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That possibility is no longer just wishful thinking—it may soon become a practical reality, with multiple testing options on the horizon.  Why Diagnosing NTM-PD in Bronchiectasis Is So Challenging Since NTM pulmonary disease (NTM-PD) is a treatable cause of bronchiectasis, international guidelines recommend testing sputum for mycobacteria during both initial evaluations and follow-up visits. But diagnosis can be tricky. Many people with bronchiectasis struggle to produce sputum, and traditional culture tests are not only time-consuming but also have low sensitivity. To complicate matters, the symptoms and CT scan findings of NTM-PD often overlap with those of bronchiectasis alone—making underdiagnosis a very real concern. Led by Dr. Chalmers and European Researchers A recent study titled Clinical Efficacy of Serum Antiglycopeptidolipid Core IgA Antibody Test for Screening Nontuberculous Mycobacterial Pulmonary Disease in Bronchiectasis: A European Multicenter Cohort Study, brings promising news. Led by Dr. James Chalmers and colleagues, the study analyzed data from 282 bronchiectasis patients. The results? Antibody levels were highly accurate in identifying individuals with true NTM-PD. Just as importantly, the test could distinguish those with active disease from patients with NTM isolation who didn’t meet diagnostic criteria. Why a Blood-Based Test Could Be a Breakthrough This could be a meaningful breakthrough for our bronchiectasis community. For those of us who can’t easily produce sputum, a blood test could one day replace the need for invasive bronchoscopies or help avoid unnecessary antibiotics. And in a community already burdened with anxiety, quicker and more accurate answers could mean less stress and peace of mind. Like I always say--stay the course. Help is on the way. Thank you, Dr. James Chalmers—aka Dr. Bronchiectasis. You are there for us every step of the way. #Bronchiectasis #NTMPD #NTMinfection #LungHealth #RespiratoryHealth #ChronicIllness #RareDisease #PulmonaryCare
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Bacteriophages, or phages, are viruses that specifically target and destroy bacteria. These microscopic entities outnumber all other organisms on Earth and thrive in diverse environments, including ponds, lakes, and oceans.  Phages exhibit a unique structure, often resembling tiny robotic explorers with a 20-sided head mounted on a tail equipped with leg-like fibers. This design enables them to attach to specific bacterial hosts, inject their genetic material, and hijack the bacterium’s machinery to produce new phages, ultimately leading to the destruction of the bacterial cell. (Microbe Notes – Bacteriophage Structure & Function) A Brief History of Phage Therapy The discovery of bacteriophages dates back to 1915 when British bacteriologist Frederick Twort observed their antibacterial properties. Two years later, Félix d’Hérelle independently identified these viruses and recognized their potential as antibacterial agents. D’Hérelle pioneered phage therapy, establishing treatment centers across Eastern Europe. However, the advent of antibiotics—particularly penicillin, discovered by Alexander Fleming in 1928—led to a decline in the popularity of phage therapy in Western medicine. (ScienceDirect – History of Phage Therapy) The Resurgence of Phage Therapy Amid Antibiotic Resistance With the alarming rise of antibiotic-resistant bacteria, phage therapy is experiencing a renaissance. Phages offer a targeted approach to combating bacterial infections, especially those resistant to conventional antibiotics. Unlike broad-spectrum antibiotics, phages can be tailored to attack specific bacterial strains, reducing collateral damage to beneficial microbiota and minimizing the risk of resistance development. (ScienceDirect – Phage Therapy and Antibiotic Resistance) Recent Advances: Armata Pharmaceuticals’ AP-PA02 A notable advancement in phage therapy is the development of AP-PA02 by Armata Pharmaceuticals. This inhaled bacteriophage therapy targets Pseudomonas aeruginosa infections in patients with non-cystic fibrosis bronchiectasis. The Phase 2 Tailwind study demonstrated that AP-PA02 was well-tolerated and showed potential in reducing reliance on chronic antibiotics. Encouraged by these results, Armata is progressing toward a Phase 3 clinical trial, marking a significant step forward in the application of phage therapy for respiratory infections. (PR Newswire – Tailwind Study Results) The Future of Phage Therapy The renewed interest in phage therapy underscores its potential as a viable alternative or adjunct to antibiotics. As research advances, phage therapy may play a crucial role in personalized medicine, offering targeted treatments for bacterial infections that are unresponsive to traditional antibiotics. Continued clinical trials and regulatory support will be essential to integrating phage therapy into mainstream medical practice. (Journal of Intensive Care – Current Status