Immune-mediated lung diseases: A narrative review

Frontiers in Medicine

Medicine

Abeera Azam¹  Jacqueline Jansz²  Christian Ascoli³  Israel Rubinstein⁴  Fatima Alnaimat⁵  Nadera Sweiss⁶  Alaa Alsakaty⁶  Hesham Elmergawy⁶  Ting-Wei Ernie Liao⁷  Jaleel Jerry G. Sweis⁸  Nabil W. G. Sweis⁸  Hali A. Hanson⁹ 

[1]Department of Internal Medicine, The University of Texas Health Science Center at Tyler, Tyler, TX, United States

[2]Department of Medicine, University of Illinois Chicago, Chicago, IL, United States

[3]Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois Chicago, Chicago, IL, United States

[4]Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois Chicago, Chicago, IL, United States

[5]Research Service, Jesse Brown VA Medical Center, Chicago, IL, United States

[6]Division of Rheumatology, Department of Internal Medicine, The University of Jordan, Amman, Jordan

[7]Division of Rheumatology, Department of Medicine, University of Illinois Chicago, Chicago, IL, United States

[8]School of Medicine, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan

[9]Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan

[10]School of Medicine, The University of Jordan, Amman, Jordan

[11]UIC College of Pharmacy, University of Illinois Chicago, Chicago, IL, United States

关键词: immune-mediated lung diseases;    interstitial lung disease;    connective tissue diseases;    post-COVID-19;    idiopathic pulmonary fibrosis;    sarcoidosis;    drug-induced lung injury;    post-lung transplant;   

DOI  :  10.3389/fmed.2023.1160755

 received in 2023-02-07, accepted in 2023-03-20,  发布年份 2023

来源: Frontiers

【 摘 要 】

The role of immunity in the pathogenesis of various pulmonary diseases, particularly interstitial lung diseases (ILDs), is being increasingly appreciated as mechanistic discoveries advance our knowledge in the field. Immune-mediated lung diseases demonstrate clinical and immunological heterogeneity and can be etiologically categorized into connective tissue disease (CTD)-associated, exposure-related, idiopathic, and other miscellaneous lung diseases including sarcoidosis, and post-lung transplant ILD. The immunopathogenesis of many of these diseases remains poorly defined and possibly involves either immune dysregulation, abnormal healing, chronic inflammation, or a combination of these, often in a background of genetic susceptibility. The heterogeneity and complex immunopathogenesis of ILDs complicate management, and thus a collaborative treatment team should work toward an individualized approach to address the unique needs of each patient. Current management of immune-mediated lung diseases is challenging; the choice of therapy is etiology-driven and includes corticosteroids, immunomodulatory drugs such as methotrexate, cyclophosphamide and mycophenolate mofetil, rituximab, or other measures such as discontinuation or avoidance of the inciting agent in exposure-related ILDs. Antifibrotic therapy is approved for some of the ILDs (e.g., idiopathic pulmonary fibrosis) and is being investigated for many others and has shown promising preliminary results. A dire need for advances in the management of immune-mediated lung disease persists in the absence of standardized management guidelines.

【 授权许可】

Unknown   
Copyright © 2023 Sweis, Sweis, Alnaimat, Jansz, Liao, Alsakaty, Azam, Elmergawy, Hanson, Ascoli, Rubinstein and Sweiss.