FDA-approved medication for bronchiectasis: Brensocatib (brand name BRINSUPRI™). Why This MattersFor decades, people living with bronchiectasis have had limited treatment options beyond airway clearance and antibiotics. The FDA’s approval of Brensocatib marks the first new therapy specifically approved for non-CF bronchiectasis, and the ripple effects are already being felt in the bronchiectasis care centers across the country. Dr. Daley explained that at National Jewish Health, clinicians will begin prescribing Brensocatib to patients who are most likely to benefit—including those who struggle with chronic infections like nontuberculous mycobacteria (NTM). Even more importantly, NJH will collect data from these patients to help determine the drug’s long-term effectiveness across different subgroups. A Standout FindingWhat truly lit up the conversation was one of the most exciting results from the pivotal clinical trial:
A New Chapter of HopeThese updates (see video for complete talk) remind us that the field of bronchiectasis care is finally moving forward. We are not standing still. From clinical trials to FDA approval to real-world prescribing, there is momentum, hope, and possibility taking shape. For patients, caregivers, and clinicians alike, this is the beginning of a new chapter—one where the words “stable lung function” carry the promise of more time, more strength, and more opportunities to live fully. Click to learn more about BE CLEAR resources, including the book and individual consultations. In patient education webinars, bronchiectasis expert Dr. James Chalmers often shares his enthusiasm for sputum.  One of his favorite teaching tools is a sputum color chart 💛💚💛—and for good reason. Why Mucus MattersMucus is part of the body’s defense system, trapping bacteria and harmful particles before they reach the lungs. But mucus also acts as a signal: when infection strikes, it can become thicker and shift toward a darker or greenish color. This change is caused by the release of myeloperoxidase (MPO), an enzyme from immune cells called neutrophils. MPO is powerful—it produces reactive oxidants such as hypochlorous acid to kill pathogens and helps form neutrophil extracellular traps (NETs) to capture microbes. While essential in fighting infection, excessive MPO activity can damage lung tissue and fuel chronic inflammation. |
AuthorLinda Cooper Esposito, MPH is a health educator with bronchiectasis. She developed the BE CLEAR Method to Living with Bronchiectasis and writes with compassion and humor about this chronic lung disease. Archives
November 2025
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