Bronchiectasis is a chronic condition of global relevance resulting in permanent and irreversible structural airway damage. Bacterial infection in bronchiectasis is well studied; however, recent molecular studies identify fungi as important pathogens, either independently or in association with bacteria. Aspergillus species are established fungal pathogens in cystic fibrosis and their role is now increasingly being recognized in noncystic fibrosis bronchiectasis. While the healthy airway is constantly exposed to ubiquitously present Aspergillus conidia in the environment, anatomically damaged airways appear more prone to colonization and subsequent infection by this fungal group. Aspergilli possess diverse immunopathological mechanistic capabilities and when coupled with innate immune defects in a susceptible host, such as that observed in bronchiectasis, it may promote a range of clinical manifestations including sensitization, allergic bronchopulmonary aspergillosis, Aspergillus bronchitis, and/or invasive aspergillosis. How such clinical states influence “endophenotypes” in bronchiectasis is therefore of importance, as each Aspergillus-associated disease state has overlapping features with bronchiectasis itself, and can evolve, depending on underlying host immunity from one type into another. Concurrent Aspergillus infection complicates the clinical course and exacerbations in bronchiectasis and therefore dedicated research to better understand the Aspergillus-host interaction in the bronchiectasis airway is now warranted.

支气管扩张是一种全球相关的慢性疾病，会导致永久性和不可逆的结构性气道损伤。支气管扩张中的细菌感染已得到充分研究；然而，最近的分子研究将真菌确定为重要的病原体，无论是独立还是与细菌相关。曲霉属是囊性纤维化中已确定的真菌病原体，它们在非囊性纤维化支气管扩张中的作用现在越来越得到认可。虽然健康的气道不断暴露于环境中普遍存在的曲霉分生孢子，但解剖受损的气道似乎更容易被这种真菌群定植和随后感染。曲霉具有多种免疫病理学机制能力，并且当与易感宿主的先天免疫缺陷相结合时，例如在支气管扩张中观察到的缺陷，它可能会促进一系列临床表现，包括致敏、过敏性支气管肺曲霉病、曲霉支气管炎和/或侵袭性曲霉病。因此，这些临床状态如何影响支气管扩张中的“内表型”非常重要，因为每种曲霉相关疾病状态都与支气管扩张本身具有重叠的特征，并且可以根据宿主从一种类型到另一种类型的潜在免疫力而进化。并发曲霉感染使支气管扩张的临床过程和恶化变得复杂，因此现在有必要进行专门的研究以更好地了解支气管扩张气道中曲霉菌与宿主的相互作用。