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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 ChallengingSince 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 ResearchersA 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 BreakthroughThis 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.
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Let’s be honest—managing bronchiectasis can feel like a full-time job some days: ⭐️4 small meals a day ⭐️Twice-daily airway clearance ⭐️Exercise ⭐️Managing reflux It sounds like mission impossible, right?  But don’t worry—there’s a simple trick that can really help:
🛟 RefluxRaft to the Rescue! When you’re short on time and still need to fit in airway clearance or exercise, RefluxRaft can give you an extra layer of support. Here’s how it works: A teaspoon of this alginate-based supplement after meals (and before you get moving) creates a natural “raft” that floats on top of your stomach contents. This helps prevent reflux — especially when you don’t have 3 hours to wait. It’s made from seaweed (yes, really!) and forms a gentle, protective barrier to help prevent reflux. ✨Personal Tip:✨ I’ve been using RefluxRaft for months and like both the Lemon Ginger and Berry Burst flavors. Most importantly—they work‼️ Want to try It? Here’s a little bonus for you: 👉 Save with this discount link! https://refluxraft.com/discount/BECLEAR As always, talk with your medical team before changing your current care! Proud collaboration between BE CLEAR with Bronchiectasis, LLC and RefluxRaft. I wouldn’t exactly call myself a handy person—but I do love the idea of having toolkits to manage bronchiectasis. One for infections, another for reflux (which can drive disease progression), and of course, my favorite: an airway clearance toolkit.  When I meet with clients, I often present information this way—packaged in practical, easy-to-understand terms. Not a one-size-fits-all approach, but rather a collection of tools they can explore with their medical team to figure out what works best for them.
In my latest YouTube video, I talk about the airway clearance toolkit. It’s not a deep dive into any one method (I do that in other videos – 119 altogether‼️), but a big-picture overview of the many tools available: breathing techniques, oscillatory PEP (OPEP) devices, vibration, vests, massagers, and most importantly—a relaxed, flexible attitude about getting mucus out. Because as we know, the process is often just as important as the outcome. Even if nothing “comes up” during a session, you’re still helping to mobilize mucus, improve airflow, and disrupt bacterial biofilms. And since I like to keep things light—even when talking about serious topics like airway clearance—I like to imagine the pathogens in my lungs getting a clear message: there’s a cop on the beat. The lungs aren’t sterile (we’ve known that for over 15 years), but I’m not letting anything get too cozy. I’ll hit them with hypertonic saline, shake things up with my vest and Aerobika, and generally create a very unpleasant environment for any bugs thinking of settling down. This is one of my longer videos—nearly 20 minutes—and there aren’t a ton of visuals, so it’s perfect to listen to while cooking, folding laundry, tackling other household chores or better yet, taking a walk. BE CLEAR with Bronchiectasis, LLC has a consulting relationship with Monaghan Medical Corp. The BE CLEAR Method to Living with Bronchiectasis — Discover the book that’s changing lives‼️ Living with bronchiectasis can be overwhelming—but you’re not alone.  In this empowering guide, patient educator Linda Esposito, MPH, introduces her BE CLEAR system: a seven-part program designed to help you manage your symptoms, put important systems in place, and live well with bronchiectasis.
The BE CLEAR Method combines evidence-based medical insights with practical lifestyle strategies, covering everything from airway clearance and infection control to nutrition, exercise, and emotional well-being. This isn’t just a book—it’s a roadmap to a more confident, informed life. Why Readers Recommend This Book: “This book is a godsend. I finally feel seen and understood.” — Carolyn H. “I’ve been living with bronchiectasis for over 10 years, and I still learned new things in every chapter.” — James R. “If you feel alone or confused about your diagnosis, read this. It’s like having a wise, kind friend walk you through it all.” — Alicia M. What You’ll Gain: ⭐ Clear, concise strategies for airway clearance and infection management ⭐ Insights into nutrition and self-care tailored for bronchiectasis ⭐ Guidance on building a supportive care team ⭐ A sense of empowerment and hope Join the community of readers who have found clarity and confidence through The BE CLEAR Method. Buy Now: The BE CLEAR Method to Living with Bronchiectasis on Amazon ⭐ Many of us in the bronchiectasis community have followed the development of brensocatib for years — from the promising results of the Phase 2 WILLOW trial to the eagerly awaited findings of the Phase 3 ASPEN trial.  While preliminary results were publicly shared last year and widely discussed at the 2023 Bronchiectasis World Conference in Dundee, Scotland, the news has now reached a significant milestone: the findings have been formally published in The New England Journal of Medicine — one of the most respected and influential medical journals in the world.
