Division of Pulmonary, Critical Care and Sleep Medicine, Ubben Center for Pulmonary Fibrosis Research, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Department of Respiratory Medicine, University Hospital of Patras, Greece.
EBioMedicine. 2023 Sep;95:104766. doi: 10.1016/j.ebiom.2023.104766. Epub 2023 Aug 23.
Idiopathic pulmonary fibrosis (IPF) is a highly heterogeneous, unpredictable and ultimately lethal chronic lung disease. Over the last decade, two anti-fibrotic agents have been shown to slow disease progression, however, both drugs are administered uniformly with minimal consideration of disease severity and inter-individual molecular, genetic, and genomic differences. Advances in biological understanding of disease endotyping and the emergence of precision medicine have shown that "a one-size-fits-all approach" to the management of chronic lung diseases is no longer appropriate. While precision medicine approaches have revolutionized the management of other diseases such as lung cancer and asthma, the implementation of precision medicine in IPF clinical practice remains an unmet need despite several reports demonstrating a large number of diagnostic, prognostic and theragnostic biomarker candidates in IPF. This review article aims to summarize our current knowledge of precision medicine in IPF and highlight barriers to translate these research findings into clinical practice.
特发性肺纤维化(IPF)是一种高度异质性、不可预测且最终致命的慢性肺部疾病。在过去的十年中,已经有两种抗纤维化药物被证明可以减缓疾病进展,然而,这两种药物的使用都是统一的,很少考虑疾病的严重程度和个体之间的分子、遗传和基因组差异。对疾病表型的生物学理解的进展以及精准医学的出现表明,对慢性肺部疾病的“一刀切”管理方法已经不再适用。虽然精准医学方法已经彻底改变了肺癌和哮喘等其他疾病的治疗,但尽管有多项报告表明在 IPF 中有大量的诊断、预后和治疗生物标志物候选物,但在 IPF 临床实践中实施精准医学仍然是一个未满足的需求。本文旨在总结目前对 IPF 精准医学的认识,并强调将这些研究结果转化为临床实践的障碍。