Editorial: Interstitial Lung Disease in the Context of Systemic Disease: Pathophysiology, Treatment and Outcomes

Korsten, Peter; Konig, Maximilian F.; Tampe, Björn; Mirsaeidi, Mehdi

doi:10.3389/fmed.2020.644075

Cited by 3 publications

(5 citation statements)

References 11 publications

(6 reference statements)

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“…Further, once the patient progresses to pulmonary fibrosis, the prognosis becomes less optimistic. Owing to the complexity of treatment, tailoring treatment protocols for CTD-ILD requires vigorous effort and a multidisciplinary team approach often including close collaboration with the patient’s pulmonologist ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Interstitial Lung Disease in Connective Tissue Disease: A Common Lesion With Heterogeneous Mechanisms and Treatment Considerations

et al. 2021

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Connective tissue disease (CTD) related interstitial lung disease (CTD-ILD) is one of the leading causes of morbidity and mortality of CTD. Clinically, CTD-ILD is highly heterogenous and involves rheumatic immunity and multiple manifestations of respiratory complications affecting the airways, vessels, lung parenchyma, pleura, and respiratory muscles. The major pathological features of CTD are chronic inflammation of blood vessels and connective tissues, which can affect any organ leading to multi-system damage. The human lung is particularly vulnerable to such damage because anatomically it is abundant with collagen and blood vessels. The complex etiology of CTD-ILD includes genetic risks, epigenetic changes, and dysregulated immunity, which interact leading to disease under various ill-defined environmental triggers. CTD-ILD exhibits a broad spectra of clinical manifestations: from asymptomatic to severe dyspnea; from single-organ respiratory system involvement to multi-organ involvement. The disease course is also featured by remissions and relapses. It can range from stability or slow progression over several years to rapid deterioration. It can also present clinically as highly progressive from the initial onset of disease. Currently, the diagnosis of CTD-ILD is primarily based on distinct pathology subtype(s), imaging, as well as related CTD and autoantibodies profiles. Meticulous comprehensive clinical and laboratory assessment to improve the diagnostic process and management strategies are much needed. In this review, we focus on examining the pathogenesis of CTD-ILD with respect to genetics, environmental factors, and immunological factors. We also discuss the current state of knowledge and elaborate on the clinical characteristics of CTD-ILD, distinct pathohistological subtypes, imaging features, and related autoantibodies. Furthermore, we comment on the identification of high-risk patients and address how to stratify patients for precision medicine management approaches.

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Section: Introductionmentioning

confidence: 99%

Interstitial Lung Disease in Connective Tissue Disease: A Common Lesion With Heterogeneous Mechanisms and Treatment Considerations

et al. 2021

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“…PF is an irreversible disease that causes symptoms such as coughing, dyspnea, fatigue, weight loss (39,40). PF is caused by a cycle of injury and repair that occurs in the lung as a result of long time exposure to certain environmental factors, drugs or radiotherapy, and some in ammatory diseases such as dermatomyositis, polymyositis, sarcoidosis, scleroderma, and pneumonia-causing pathogens (41). Patients with PF have a reduced quality of life with progressive and irreversible organ dysfunction (42).…”

Section: Discussionmentioning

confidence: 99%

Angiotensin II-pretreated hucMSCs attenuate inflammation and reverse pulmonary fibrosis in SD rat lung

Wang

Song

Deng

et al. 2022

Preprint

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Background Pulmonary fibrosis (PF) is an irreversible disease with a poor prognosis and a serious impact on patients' health. PF is also associated with COVID-19, especially in immunocompromised people. Herein, efforts have been made to treat PF using pretreatment of human umbilical cord mesenchymal stem cells (hucMSCs) with angiotensin II (Ang II) as a novel therapeutic method. Results Our results first showed that Ang II pretreatment induced more hucMSCs to reach the injured lung and alleviated pulmonary fibrosis. Transplantation of hucMSCs-Ang II reduced inflammatory infiltration, increased IL-10 expression and enhanced macrophage matrix-metallopeptidase-9 (MMP-9) expression for collagen degradation. Moreover, the Ang II-treated hucMSCs decreased hydroxyproline (HYP) and alpha-smooth muscle actin (α-SMA) expression in SD rats and promoted collagen and collagen fiber degradation. Conclusions Ang II pretreatment enhanced the homing ability of hucMSCs, and hucMSCs-Ang II transplantation reversed PF by inhibiting inflammation and promoting collagen and collagen fiber degradation, promising its clinical application in the treatment of post-inflammatory PF caused by various disorders, including COVID-19 and related pneumonia.

