Lema Diego, Kosak Lopez Esteban, Lam Justin, Tskhakaia Irakli, Gonzalez Moret Yurilu, Abdollahi Shahrzad
Department of Medicine, Jefferson Einstein Hospital, Philadelphia, PA 19141, USA.
Division of Rheumatology, Jefferson Einstein Hospital, Philadelphia, PA 19141, USA.
Int J Mol Sci. 2025 Jul 7;26(13):6538. doi: 10.3390/ijms26136538.
Emerging evidence suggests a significant association between monocytes and the pathophysiology and prognosis of idiopathic pulmonary fibrosis (IPF). This review aims to systematically evaluate current knowledge regarding blood monocyte counts and their relationship with the etiology, progression, and prognosis of IPF. We conducted a systematic search in the PubMed database for articles published through 17 February 2025, using the MeSH terms "lung diseases, interstitial" and "monocytes," which yielded 314 results. After filtering for full-text articles in English (n = 242), we included only studies focusing on blood monocyte counts with clinical implications in IPF. Articles relating to other cell types or non-IPF lung diseases were excluded. Our systematic search identified 12 relevant articles. Monocytes play an essential role in regulating inflammatory responses and resolution across multiple diseases, with established but incompletely understood contributions to lung fibrosis development in IPF. Correlations have been demonstrated between elevated blood monocyte counts and the following: (1) the presence and progression of interstitial lung abnormalities, (2) the progression from an indeterminate usual interstitial pneumonia (UIP) pattern on CT scans to definitive IPF, and (3) worse lung function parameters, an increased risk of acute exacerbations, and reduced overall survival in IPF patients. Monocytes serve as critical orchestrators throughout IPF's natural history-from early interstitial changes to disease progression and acute exacerbations. Targeting monocyte recruitment pathways and reprogramming their differentiation represents a promising therapeutic approach, while circulating monocyte counts offer potential as accessible biomarkers for disease progression and treatment response. Future research should characterize stage-specific monocyte phenotypes to enable precision-targeted interventions.
新出现的证据表明，单核细胞与特发性肺纤维化（IPF）的病理生理学和预后之间存在显著关联。本综述旨在系统评估目前关于血液单核细胞计数及其与IPF病因、进展和预后关系的知识。我们在PubMed数据库中进行了系统检索，以查找截至2025年2月17日发表的文章，使用医学主题词“肺疾病，间质性”和“单核细胞”，共获得314条结果。在筛选出英文全文文章（n = 242）后，我们仅纳入了关注血液单核细胞计数且对IPF有临床意义的研究。排除了与其他细胞类型或非IPF肺部疾病相关的文章。我们的系统检索确定了12篇相关文章。单核细胞在调节多种疾病的炎症反应和炎症消退中起着至关重要的作用，对IPF肺纤维化发展的作用已得到证实但尚未完全了解。血液单核细胞计数升高与以下情况之间存在相关性：（1）间质性肺异常的存在和进展；（2）CT扫描上从不确定的普通间质性肺炎（UIP）模式进展为明确的IPF；（3）IPF患者肺功能参数更差、急性加重风险增加和总生存期缩短。单核细胞在IPF的整个自然病程中起着关键的协调作用——从早期间质性改变到疾病进展和急性加重。靶向单核细胞募集途径并重新编程其分化代表了一种有前景的治疗方法，而循环单核细胞计数有望作为疾病进展和治疗反应的可获取生物标志物。未来的研究应明确阶段特异性单核细胞表型，以实现精准靶向干预。
