Bronchiectasis and connective tissue diseases

Abstract

Connective tissue diseases (CTD) encompass a range of heritable and autoimmune conditions that are well known for their systemic effects. While these conditions have been observed to impact the lung in myriad fashion, bronchiectasis remains an often overlooked pulmonary complication, despite the fact that the prevalence of bronchiectasis can be as high as 60 % in patients with rheumatoid arthritis. In this review, we cover the epidemiology and clinical findings of bronchiectasis in autoimmune CTDs such as rheumatoid arthritis and Sjogren’s syndrome and heritable CTDs such as Marfan syndrome and Ehlers-Danlos syndrome. We propose that changes in the oral, gut, and lung microbiome may influence autoimmunity and the structural integrity of the airway, thus leading to bronchiectasis.