Bronchiectasis: A Complex, Heterogeneous Disease

Abstract

Most areas of respiratory medicine continue to use an Oslerian approach, based on signs and symptoms, in which the disease is the center of all activity. However, this paradigm is changing. Now that lung diseases have been recognized as heterogeneous and complex, we are moving towards more personalized, precise, patient-oriented medicine. The aim of this review was to define the current state of the knowledge on bronchiectasis, or, more accurately, the bronchiectasis syndrome, as a multidimensional, systemic, heterogeneous, complex disease. We explore the advances that have already been made, and above all the many steps that are still to be taken. We also propose some tools which might facilitate the application of these concepts in clinical practice, and help us continue our journey towards a more holistic view of this disease.

Keywords: Actividad biomarcador; BSI; Biomarker activity; Clinical phenotypes; Complejidad; Complexity; E-FACED; Endotipos; Endotypes; FACED; Fenotipos clínicos; Gravedad; Heterogeneidad; Heterogeneity; Impact; Impacto; Medicina personalizada; Personalized medicine: BSI; Severity.