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进展性肺纤维化间质性肺病的靶向治疗进展。

Advances in Targeted Therapy for Progressive Fibrosing Interstitial Lung Disease.

机构信息

Division of Pulmonary and Critical Care Medicine, NYU Langone Health, New York University Grossman School of Medicine, 550 1 Ave, New York, NY, 10016, USA.

出版信息

Lung. 2020 Aug;198(4):597-608. doi: 10.1007/s00408-020-00370-1. Epub 2020 Jun 26.

Abstract

Progressive fibrosing interstitial lung disease (PF-ILD) has been redefined as a new clinical syndrome that shares similar genetics, pathophysiology, and natural history to idiopathic pulmonary fibrosis (IPF). IPF is the most common form of idiopathic interstitial pneumonias, which is progressive in nature and is associated with significant mortality. Therapies targeting an inflammatory and/or immune response have not been consistently effective or well tolerated in patients with IPF. The two antifibrotic drugs approved for IPF treatment, nintedanib and pirfenidone, have been shown to reduce lung function decline in PF-ILD. Novel uses of antifibrotic therapy are emerging due to a paucity of evidence-based treatments for multiple ILD subtypes. In this review, we describe the current body of knowledge on antifibrotic therapy and immunomodulators in PF-ILD, drawing from experience in IPF where appropriate.

摘要

进行性纤维性间质性肺病 (PF-ILD) 被重新定义为一种新的临床综合征,其具有与特发性肺纤维化 (IPF) 相似的遗传、病理生理学和自然病史。IPF 是特发性间质性肺炎中最常见的一种,其性质呈进行性,与显著的死亡率相关。针对炎症和/或免疫反应的治疗方法在 IPF 患者中并未始终有效或耐受良好。两种批准用于 IPF 治疗的抗纤维化药物,尼达尼布和吡非尼酮,已被证明可降低 PF-ILD 中的肺功能下降。由于缺乏针对多种间质性肺病亚型的循证治疗方法,抗纤维化治疗的新用途正在出现。在这篇综述中,我们描述了当前关于 PF-ILD 中抗纤维化治疗和免疫调节剂的知识体系,在适当的情况下借鉴了 IPF 的经验。

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