Monitoring Lung Health in Genetic Immune Disorders: Ongoing Challenges and New Strategies

By
Ernest Hoptioncann
Rachel L. Eddy
Catherine M. Biggs
Jonathan H. Rayment
May 20, 2026

Frontiers In Immunology

Overview

Inborn errors of immunity (IEIs) significantly increase the risk of pulmonary complications, primarily due to recurrent infections and immune dysregulation. Emerging monitoring techniques, such as multiple-breath washout and pulmonary MRI, may enhance detection and management of these complications.

Background

Pulmonary complications are a leading cause of morbidity and mortality in individuals with inborn errors of immunity (pwIEIs). The high prevalence of these complications necessitates effective monitoring strategies to improve patient outcomes. Traditional methods have limitations, highlighting the need for innovative approaches to assess lung health in this vulnerable population.

Data Highlights

Complication Type	Prevalence (%)
Airway Disease	86.8
Parenchyma Involvement	18.5
Pleura Involvement	4.6
Vasculature Involvement	4.3

Key Findings

Nearly 40% of pwIEIs develop pulmonary complications.
Common variable immunodeficiency (CVID) accounts for nearly half of all reported pulmonary complications.
Pulmonary complications contribute to 17.4% of deaths in pwIEIs.
Recurrent infections lead to chronic airway disease, notably bronchiectasis.
Emerging techniques like pulmonary MRI offer radiation-free assessments of lung function.

Clinical Implications

Healthcare providers should consider incorporating advanced monitoring techniques to better assess lung health in pwIEIs. A multidisciplinary approach is essential for managing pulmonary complications effectively, including regular pulmonary function testing and imaging.

Conclusion

The high burden of pulmonary complications in pwIEIs underscores the need for improved monitoring strategies. Utilizing emerging technologies may enhance patient care and outcomes in this population.