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“…UIP is characterized by non-uniform fibrosis with honeycomb change, fibroblast foci, and mild inflammation, while NSIP is characterized by uniform fibrosis with a varying proportion of interstitial inflammation 4 . The dominant pattern of ILD is UIP in RA, and NSIP in SSc 3 .…”

Section: Introductionmentioning

confidence: 96%

“…Connective tissue disease-associated interstitial lung disease (CTD-ILD) is characterized by inflammation and/or fibrosis of the lungs in patients with systemic rheumatic diseases, such as rheumatoid arthritis (RA), SSc, systemic lupus erythematosus (SLE), and polymyositis/dermatomyositis (PM/DM) 3 . Based on a histopathologic analysis, CTD-ILD can be classified into the following subtypes: nonspecific interstitial pneumonia (NSIP), usual interstitial pneumonia (UIP), organizing pneumonia (OP), apical fibrosis, diffuse alveolar damage (DAD), and lymphoid interstitial pneumonia (LIP) 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Based on a histopathologic analysis, CTD-ILD can be classified into the following subtypes: nonspecific interstitial pneumonia (NSIP), usual interstitial pneumonia (UIP), organizing pneumonia (OP), apical fibrosis, diffuse alveolar damage (DAD), and lymphoid interstitial pneumonia (LIP) 4 . The two most common subtypes of CTD-ILD are NSIP and UIP 3 . UIP is characterized by non-uniform fibrosis with honeycomb change, fibroblast foci, and mild inflammation, while NSIP is characterized by uniform fibrosis with a varying proportion of interstitial inflammation 4 .…”

Section: Introductionmentioning

confidence: 99%

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A retrospective analysis of the relationship between anti-cyclic citrullinated peptide antibody and interstitial lung disease in systemic sclerosis

Hong

Jin

et al. 2022

Sci Rep

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Anti-cyclic citrullinated peptide antibody testing is used to diagnose rheumatoid arthritis and associated with interstitial lung disease in RA. Herein, we investigate the relationship between anti-CCP antibody and ILD in SSc. We performed a retrospective analysis at a tertiary medical center between 2005 and 2019. Patients with SSc, systemic lupus erythematosus, and polymyositis/dermatomyositis (PM/DM) were evaluated for anti-CCP antibody and ILD. Additionally, medical records of SSc patients with ILD were reviewed. SSc patients had the highest anti-CCP antibody positivity rate compared to those with SLE and PM/DM. The incidence of ILD was higher in SSc patients with anti-CCP antibody than in those without. The usual interstitial pneumonia (UIP) incidence was higher in the anti-CCP antibody-positive group than in the anti-CCP antibody-negative group. The DLCO was lower in the anti-CCP antibody-positive group than in the anti-CCP antibody-negative group. On multivariable analysis, factors associated with SSc-ILD were anti-CCP antibody or rheumatoid factor (β coefficient, 2.652 [95% CI 1.472 to 4.776]) and anti-Scl70 antibody (β coefficient, 4.011 [95% CI 2.142 to 7.508]). Anti-CCP antibody may be associated with a higher incidence of ILD in SSc. SSc patients with anti-CCP antibody may have more UIP pattern and lower DLCO.Trial Registration Retrospectively registered.

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Editorial: Interstitial Lung Disease in the Context of Systemic Disease: Pathophysiology, Treatment and Outcomes

Cited by 3 publications

References 11 publications

Interstitial Lung Disease in Connective Tissue Disease: A Common Lesion With Heterogeneous Mechanisms and Treatment Considerations

Interstitial Lung Disease in Connective Tissue Disease: A Common Lesion With Heterogeneous Mechanisms and Treatment Considerations

Angiotensin II-pretreated hucMSCs attenuate inflammation and reverse pulmonary fibrosis in SD rat lung

A retrospective analysis of the relationship between anti-cyclic citrullinated peptide antibody and interstitial lung disease in systemic sclerosis

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