A research study conducted in China entitled “Impacts of Co-Existing Chronic Rhinosinusitis on Disease Severity and Risks of Exacerbations in Chinese Adults with Bronchiectasis,” published in PLoS ONE, recently looked at whether or not chronic nasal and sinus infections worsened bronchiectasis symptoms among a group of 148 Chinese patients who otherwise had stable bronchiectasis. The findings could have implications in addressing nasal and sinus infections among bronchiectasis patients overall.

Bronchiectasis is a chronic lung disease in which the smaller airways of the lungs become permanently dilated.  People with bronchiectasis often exhibit the following symptoms:

• Coughing of blood
• Cough
• Wheezing in the chest
• Chest pain
• Shortness of breath
• Bad breath
• Cyanosis

The researchers found that about 32 percent of all bronchiectasis patients also had chronic nasal and sinus infections.  They discovered that patients who had both bronchiectasis and chronic nasal and sinus infections had worsened bronchiectasis symptoms and more exacerbations of their disease process.  This included having a more severe cough, increased sputum production, and a decrease in quality of life.

The researchers found that there were fewer cases of chronic and sinus infections in Chinese bronchiectasis patients when compared to Caucasians with both conditions but felt that this was artificially due to the small study size of only 148 patients with bronchiectasis.

They evaluated the degree of bronchiectasis symptoms by conducting the “Bronchiectasis Severity Score” and by evaluating the number of patients hospitalized with exacerbations of bronchiectasis.  Those without chronic nasal and sinus infections scored better on the “Bronchiectasis Severity Score” and had fewer symptoms of the disease when compared to those who had chronic nasal and sinus infections.

The difference in symptoms was felt to be due to the fact that people with chronic nasal and sinus infections were colonized with bacteria such as “Pseudomonas aeruginosa” that affected the bronchiectasis and that they negatively impacted the function of the respiratory cilia in patients with bronchiectasis.

People with chronic nasal and sinus infections were identified as having the following criteria:

• At least two symptoms or signs of nasal and paranasal sinus inflammation.
• CT changes identifying inflammation of the nasal and paranasal sinuses.

The researchers determined that the best way to manage the coexistence of these two diseases is to actively treat the chronic nasal and sinus infections since bronchiectasis cannot be as easily treated.  The improvement in bronchiectasis symptoms also corresponded with a better quality of life and an ability to smell better.  Some patients with chronic nasal and sinus infections also had nasal polyps but no differentiation was made between those with and without nasal polyps.