I knew this publication was on the horizon. Dr. Chuck Daley, a key voice in bronchiectasis care and research, has referenced it in multiple recent talks. Seeing it in print is a powerful moment — not just for him and the incredible research teams involved, but for all of us living with the daily challenges of bronchiectasis. It represents hope, validation, and real scientific momentum. As always, let’s stay the course while we wait for what may come next. That means keeping our weight in a healthy range, choosing nutrient-rich foods, doing our daily airway clearance, exercising regularly, managing GERD, and just as importantly — having faith, staying connected, and taking deep breaths when we need to. Because now more than ever, it feels like help is on the way. You’ve probably heard the old saying, “Laughter is the best medicine.” But did you know that this isn’t just feel-good fluff? Norman Cousins, former editor of The Saturday Review, brought this idea to the forefront in his groundbreaking 1979 book, Anatomy of an Illness. Faced with a painful degenerative condition and grim odds of recovery, Cousins took his healing into his own hands—with humor.  He created his own laughter therapy, watching classic comedies like Candid Camera, The Three Stooges, and The Marx Brothers.
The results were remarkable: not only did his pain decrease, but he credited laughter as a significant part of his remission. Cousins’ personal experiment was so compelling that it was published in the New England Journal of Medicine. Although many in the medical community were initially skeptical, researchers began to take note. In the 1980s, preventive care specialist Dr. Lee Berk led studies showing that laughter reduces stress hormones and supports immune function. The science was catching up to the smiles. Then in 1995, Dr. Madan Kataria of Mumbai took it a step further with the creation of the first Laughter Yoga club. His practice, which combines deep breathing, clapping, and playful group exercises, quickly went global. Thousands of laughter yoga clubs exist today, encouraging people to laugh—not just as a reaction, but as a practice. I experienced this firsthand during a Laughter Yoga class I stumbled into while on vacation. At first, I was hesitant. The idea of forced laughter felt, well, kind of ridiculous. But after a few deep breaths and shared silly “hee hee, ha ha ha” chants with a group of strangers, something shifted. We ended up in real, full-belly laughter—and I walked away feeling lighter, calmer, and more connected. This experience reminded me of something easy to forget when managing a chronic condition like bronchiectasis: healing isn’t just about what you do—it’s about how you feel while doing it. For those of us living with bronchiectasis, the day-to-day can become consumed by managing symptoms--airway clearance routines, staying on top of medications, navigating fatigue, and trying to keep inflammation and infections at bay. Add to that the ongoing effort of staying active and eating well, and the weight of it all can start to dull our joy. That’s why balance is so critical. Yes, airway clearance is essential—it keeps our lungs moving and helps prevent exacerbations. Exercise builds respiratory strength and endurance, and healthy cooking fuels our bodies with nutrients that support immunity and recovery. But just as vital is making room for stress reduction and, yes, even fun. Laughter, relaxation, and shared joy aren’t extra—they’re therapeutic. The Mayo Clinic backs this up, noting that laughter reduces stress, soothes tension, improves mood, and even boosts immunity. And for people with bronchiectasis, every bit of stress relief counts. Chronic stress can compromise immune function, increase inflammation, and make symptoms feel heavier. So, what does this look like in real life? It might be building a weekly rhythm that includes:
When we frame laughter and joy as part of our self-care, not a distraction from it, we begin to feel whole again—not just as people with a diagnosis, but as full human beings who need connection, levity, and balance. So today, let’s not only commit to our health routines—but also to our happiness. Whether it’s a belly laugh or a gentle chuckle, may you find a moment of joy and let it breathe new life into your lungs. Feeling tired? No pep? Short of breath more than in the past? If everyday tasks seem daunting due to fatigue and weakness, consider pulmonary rehab to regain your strength.  Pulmonary rehabilitation isn’t just about breathing exercises, it’s a holistic approach to revitalizing your overall well-being with exPercise classes, nutritional guidance, and improving airway clearance techniques.
