26 March, 2026
The ERS Clinical Research Collaboration (CRC), EARCO (European alpha-1 research collaboration), has published new research from the EARCO registry on bronchiectasis in alpha-1 antitrypsin deficiency (AATD).
Using the EARCO European registry, the researchers have found that bronchiectasis is a relevant and often under-recognised feature of severe AATD. These results support routinely assessing for bronchiectasis in patients with severe AATD and tailoring follow-up and management early – particularly when emphysema co-exists – so that airway-focused strategies and infection prevention can be implemented in a timely, integrated way.
This publication aligns closely with EARCO’s CRC mission: leveraging a large pan-European collaboration to characterise disease heterogeneity in AATD and generate evidence that can improve care. By describing bronchiectasis across severe genotypes, the study helps fill an important evidence gap and strengthens the rationale for broader, standardised assessment of airway disease within AATD research and clinical pathways.
The next steps for this development include longitudinal analyses within EARCO to understand how bronchiectasis evolves over time in AATD; its relationship with exacerbations; lung-function decline and hospitalisations; and how co-existing emphysema influences outcomes. Further work will also benefit from more standardised reporting of imaging and microbiology to refine phenotyping and guide targeted management strategies.
There are several opportunities to get involved with this research by contributing patients and data to EARCO through participating centres or joining follow-up sub-studies within the collaboration.