Fujimoto Hajime, Kobayashi Tetsu, Azuma Arata
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mie University Graduate School of Medicine, Edobashi Tsu, Mie, Japan.
Department of Pulmonary Medicine, Infectious Disease and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
Clin Med Insights Circ Respir Pulm Med. 2016 Dec 8;9(Suppl 1):179-185. doi: 10.4137/CCRPM.S23321. eCollection 2015.
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease with a prognosis that can be worse than for many cancers. The initial stages of the condition were thought to mainly involve chronic inflammation; therefore, corticosteroids and other drugs that have anti-inflammatory and immunosuppressive actions were used. However, recently, agents targeting persistent fibrosis resulting from aberrant repair of alveolar epithelial injury have been in the spotlight. There has also been an increase in the number of available antifibrotic treatment options, starting with pirfenidone and nintedanib. These drugs prevent deterioration but do not improve IPF. Therefore, nonpharmacologic approaches such as long-term oxygen therapy, pulmonary rehabilitation, and lung transplantation must be considered as additional treatment modalities.
特发性肺纤维化(IPF)是一种慢性进行性肺部疾病,其预后可能比许多癌症还要差。该病的初始阶段被认为主要涉及慢性炎症;因此,曾使用具有抗炎和免疫抑制作用的皮质类固醇及其他药物。然而,近来,针对肺泡上皮损伤异常修复导致的持续性纤维化的药物受到关注。从吡非尼酮和尼达尼布开始,可用的抗纤维化治疗选择的数量也有所增加。这些药物可防止病情恶化,但无法改善IPF。因此,必须将长期氧疗、肺康复和肺移植等非药物方法视为额外的治疗方式。