With an array of options available, including online programs, finding the right pulmonary rehabilitation program will require a little research. Seek recommendations from your doctor or explore centers affiliated with hospitals or bronchiectasis specialists. Benefits of Pulmonary Rehabilitation: 🌟Boosts your stamina 🌟Improves Quality of Life 🌟Reduces breathlessness 🌟Strengthens respiratory muscles 🌟Improves self-management Remember, if you feel you are in a downward spiral, you need to take action to stop it. Even a small step in the right direction can make a big difference. Once you’ve completed your program, my book, The BE CLEAR Method to Living with Bronchiectasis has 10 exercises to help you stay strong and breathe better. Additionally, the BE CLEAR with Bronchiectasis YouTube channel I have gentle exercise routines. If you have a Gmail account, you can subscribe to my channel and be notified when a new video is available. #pulmonaryrehab #bronchiectasis #COPD #exercise I shared with my 24-year-old granddaughter how much I dislike promoting my book, consultation services, and YouTube channel. She looked at me and said, “But why, Grandma? If you believe in the work you’ve done and know it’s helping people, why feel embarrassed about sharing it?"  She had a point. My book, The BE CLEAR Method to Living with Bronchiectasis, has made a difference for thousands of people since its publication in 2021.
I also regularly receive heartfelt emails from clients after consultations, expressing gratitude for the personalized guidance. Many share how they’ve gained a sense of control over their condition. With tailored suggestions designed for their unique lifestyles, they’re able to see a clear path forward—one that shows how they can live a full and active life while managing bronchiectasis. Then there’s the BE CLEAR with Bronchiectasis YouTube channel, which now features over 100 videos—a completely free resource for subscribers. Even though it may be years before I earn income from it, the real reward comes from knowing that people across the globe—especially those without local resources—are getting the tools and knowledge they need to better care for themselves. So, inspired by my granddaughter’s wisdom, I’m embracing the importance of sharing. If you or someone you care about could benefit from these resources, please check them out! With these BE CLEAR tools, we can kick off a renewed determination and a deeper commitment to living our best life. 🩵The BE CLEAR Method book is available on Amazon 💙Right here on my website letsbecleartoday.com, you can schedule a consultation: 💛Visit the BE CLEAR with Bronchiectasis YouTube channel for lots of FREE tutorials on how to stay our healthiest!! Please spread the word in your bronchiectasis and NTM Lung Disease support groups and on social media about these resources⭐️❤️⭐️❤️ In this video, I show exactly how I treat the showerhead while staying in a rental condo—a practical tip that some of you may find helpful for travel or even as a long-term solution at home.  How I Stay Safe from Waterborne Pathogens—Even in a Rental Shower
These kinds of precautions might not be necessary for everyone, and they’re always best discussed with your healthcare provider.That said, if you’ve been told, “You can’t really avoid waterborne exposure,” or “There’s nothing you can do in a rental,” I invite you to see for yourself. You be the judge! Why This Matters: Insights from Dr. Joseph Falkinham on Shower Safety Dr. Joseph Falkinham—an environmental microbiologist and one of the leading researchers on nontuberculous mycobacteria (NTM)—has spent decades studying how these bacteria, including Mycobacterium avium complex (MAC), thrive in household water systems. 🔬Key Takeaways from Dr. Falkinham’s Research
💡 What You Can Do in a Rental House
Let’s Grow the BE CLEAR with Bronchiectasis YouTube Channel—Together! I’ve created over 100 free videos on the BE CLEAR YouTube channel to make helpful, accurate, and empowering information available to people living with bronchiectasis all over the world. One of the best features of YouTube is its built-in translation tools, making my content accessible to viewers in multiple languages. Whether you’re watching for yourself—or your dog enjoys the soothing sounds while you’re out running errands—every single view, share, and subscription helps the channel grow. 🎯 My goal: Reach 3,000 total watch hours so I can begin earning from the platform—and reinvest into creating even more educational content. 🙏 How You Can Help:
