Unità Operativa Complessa di Pneumologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico A. Gemelli, Rome, Italy; National Institute for Health Research Southampton Respiratory Biomedical Research Unit and Clinical and Experimental Sciences, University of Southampton, Southampton, UK.
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Lancet. 2017 May 13;389(10082):1941-1952. doi: 10.1016/S0140-6736(17)30866-8. Epub 2017 Mar 30.
Idiopathic pulmonary fibrosis is a prototype of chronic, progressive, and fibrotic lung disease. Healthy tissue is replaced by altered extracellular matrix and alveolar architecture is destroyed, which leads to decreased lung compliance, disrupted gas exchange, and ultimately respiratory failure and death. In less than a decade, understanding of the pathogenesis and management of this disease has been transformed, and two disease-modifying therapies have been approved, worldwide. In this Seminar, we summarise the presentation, pathophysiology, diagnosis, and treatment options available for patients with idiopathic pulmonary fibrosis. This disease has improved understanding of the mechanisms of lung fibrosis, and offers hope that similar approaches will transform the management of patients with other progressive fibrotic lung diseases.
特发性肺纤维化是一种慢性、进行性、纤维化肺部疾病的典型代表。健康组织被改变的细胞外基质所取代,肺泡结构被破坏,导致肺顺应性降低,气体交换受损,最终导致呼吸衰竭和死亡。在不到十年的时间里,人们对这种疾病的发病机制和治疗方法的理解发生了转变,并且已经在全球范围内批准了两种能够改变疾病进程的治疗方法。在本次专题讨论会上,我们总结了特发性肺纤维化患者的临床表现、病理生理学、诊断和治疗选择。该疾病提高了对肺纤维化机制的认识,并为其他进行性肺纤维化疾病患者的治疗带来了希望。