In this retrospective analysis, more than 300 patients with fibrosing ILDs were included and systematically evaluated. The study combined high-resolution CT (HRCT) imaging with microbiological data, clinical parameters, and longitudinal follow-up analyses. A significant correlation was observed between the extent of traction bronchiectasis and the radiologically quantified fibrosis burden. In addition, traction bronchiectasis emerged as an independent predictor of mortality during follow-up. In contrast, there was no evidence of increased detection rates of respiratory pathogens, nor were there clinical patterns indicative of classical bronchiectatic disease characterized by chronic infection or frequent exacerbations.

These findings support a clear pathophysiological classification of traction bronchiectasis in the context of fibrosing ILDs. “Our data show that traction bronchiectasis primarily reflects the underlying fibrotic remodeling and should not be interpreted as a manifestation of an independent, infection-driven bronchiectatic disease,” explains first author Jakob Raith, a doctoral researcher at the Department of Pneumology and Infectious Diseases. For clinical practice, this implies that corresponding HRCT findings should be interpreted with caution and should not automatically lead to therapeutic interventions targeting bronchiectasis.

From a radiological perspective, the study also highlights the importance of precise quantitative imaging analysis for assessing disease progression. “The detailed characterization of structural changes in HRCT allows for a much more accurate evaluation of fibrosis burden and may help to identify prognostically relevant patterns at an early stage,” emphasizes Prof. Dr. Sabine Dettmer, radiologist and co-author of the study. Imaging markers such as traction bronchiectasis are therefore gaining increasing importance for risk stratification and monitoring in clinical and translational studies.

The scientific relevance of the work was also recognized at the DGP Congress 2026, where Jakob Raith presented the findings and received the poster award in the bronchiectasis category. BREATH congratulates Jakob Raith on this achievement and wishes him continued success in his future research projects.

Original publication:

Raith J, Ruwisch J, Schupp JC, Graalmann T, Drick N, Hoeper MM, Prasse A, Fuge J, Ringshausen FC, Knegendorf L, Rademacher J, Dettmer S, Seeliger B. Clinical implications of traction bronchiectasis in IPF and fibrotic RA-ILD - a retrospective single-center cohort study. Respir Res. 2026 Jan 13;27(1):31. doi: 10.1186/s12931-026-03497-6. PMID: 41530804; PMCID: PMC12849085.

Text: BREATH/AB

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