🧠 Final Thoughts Staying safe doesn’t have to be complicated—but it does require intention. With a little preparation and some trusted guidance, you can take small steps that make a big difference—whether you’re at home or on the go. I hope this video gives you something actionable, empowering, and even a little hopeful. Urinary incontinence—can affect anyone, but it’s especially common among women as we age or experience changes in our pelvic health.  What You Should Know About Urinary Incontinence—and What’s Helped Me MostFor some, it’s just a small leak when laughing or coughing. For others, it might be a bigger accident during physical activity or even while at rest. Common triggers include:
Are Kegels the Answer?Most people have heard of Kegel exercises, which involve squeezing and holding the pelvic floor muscles to improve strength and control. But let’s be honest--Kegels can be hard to get right. Without biofeedback or guidance from a pelvic floor therapist, many people are unsure if they’re doing them correctly. In fact, a biofeedback study found that up to 50% of women perform Kegels incorrectly without instruction. What Worked for Me: Functional Movement Over IsolationAfter having a hysterectomy in my 40s, I started experiencing occasional urinary leakage—especially when I had a bad cough or was active. Kegels alone didn’t help much, and honestly, I found them frustrating. That’s when I began focusing on functional movement and core integration—and everything changed. The exercises that helped me most included:
When I stay consistent with this approach, I rarely have leaks—even when I’m sick and coughing. Curious about what exercises to try? Check out The National Association for Continence or speak with a licensed pelvic floor physical therapist. Let’s Talk About ItUrinary incontinence can feel isolating, but it’s incredibly common—and very treatable. Whether you’re just noticing small leaks or dealing with more significant issues, you’re not alone. More open conversations lead to more awareness, more solutions, and less shame. Resources:PubMed: Pelvic Floor Muscle Training Study
#coughing #bronchiectasis #pelvicfloor #incontinence I switched to the Ombra compressor nebulizing system after noticing that it was consistently prescribed at National Jewish Health, one of the world’s leading lung hospitals.  When working with clients, I often demonstrate my own airway clearance routine but always recommend consulting a respiratory professional whenever possible. Unfortunately, many people don’t have access to specialized care in their communities and must rely on manufacturer inserts, online videos, and our education sessions together.
Dr. Charles Daley, a world-renowned expert on bronchiectasis and NTM disease, recently said: “The cornerstone of therapy is what is termed airway clearance. Part of the pathophysiology of bronchiectasis is the airways produce too much mucus. The airways get plugged up. That makes people cough, it makes their pulmonary function worsen, and also their risk for infection increase. So airway clearance, and when we when we talk about that, there are several ways we can improve airway clearance. We can give someone what are called Oscillating PEP valves. These are handheld devices that you breathe (into), and it causes some vibration in the airwaves. It causes some back pressure, and that helps open the airways and shear the thicker mucus, so so the patient can get it out. My favorite is the Aerobika used in tandem with the Aeroeclipse nebulizing cup. There are other things we can do. We can give them inhaled hypertonic saline, which can thin the mucus. Vests are (what) people wear that also vibrate and can help break up the mucus. So there’s different approaches. In the exact way we do it varies from patient to patient. One may be on one of those, one may be on all of those.” Let’s remember airway clearance isn’t one-size-fits-all—it requires the right tools and techniques for each person. When specialized care isn’t available, education and the right resources empower people to take charge of their lung health. www.letsbecleartoday.com BE CLEAR has a consulting relationship with Monaghan Medical Thirty-three U.S. centers join the new Bronchiectasis and NTM Care Center Network facilitating access to high-quality, specialized patient care for bronchiectasis and NTM lung disease.  www.emoryhealthcare.org/services/pulmonology/conditions/bronchiectasisMiami (March 12, 2025) – The Bronchiectasis and NTM Association has accepted 27 Care Center and six Clinical Associate Center sites in 23 states and the District of Columbia into the new Bronchiectasis and NTM Care Center Network (CCN).
