Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, Davis, School of Medicine and VA Northern California Health Care System, Sacramento, California, USA;
J Thorac Dis. 2013 Feb;5(1):48-73. doi: 10.3978/j.issn.2072-1439.2012.12.07.
Idiopathic pulmonary fibrosis (IPF) is a progressively fibrotic interstitial lung disease that is associated with a median survival of 2-3 years from initial diagnosis. To date, there is no treatment approved for IPF in the United States, and only one pharmacological agent has been approved outside of the United States. Nevertheless, research over the past 10 years has provided us with a wealth of information on its histopathology, diagnostic work-up, and a greater understanding of its pathophysiology. Specifically, IPF is no longer thought to be a predominantly pro-inflammatory disorder. Rather, the fibrosis in IPF is increasingly understood to be the result of a fibroproliferative and aberrant wound healing cascade. The development of therapeutic targets has shifted in accord with this paradigm change. This review highlights the current understanding of IPF, and the recent as well as novel therapeutics being explored in clinical trials for the treatment of this devastating disease.
特发性肺纤维化(IPF)是一种进行性纤维化的间质性肺疾病,从最初诊断到中位生存期为 2-3 年。迄今为止,在美国还没有批准用于 IPF 的治疗方法,而在美国以外只有一种药物获得批准。然而,过去 10 年的研究为其组织病理学、诊断检查以及对其病理生理学的更深入了解提供了丰富的信息。具体而言,IPF 不再被认为是一种主要的炎症性疾病。相反,IPF 中的纤维化越来越被认为是纤维增生性和异常的伤口愈合级联反应的结果。治疗靶点的发展也与这种范式转变相一致。本综述强调了对 IPF 的现有认识,以及正在临床试验中探索用于治疗这种毁灭性疾病的最新和新型治疗方法。