scholarly journals The Role of the Lung’s Microbiome in the Pathogenesis and Progression of Idiopathic Pulmonary Fibrosis

2019 ◽  
Vol 20 (22) ◽  
pp. 5618 ◽  
Author(s):  
Paolo Spagnolo ◽  
Philip L. Molyneaux ◽  
Nicol Bernardinello ◽  
Elisabetta Cocconcelli ◽  
Davide Biondini ◽  
...  

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease that commonly affects older adults and is associated with the histopathological and/or radiological patterns of usual interstitial pneumonia (UIP). Despite significant advances in our understanding of disease pathobiology and natural history, what causes IPF remains unknown. A potential role for infection in the disease’s pathogenesis and progression or as a trigger of acute exacerbation has long been postulated, but initial studies based on traditional culture methods have yielded inconsistent results. The recent application to IPF of culture-independent techniques for microbiological analysis has revealed previously unappreciated alterations of the lung microbiome, as well as an increased bacterial burden in the bronchoalveolar lavage (BAL) of IPF patients, although correlation does not necessarily entail causation. In addition, the lung microbiome remains only partially characterized and further research should investigate organisms other than bacteria and viruses, including fungi. The clarification of the role of the microbiome in the pathogenesis and progression of IPF may potentially allow its manipulation, providing an opportunity for targeted therapeutic intervention.

2021 ◽  
Author(s):  
Giovanna Elisiana Carpagnano ◽  
Piera Soccio ◽  
Giulia Scioscia ◽  
Grazia Pia Palladino ◽  
Maria Pia Foschino Barbaro ◽  
...  

Author(s):  
Luísa Coutinho Coelho ◽  
Karina Smidt Simon ◽  
Cesar Augusto Melo-Silva ◽  
Paulo Henrique De Holanda Veloso Junior ◽  
João Paulo Figueiró Longo ◽  
...  

Author(s):  
Takafumi Suda

Pulmonary involvement is common in rheumatoid arthritis (RA) and affects all the components of the lung. Interstitial lung disease (ILD) is the most predominant pulmonary manifestation and has been identified as the main cause of morbidity and mortality in RA. Clinically significant RA-ILD occurs in approximately 10% of RA patients. Several risk factors, such as old age, male gender, and smoking, have been reported to date. Histologically, the proportion of the usual interstitial pneumonia (UIP) pattern is higher in RA-ILD than in ILD associated with other connective tissue diseases, and RA-ILD also shows nonspecific interstitial pneumonia and organizing pneumonia patterns. High-resolution computed tomography scans are highly predictive of the histological UIP pattern with a specificity of 96%-100%. Acute exacerbation, which is the acute deterioration of the respiratory status characterized by newly developed bilateral infiltrates with unknown etiologies, has been reported in RA-ILD. Although acute exacerbation of RA-ILD has high mortality, similar to that of idiopathic pulmonary fibrosis, its incidence is lower in RA-ILD than in idiopathic pulmonary fibrosis. A consensus treatment has not yet been established. Current therapeutic regimens typically include corticosteroids with or without cytotoxic agents. Recent large longitudinal studies reported that the prognosis of RA-ILD was poor with a median survival of 2.6-3.0 years. Furthermore, histological and/or radiological patterns, such as UIP or non-UIP, have significant prognostic implications. RA-ILD patients with histological or radiological UIP patterns have poorer prognoses than those with non-UIP patterns. This review assessed the characteristics of RA-ILD by overviewing recent studies in the field and focused on the clinical significance of histological and/or radiological patterns in RA-ILD.


2008 ◽  
Vol 177 (9) ◽  
pp. 1048-1048 ◽  
Author(s):  
Alfredo N. C. Santana ◽  
Ronaldo A. Kairalla ◽  
Carlos R. R. Carvalho

2017 ◽  
Vol 95 (5) ◽  
pp. 389-393
Author(s):  
V. A. Akhmedov ◽  
O. V. Gaus ◽  
D. V. Petrov

Idiopathic pulmonary fibrosis (IPF) is a most widespread clinic-morphological variant of Idiopathic interstitial pneumonias. Its pathophysiology includes recurrent damages to epithelial cells and anomalous reparative reaction in response to aseptic inflammation in the form of excess fibroblast proliferation. The cause of epithelium damage remains unknown; the involvement of smoking, viral infections, inhaled pollutants, and toxic drug n the initiation of the pathological process is conjectured. Numerous studies of recent years suggest the potential role of gastroesophageal reflux and microaspiration as etiological factors of IPF progression. A brief review of modern views of the relationship between IPF and gastroesophageal reflux is presented.


2019 ◽  
Vol 14 ◽  
Author(s):  
Claudia Ravaglia ◽  
Marcello Bosi ◽  
Athol U. Wells ◽  
Carlo Gurioli ◽  
Christian Gurioli ◽  
...  

Background: Prognostic evaluation in idiopathic pulmonary fibrosis (IPF) may be important as it can guide management decisions, but the potential role of honeycomb changes in providing information about outcome and survival of patients with IPF, particularly if diagnosed using cryobiopsy, has not been evaluated. Aim of this study was to determinate whether a relationship exists between honeycombing on cryobiopsy and clinical/radiological picture and outcome in patients with IPF and to assess whether the same pathologic criteria that have been used to define the UIP pattern (usual interstitial pneumonia) for surgical biopsy can also be applied to cryobiopsy. Methods: Sixty-three subjects with a multidisciplinary diagnosis of IPF and a UIP pattern on cryobiopsy were evaluated. Patients were classified into two sub-groups depending on the presence of honeycombing on histology. Results: The presence of honeycombing on cryobiopsy did not identify a specific phenotype of patients as it did not correlate with radiological and clinical picture and it was not associated neither with the risk of death (p = 0. 1192) or with the event-free survival (p = 0.827); a higher number of samples and the presence of pleura on biopsy were instead associated with an increase in the finding of honeycombing. Conclusions: The same pathologic criteria that have been used to define the UIP pattern in surgical biopsies (with honeycombing changes considered as non-mandatory for the definition of the pattern itself) can be applied to cryobiopsy samples, as the presence of these changes do not define different clinical or radiological phenotypes of patients with IPF.


Pneumologie ◽  
2011 ◽  
Vol 65 (12) ◽  
Author(s):  
S Barkha ◽  
M Gegg ◽  
H Lickert ◽  
M Königshoff

Pneumologie ◽  
2014 ◽  
Vol 68 (06) ◽  
Author(s):  
S Skwarna ◽  
I Henneke ◽  
W Seeger ◽  
T Geiser ◽  
A Günther ◽  
...  

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