NEMA Research, Inc., Naples, FL, USA.
Department of Radiology, University of L'Aquila, L'Aquila, Italy.
Adv Ther. 2023 Apr;40(4):1334-1346. doi: 10.1007/s12325-022-02395-9. Epub 2023 Jan 24.
The most common type of idiopathic interstitial pneumonia is idiopathic pulmonary fibrosis (IPF), an irreversible, progressive disorder that has lately come into question for possible associations with COVID-19. With few geographical exceptions, IPF is a rare disease but its prevalence has been increasing markedly since before the pandemic. Environmental exposures are frequently implicated in IPF although genetic factors play a role as well. In IPF, healthy lung tissue is progressively replaced with an abnormal extracellular matrix that impedes normal alveolar function while, at the same time, natural repair mechanisms become dysregulated. While chronic viral infections are known risk factors for IPF, acute infections are not and the link to COVID-19 has not been established. Macrophagy may be a frontline defense against any number of inflammatory pulmonary diseases, and the inflammatory cascade that may occur in patients with COVID-19 may disrupt the activity of monocytes and macrophages in clearing up fibrosis and remodeling lung tissue. It is unclear if COVID-19 infection is a risk factor for IPF, but the two can occur in the same patient with complicating effects. In light of its increasing prevalence, further study of IPF and its diagnosis and treatment is warranted.
特发性间质性肺炎最常见的类型是特发性肺纤维化 (IPF)，这是一种不可逆转的进行性疾病，最近有人提出它可能与 COVID-19 有关联。除了少数地理位置的例外，IPF 是一种罕见的疾病，但自大流行前以来，其发病率显著增加。尽管遗传因素也起作用，但环境暴露经常与 IPF 有关。在 IPF 中，健康的肺组织逐渐被异常的细胞外基质取代，这阻碍了正常的肺泡功能，同时，自然修复机制变得失调。虽然慢性病毒感染是 IPF 的已知危险因素，但急性感染不是，与 COVID-19 的联系尚未确定。吞噬作用可能是对抗任何数量的炎症性肺部疾病的第一道防线，而 COVID-19 患者可能发生的炎症级联反应可能会破坏单核细胞和巨噬细胞清除纤维化和重塑肺组织的活性。目前尚不清楚 COVID-19 感染是否是 IPF 的一个危险因素，但两者可能同时发生在同一患者身上，产生复杂的影响。鉴于其发病率的增加，有必要进一步研究 IPF 及其诊断和治疗。