The CCN aims to facilitate access to specialized care and support for the hundreds of thousands of people with bronchiectasis and nontuberculous mycobacterial (NTM) lung disease. “As the prevalence of bronchiectasis and NTM lung disease grows, it is even more important for us to create this Care Center Network to improve access to high-quality, specialty care and resources patients need,” said Doreen Addrizzo-Harris, M.D., Chair of the CCN Steering Committee. “The CCN’s innovative, nationwide network will help us achieve our goals of improving care and quality of life for those with these conditions, as well as advancing toward a cure.” Centers accepted into the CCN receive a designation of either a Bronchiectasis and NTM Care Center or a Bronchiectasis and NTM Clinical Associate Center, based on institutional resources and infrastructure. The requirements are established by the CCN’s Steering Committee, comprised of leading experts in the field. The new Bronchiectasis and NTM Care Center sites are:
The network will span 150 medical centers in diverse geographical locations nationwide over the next three years. For more information about the Bronchiectasis and NTM Care Center Network, visit www.bronchandntm.org. Let’s Talk Morning Routines! These are my top 3 products I use every morning. I thought I’d made a quick video to show you how and why they are my favorites! www.refluxraft.com/?utm_source=lindaesposito&utm_medium=social&utm_campaign=affiliate
💡 A Simple Tool to Help Manage Reflux and Protect Your Lungs Did you know that reflux and aspiration can contribute to worsening lung conditions like bronchiectasis? That’s why managing reflux is such an important part of my daily routine. One product I’ve added to my Reflux Tool Kit is RefluxRaft. It forms a protective raft-like barrier on top of stomach contents, helping to reduce acid reflux—especially after meals and while lying down. I personally use RefluxRaft after breakfast and before bed to help minimize the chance of aspiration into the lungs, which is a known risk factor for lung inflammation and damage in people with bronchiectasis. ✨ It’s become an essential part of my Reflux Tool Kit! Click here to learn more about RefluxRaft and how alginate therapy works to reduce reflux and support both digestive and respiratory health. ‼️ Important Note: As always, please consult your healthcare provider before making changes to your current care routine. BE CLEAR with Bronchiectasis, LLC is proud to collaborate with RefluxRaft. Traveling with Bronchiectasis: How I Minimize MAC Exposure from Water When I travel, I take extra precautions to reduce my risk of exposure to Mycobacterium avium complex (MAC).  Mycobacterium avium complex (MAC)—are a group of bacteria commonly found in water and soil that can be inhaled or aspirated into the lungs.
To stay safe, I either:
The answer lies in two common mechanisms:
We all occasionally micro-aspirate fluids—especially when something “goes down the wrong pipe.” For most healthy people, the lungs can clear these small amounts without issue. But for those of us with bronchiectasis, compromised mucociliary clearance makes it harder to remove aspirated material, which can lead to inflammation and chronic infection. Another risk factor is gastric reflux. Both acid and non-acid reflux can move from the stomach up into the esophagus and airways—especially during sleep. If this reflux contains MAC bacteria from drinking water that wasn’t neutralized by stomach acid, the lungs may be vulnerable to colonization. GERD Precautions to Lower Aspiration Risk If you’re managing GERD or concerned about silent reflux, here are some practical tips that may help:
To lower my exposure to environmental MAC bacteria, I avoid:
According to Dr. Joseph Falkinham, a leading microbiologist and expert on NTM exposure, “MAC thrives in biofilms in household water systems and is resistant to chlorine disinfection.” Finding Balance in Prevention Some bronchiectasis and MAC specialists take a more relaxed view on environmental exposure, suggesting patients avoid “bacteria fixation” and focus on quality of life. Others recommend more proactive strategies, especially for patients with recurrent infections or risk factors like GERD. Your care should be tailored. Talk to your pulmonologist or infectious disease specialist about what’s best for your health and lifestyle. Find support: NTM Info & Research – Find a Doctor 💙 A Reminder Bronchiectasis is a lifelong condition, but it doesn’t mean you need to overhaul everything at once. Even small steps—like changing your water source or elevating your bed—can make a meaningful difference in reducing risk and preserving lung health. 📌 Helpful Resources: 🚫 What to Avoid:
