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28/05/2026 - General information

Opening the door to new therapeutic strategies in patients with bronchiectasis

Two studies by the Bronchiectasis Unit at Hospital del Mar point to new ways to address sarcopenia, the progressive loss of muscle mass, in patients diagnosed with bronchiectasis. The studies are published in the journal ERJ Open Research, published by the European Respiratory Society.

The Bronchiectasis Unit of the Pulmonology Department at Hospital del Mar has just published two studies in the journal ERJ Open Research that may pave the way for applying new treatments focused on sarcopenia in people diagnosed with bronchiectasis. Their significance lies in the fact that people diagnosed with bronchiectasis show loss of muscle mass early on and in mild and moderate stages of this respiratory disease. This is why it is so important to understand the molecular mechanisms involved.

The studies, led by Dr Esther Barreiro, coordinator of the unit and of the Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group at the Hospital del Mar Research Institute (HMRIB), and a researcher in the CIBER respiratory diseases research area (CIBERES), analyse the mechanisms that lead to loss of muscle mass in these patients and the oxidative stress and inflammation parameters they present. Members of the Diagnostic Imaging Department at Hospital del Mar, part of the dibi network, and of Hospital Mútua de Terrassa also participated.

The role of two proteins in sarcopenia

The first of the studies analysed molecular markers linked to the mechanism known as endoplasmic reticulum stress in the participants' quadriceps muscle. This made it possible to confirm that people with bronchiectasis have higher levels of two proteins, a finding that is inversely related to several clinical parameters of sarcopenia, such as body mass index, fat-free mass index and quadriceps strength. This may contribute to the loss of muscle mass in these patients.

The results indicate that using these factors as therapeutic targets may help protect muscle function in these patients and improve their quality of life and clinical outcomes. In any case, no treatments have yet been developed that act satisfactorily on these elements without affecting other factors of muscle physiology.

Systemic oxidative stress and inflammation

The researchers studied markers of oxidative stress and inflammation in the same muscle, the quadriceps, and in the blood (systemic compartment) of patients with bronchiectasis and sarcopenia. In fact, these factors are elevated in other diseases, such as chronic obstructive pulmonary disease (COPD). The results indicate an increase in these factors in the blood, but not in the muscle, unlike in COPD.

This finding implies that treating the inflammation and oxidative stress associated with muscle loss in bronchiectasis may help combat sarcopenia. For this reason, the Hospital del Mar Bronchiectasis Unit is working on several clinical trials that include the administration of anti-inflammatory drugs to reduce the inflammatory burden and reduce respiratory and systemic symptoms in these patients.

Reference articles

Núñez-Robainas A, Alvarado-Miranda M, Solano A, et al. Systemic inflammation and oxidative stress in bronchiectasis-associated sarcopenia. ERJ Open Res 2026; 12: 00556-2025 [DOI: 10.1183/23120541.00556-2025].

Núñez-Robainas A, Solano A, Marsico S, et al. Selective activation of the unfolded protein response and proteolytic pathways in sarcopenic limb muscles of bronchiectasis patients. ERJ Open Res 2026; 12: 00746-2025 [DOI: 10.1183/23120541.00746-2025].

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