of Phage Therapy) #PhageTherapy #Bacteriophage #Bronchiectasis #Phage #Pseudomonas #Biologic FDA Grants Priority Review to Brensocatib: A Potential Breakthrough for Bronchiectasis Treatment  On February 6, 2025, the U.S. Food and Drug Administration (FDA) accepted Insmed Incorporated’s New Drug Application (NDA) for brensocatib, granting it Priority Review status.This designation accelerates the regulatory timeline, setting a target PDUFA action date of August 12, 2025, under the Prescription Drug User Fee Act (PDUFA). Brensocatib: A First-in-Class DPP1 Inhibitor Brensocatib is an oral, reversible inhibitor of dipeptidyl peptidase 1 (DPP1), an enzyme responsible for activating neutrophil serine proteases (NSPs) such as neutrophil elastase. By blocking DPP1, brensocatib aims to reduce NSP activity, which in turn may help decrease inflammation and tissue damage in the lungs. Addressing an Unmet Need in Bronchiectasis Non-cystic fibrosis bronchiectasis is a chronic lung disease marked by permanent airway dilation, frequent infections, and excessive inflammation. Despite its rising prevalence—affecting over 500,000 people in the U.S.--there are currently no FDA-approved treatments specifically for this condition. Brensocatib has the potential to:
Promising Results from the ASPEN Study The NDA submission is backed by data from the Phase 3 ASPEN study—the largest clinical trial ever conducted in patients with bronchiectasis. The study showed that both 10 mg and 25 mg doses of brensocatib significantly reduced the annualized rate of pulmonary exacerbations compared to placebo over a 52-week period. 📄 View Insmed’s ASPEN Study press release. Brensocatib also demonstrated consistent benefits across diverse patient subgroups, suggesting wide applicability. Looking Ahead With FDA Priority Review, brensocatib could soon offer a long-awaited, disease-modifying treatment for patients living with non-cystic fibrosis bronchiectasis. If approved by August 2025, it would mark a major advancement in care, offering hope to those affected by this underrecognized and difficult-to-treat condition. 🧠 Learn more about brensocatib’s mechanism and development on ClinicalTrials.gov. #Brensocatib #Bronchiectasis #FDAReview #DPP1Inhibitor #PulmonaryHealth #Insmed #ASPENStudy Biologics are therapies made from living organisms or their components—such as proteins, cells, or bacteria.  Unlike traditional drugs made through chemical synthesis, biologics are developed using biotechnology. This allows them to target disease processes more precisely, often resulting in better outcomes and fewer side effects for certain conditions.
🧬 Learn more about how biologics are made and approved from the U.S. Food and Drug Administration (FDA). You’ve Probably Already Had a Biologic If you’ve received a vaccine, you’ve already experienced a biologic therapy in action. Vaccines for:
A Personal Note: How the HPV Vaccine Changed My Perspective More than 25 years ago, I had a hysterectomy following a diagnosis of cervical carcinoma in situ caused by HPV. At that time, the HPV vaccine didn’t exist. Today, it gives me peace of mind knowing that my grandchildren are protected against this cancer-causing virus, thanks to the development of preventive biologics. 📖 Read more about the HPV vaccine’s role in cancer prevention from the National Cancer Institute. Biologics in Chronic Illness Care Biologics aren’t just for disease prevention—they’re also used to treat a variety of chronic inflammatory and autoimmune conditions, including:
Are Biologics Being Studied for Bronchiectasis? Yes—and that’s where it gets exciting. While no biologics are currently FDA-approved specifically for bronchiectasis, researchers are exploring their potential role in managing bronchiectasis with asthma, allergies, or eosinophilic inflammation—a common combination in clinical practice. Biologics currently being studied or used for off-label treatments have shown promising results in small studies and case reports involving: Patients with these conditions may experience:
While biologics are powerful, they’re also extensively tested. As with any treatment, side effects are possible—but today’s biologics are held to high safety standards. In fact, biologics are often used when standard treatments fail or when precision is needed to avoid broader immune suppression. Biologics Are Already Changing Lives From vaccines to advanced immune therapies, biologics are transforming how we prevent, treat, and manage disease. And while they may sound “new” or “intimidating,” they’ve been part of mainstream medicine for decades—and they’re only getting better. If you live with bronchiectasis, asthma, or a chronic inflammatory condition, biologics may be an option worth discussing with your care team—especially if standard therapies aren’t enough. #BiologicsExplained #BronchiectasisCare #FutureOfMedicine #AsthmaOverlap #ChronicInflammation |
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
May 2025
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