💡 Pro Tips:
 Save the date! Join Bronchiectasis/NTM Info & Research and Running on Air for an insightful webinar with Professor James Chalmers on the latest updates from the European Bronchiectasis Workshop & Forum on Respiratory Tract Infections. Meet Prof. James D. Chalmers: A Leading Authority on Bronchiectasis When it comes to advancing bronchiectasis care, few names are as influential as Professor James D. Chalmers. As the Asthma and Lung UK Chair of Respiratory Research at the University of Dundee, Prof. Chalmers has dedicated his career to improving outcomes for individuals living with bronchiectasis. He is best known for his leadership in the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC), an international research network that has transformed our understanding of bronchiectasis, and for serving as Chief Editor of the European Respiratory Journal. With over 350 peer-reviewed publications, Prof. Chalmers has made critical contributions to our understanding of the pathophysiology, diagnosis, and treatment of bronchiectasis. He is a key author of the European Respiratory Society (ERS) guidelines for the management of adult bronchiectasis, which offer clinicians trusted, evidence-based recommendations for bronchiectasis care. Professor Chalmers' Contribution to the Aspen Study Chalmers' groundbreaking work includes leading innovative clinical trials such as the ASPEN study involving Brensocatib, a potential first-in-class therapy targeting neutrophilic inflammation. For details on this trial, see the clinical trial registry entry for Brensocatib (NCT04594369). These studies are helping pave the way for precision medicine in bronchiectasis. Contribution to International Guidelines and Standards of Care Prof. Chalmers has also chaired and contributed to major international guidelines, including the 2017 ERS guidelines and the latest European Lung Foundation bronchiectasis management recommendations. His efforts continue to standardize care and improve quality of life for bronchiectasis patients around the world. Thanks to experts like Prof. Chalmers, the future of bronchiectasis care is looking brighter—with innovative therapies, patient-centered guidelines, and individualized treatment strategies leading the way. ✨Date: February 27 2025 ✨Time: 1 PM EDT 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  I used to think I was eating healthy—until I got diagnosed.
Pasta and veggies. Rice and veggies. Potatoes and veggies. That was my go-to. But after my bronchiectasis and MAC diagnosis, I learned the hard way that protein is critical when dealing with inflammation and infection. Those days of carb-heavy meals? They’re long gone. One of my biggest lessons came from Michelle MacDonald, a nutritionist at National Jewish Health. In a webinar series sponsored by Bronchiectasis and NTM Info & Research, Michelle emphasized not only the importance of protein but also the need for a well-balanced diet—including protein, carbs, and fats—with a special focus on getting enough calories. 💥The Power of Protein💥 According to Michelle, protein should anchor every meal. And no, that doesn’t mean tossing a handful of garbanzo beans into your stir-fry. It means making a deliberate effort to get 20–30 grams per meal. Personally, I aim for the high 20s, four times a day. I think of protein as “spackle”—filling in the damage caused by inflammation and infection. I truly believe this was one of the key reasons I was able to clear a MAC infection without antibiotics—my body had what it needed to repair and rebuild. 💥Don’t Forget Carbs & Fats💥 While protein is essential, carbs and fats also play a crucial role in immunity and energy. If you’re not consuming enough, your body will start using protein for fuel instead—wasting it on energy instead of healing. 💥Trying to Gain Weight? Be Smart About Fiber💥 If you struggle with appetite or need to gain weight, Michelle recommends limiting fiber from fresh fruits, raw vegetables, and whole grains. These foods fill you up too quickly, so don’t make salads your main course! At the end of the day, airway clearance, exercise, and good habits all matter, but none of it works if your body doesn’t have the nutrients it needs to heal. #HealthyEating #EatForHealing #ProteinPower #Bronchiectasis #NTMLungDisease #NutritionMatters #RespiratoryHealth  For me, educating people about bronchiectasis isn’t just about explaining the disease—it’s also about advocating for early diagnosis. The sooner people receive the right care, the better their outcomes.
