Lung Infection Research Update

Prof Brown’s team has had two papers on bronchiectasis published recently.

The first describes the rapid development of bronchiectasis in patients who have weakened immune systems due to haematological disease.  This includes information for around 80 patients about bronchiectasis caused by haematological disorders such as lymphoma, myeloma  or leukaemia. This is the largest number of these patients described in the medical literature, and is important as it makes other doctors aware that bronchiectasis develops very quickly in these patients and causes a lot of ill health; better awareness of the problem will make doctors much better at recognising these patients and referring them to specialist centres, such as UCLH.

The other paper on bronchiectasis uses computers and CT scans to measure the exact degree of the dilatation of the bronchi in patients with bronchiectasis.  The more dilated the bronchi the worse the bronchiectasis, but at present we can only really measure this by eye just looking at the CT scans, which is not very accurate. Using computer software to give an actual measurement for the severity of bronchial dilatation would be a significant breakthrough as it would allow us to follow what happens to a particular patient over time, and rapidly identify if things are getting worse.

Three research papers have also been published which describe new findings about how the commonest cause of pneumonia.

Streptococcus pneumoniae interacts with humans to cause infection.   They describe the mechanisms by which the human immune system recognises the presence of S. pneumoniae and then responds to cause inflammation that is necessary for controlling infection. They are basic science research which do not directly feed into clinical care, but help us better understand how diseases like pneumonia develop and could therefore be prevented.

  1. Jose R et al. De novo bronchiectasis in haematological malignancies.  ERJ Open Res5(4). doi:10.1183/23120541.00166-2019.
  2. Quan et al.  Reproducibility of an airway tapering measurement in computed tomography with application to bronchiectasis.  Journal of Medical Imaging6(3). doi:10.1117/1.JMI.6.3.034003.
  3. Weight CM, et al. Epithelial control of colonisation by Streptococcus pneumoniae at the human mucosal surface.  Nature Communications 2019 10(1):3060.
  4. Javan RR et al. Prophages and satellite prophages are widespread among Streptococcus species and may play a role in pneumococcal pathogenesis.  Nature Communications10(1), 4852. doi:10.1038/s41467-019-12825-y.
  5. Periselneris J et al. Relative contribution of extracellular and internalised bacteria to early macrophage pro-inflammatory responses to Streptococcus pneumoniaeMBio10(5). doi:10.1128/mBio.02144-19.

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