a Università Cattolica del Sacro Cuore, Unità Operativa Complessa di Pneumologia , Fondazione Policlinico A. Gemelli , Rome , Italy.
b Academic Unit of Clinical and Experimental Sciences, NIHR Southampton Respiratory Biomedical Research Unit , University Hospital Southampton , Southampton , UK.
Expert Rev Respir Med. 2017 Jul;11(7):533-548. doi: 10.1080/17476348.2017.1335601. Epub 2017 May 31.
The main objective of this review is to explore the wide and expanding field of new clinical trials in IPF. Recent trials have confirmed the efficacy of the approved drugs pirfenidone and nintedanib; nonetheless, the discovery of new biological pathways has opened new horizons in this field. Areas covered: New strategies against matrix deposition are under study and so is for the role of immunity and autoimmunity. Recent advances in the use of stem cells are opening new possibilities for the recovery of damaged lung tissues. The role of microbioma is under investigation in order to evaluate the use of antibiotics in IPF treatment. Analysing all the new and the upcoming clinical trials, we are trying to offer a comprehensive view of the emerging new frontiers in the treatment of IPF. Expert commentary: The key points for the ongoing and upcoming clinical trials will be to avoid previous mistakes and to choose carefully both study populations and efficacy endpoints. The exciting possibility to enrol patients with progressive lung fibrosis, both idiopathic and not, could be a next step forward. How the existing therapies will fit in a futurist scenario of personalized medicine is still a challenge.
本次综述的主要目的是探讨 IPF 领域中新临床试验的广泛而不断扩展的领域。最近的试验证实了已批准药物吡非尼酮和尼达尼布的疗效；然而，新的生物途径的发现为该领域开辟了新的视野。涵盖领域：正在研究针对基质沉积的新策略，以及免疫和自身免疫的作用。干细胞的最新应用进展为恢复受损的肺组织开辟了新的可能性。正在研究微生物组的作用，以评估抗生素在 IPF 治疗中的应用。分析所有新的和即将进行的临床试验，我们试图提供一个全面的视角来看待 IPF 治疗中新兴的新前沿。专家评论：正在进行和即将进行的临床试验的关键点是避免以前的错误，并谨慎选择研究人群和疗效终点。招募患有进行性肺纤维化的患者（包括特发性和非特发性）的可能性令人兴奋，这可能是向前迈出的下一步。现有疗法如何适应个性化医学的未来主义方案仍然是一个挑战。