That’s why I actively share insights on LinkedIn, where I’ve built a strong community of over 8,000 connections, including many respiratory therapists and clinicians. Engaging with this network is another way I advocate for early detection, ensuring that more people recognize the signs of bronchiectasis and get the care they need as early as possible. ⭐️⭐️This is my latest LinkedIn post:⭐️⭐️ There are people who have bronchiectasis (BE) and also have asthma and/or COPD. However, according to Dr. Charles Daley, one of the top BE and NTM doctors in the world, there are others who are incorrectly diagnosed with asthma or COPD when, in fact, they have bronchiectasis. As he recently said: (This transcription may contain minor errors.) “I would go out on a limb here and say, even though I can’t prove this point, I think most people with bronchiectasis have never been diagnosed, because to get diagnosed, the clinician, the provider, has to order a CT scan. And if you don’t do that, then they’re going to just say your chronic cough is asthma, or it’s COPD, or as allergies is something else, but until you get the chest CT, you can’t see the dilated airways. And once you do that, then you can call this bronchiectasis. There are many paths that lead to the condition bronchiectasis, but the symptoms are really what should drive the thinking about bronchiectasis. So a person has a chronic cough for months, often it’s producing sputum. They often have recurrent infections, and we call those exacerbations… So those are the things that should key the clinician to say, maybe this isn’t asthma. Maybe I should get an imaging study and figure out if this is bronchiectasis.” Respiratory therapists: If you’re working with patients who are coughing, have sputum and are not improving on their current treatment, they might have bronchiectasis. Please bring it to the attention of your team physician. New bronchiectasis treatments are in the pipeline with some becoming available this year. These treatments could greatly improve the quality of life for your patients. #RespiratoryCare #PulmonaryHealth #RespiratoryTherapist #Bronchiectasis #NTM #Asthma #COPD  For the first and only time in 2025, I’m offering 10% off all my services for February—or until my schedule is fully booked. This won’t happen again this year‼️
Even at my regular rates, the value I provide is significant—which is why I don’t offer discounts often. When you book an initial consultation, here’s what you get: ✅ A detailed review of your questionnaire responses before we meet. ✅ A 75-minute deep dive into your concerns. ✅ A personalized set of resources curated just for you. But it doesn’t stop there. Once you become my client, you’re not just getting a one-time consultation—you’re gaining a trusted partner in your bronchiectasis journey. Who Am I? I’m Linda Cooper Esposito, MPH—Yale-educated, highly experienced, and fully dedicated to helping people with bronchiectasis live better lives. I currently work exclusively with bronchiectasis clients, and my LinkedIn recommendations span over a decade. Most importantly, I’m a good listener. Managing bronchiectasis isn’t one-size-fits-all, and I take the time to understand your lifestyle, your goals, and your challenges—no cookie-cutter templates. What I’m Not: ❌ I’m not ‘Coach Linda.’ I use my full name because I stand behind my work with credibility and integrity. ❌ I’m not a clinician, and I don’t give medical advice. Instead, I empower you with knowledge so you can make informed decisions with your healthcare team. ❌ I’m not here to judge. I support you, encourage best practices, and help you navigate your health—without shame or pressure. Ready to Get Started? Whether you’re booking for the first time or returning as a client, this is your chance to lock in my only all-services discount of 2025. Here’s how to book: 1️⃣ Visit LetsBeClearToday.com (link in bio) 2️⃣ Go to the Consultation page 3️⃣ Select a service and complete your booking https://www.letsbecleartoday.com/store/p2/Comprehensive_75_minute_consultation.html?#/ Once you book, I’ll personally reach out to schedule our Zoom or phone session—whichever you prefer! ‼️ Important: This is my only site-wide discount in 2025. Buy now, use it whenever—your purchase has no expiration date! Let’s connect and take the next step together! #Bronchiectasis #BronchiectasisCoach #NTMLungDisease #MACLungDisease #BeProactive #BeClearMethod https://www.letsbecleartoday.com/store/p2/Comprehensive_75_minute_consultation.html?#/  This year we anticipate having the first-ever FDA-approved treatment for bronchiectasis—brensocatib.
Many have asked me about the criteria for brensocatib eligibility and it remains uncertain. The FDA will ultimately determine who can access it, whether by restricting it to high-risk populations or allowing clinicians more discretion in prescribing it. For the clinical trial, participants had to be classified as frequent exacerbators—those experiencing two or more exacerbations per year requiring antibiotics. But that was just the trial’s criteria. Going forward, clinicians will most probably ask for an open policy that will allow them to determine who might benefit most. After all, the mechanism of brensocatib in bronchiectasis is to reduce inflammation—and inflammation is at the core of this disease, regardless of exacerbation frequency. In fact, many of us experience significant symptoms even without frequent exacerbations. So it stands to reason that reducing symptoms would improve quality of life and be a major benefit to our community. Does this give you hope? Are you someone who likes to try new treatments right away, or do you prefer to wait, see how others respond, and then decide? www.letsbecleartoday.com #Bronchiectasis #brensocatib #clinicaltrials #AspenStudy #exacerbations #flareups #hopeisintheair  Living with bronchiectasis means walking a tightrope. Every single day, we’re managing so much: airway clearance, equipment sterilization, battling fatigue, and still trying to live a full, vibrant life.
