PRIMARY IMMUNE DEFICIENCY DISEASE: Edited by M. Teresa de la Morena and Stephen JollesBronchiectasis and obstructive lung diseases in primary antibody deficiencies and beyond: update on management and pathomechanismsHanitsch, Leif G.a,b Author Information aInstitute of Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin bBerlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Center for Regenerative Therapies, Berlin, Germany Correspondence to Leif G. Hanitsch, Charité Universitätsmedizin Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany. Tel: +49 30 450 624 109; e-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: December 2022 - Volume 22 - Issue 6 - p 335-342 doi: 10.1097/ACI.0000000000000856 Buy Metrics Abstract Purpose of review Pulmonary complications are among the most frequent manifestations in patients with primary antibody deficiency (PAD), contributing significantly to morbidity and mortality. Here, we focus on recent findings in obstructive pulmonary disease and bronchiectasis in PAD. Since specific data on patients with PAD is limited and management mostly follows general recommendations, this review also aims to summarize data from the immunocompetent population. Recent findings Potential risk factors for the development and progression of bronchiectasis include reduced immunoglobulins and lower CD4 cells. In addition, Pseudomonas aeruginosa and an altered microbiome might contribute to local inflammation and disease progression. Findings on the contribution of neutrophils and eosinophils in the affected immunocompetent population require confirmation in PAD. Despite its high global burden, there is an extreme paucity of data on chronic obstructive pulmonary disease in PAD. Lower IgA and IgM are associated with asthma in PAD, but the heterogeneity of prevalence among PAD groups is poorly understood. Recent observations of non-IgE-mediated pathomechanisms in asthma may be of particular interest in PAD patients. Summary Management of PAD patients with chronic lung disease requires a multidisciplinary team approach including immunology, pulmonology, infectious disease and physiotherapy. Diagnostic processes should be harmonized to ensure a more precise perspective on prevalence and disease courses. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.