It can feel like a lot - because it IS a lot. But here’s the truth: we’re not alone in this journey. Each of us is trying to find that delicate balance between being vigilant about our health and actually ENJOYING our lives. Some days that balance feels impossible, and other days? We proudly hit all our marks. Right now, there’s frustratingly little scientific research about our daily self-care practices. How do we really sterilize equipment? What’s the best approach to drinking water or showering? We’re often left piecing together advice from manufacturers, healthcare providers, and our own community’s shared experiences. My advice? Listen to your body. Follow your device instructions carefully. Talk to your medical team. And most importantly - be kind to yourself. If you’re someone battling frequent infections, you’ll naturally be more cautious. If infections have been rare for you, you might take a more relaxed approach. But no matter where you are on this journey, remember: we’re in this together. ❤️ #BronchiectasisWarrior #ChronicIllness #SelfCare  Wouldn’t it be wonderful if there were only one way to do airway clearance? The truth is, there isn’t—and that’s okay. In fact, airway clearance is highly individualized, and as much an art as a science.
At every professional bronchiectasis conference I’ve attended, the message about airway clearance has been consistent: it should be taught by a respiratory professional and tailored to each person.Unfortunately, many people don’t have access to specialized education. While progress is being made, we’re not there yet. In the meantime, peer education and webinars have become invaluable resources. A frequent topic in these discussions is the use of devices like the Ombra compressor with AeroEclipse nebulizer cups. One advantage of this system is that the nebulizer cup can connect directly to an Aerobika OPEP (Oscillating Positive Expiratory Pressure) device. This combination is taught by National Jewish Health in Denver, Colorado—a leading lung hospital. Their method involves inhaling medicated mist and exhaling into the Aerobika, which creates lung vibrations. They believe this helps the saline mist penetrate deeper into the airways. Alternatively, specialists like Dr. Pamela McShane recommend a different sequence: nebulizing first to coat the airways with saline, followed by tools like the Aerobika, vibration vests, or breathing techniques to mobilize mucus. So, which method do I use? It depends. If I have plenty of time, I’ll nebulize first. If I’m in a hurry, I’ll attach the nebulizer cup to my Aerobika to save time. The key takeaway is that airway clearance isn’t one-size-fits-all. We shouldn’t compare ourselves to others or feel like we’re doing something wrong if one technique doesn’t work for us. One tip from experts: avoid exhaling too forcefully or coughing harshly to expel mucus. Doing so can cause floppy airways to collapse, making it harder to clear our lungs. Instead, aim for slow, steady breaths—easy does it. Do you have a preferred method? Share your experience below! (BE CLEAR has a consulting relationship with Monaghan Medical) #bronchiectasis #airwayclearance #removingmucus #phlegm #sputum #nebuliser #Aerobika  Keep your devices functioning properly, make de-scaling a monthly habit!
How to De-Scale Your Equipment: ✔️ Soak the disassembled device in a 50/50 solution of white vinegar and water for 1 hour ✔️ Wash and disinfect as usual Important: De-scaling is not the same as sterilizing—vinegar only provides low-level sterilization. ✅ Bonus Tip: Don’t forget to check your compressor filter—it may be time for a change! Check out my YouTube channel for helpful airway clearance videos: https://youtube.com/playlist?list=PLYv0bQel-IptGJS3KoAuOsyt7ia0_AkBW&si=jr5A0b1LvwkkDRmk Don’t forget to subscribe to my YouTube channel for more tips‼️ (Consulting relationship with Monaghan Medical) #Bronchiectasis #AirwayClearance #Aerobika #Acapella #Nebulizing #Nebuliser #Nebulizer |
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
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