Importance of chest HRCT in the diagnostic evaluation of fibrosing interstitial lung diseases

Torres, Pedro Paulo Teixeira e Silva; Rabahi, Marcelo Fouad; Moreira, Maria Auxiliadora do Carmo; Escuissato, Dante L.; Meirelles, Gustavo de Souza Portes; Marchiori, Edson

doi:10.36416/1806-3756/e20200096

Cited by 17 publications

(15 citation statements)

References 54 publications

(213 reference statements)

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“…bronchoalveolar lavage (BAL) and chest high resolution computed tomography (HRCT). For the ILD patients BAL and HRCT were part of the initial diagnostic evaluation (33)(34)(35)(36).…”

Section: Introductionmentioning

confidence: 99%

Collagen 1a1 Expression by Airway Macrophages Increases In Fibrotic ILDs and Is Associated With FVC Decline and Increased Mortality

et al. 2021

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Within the Interstitial Lung Diseases (ILD), patients with idiopathic pulmonary fibrosis (IPF) and a subset of those with non-IPF fibrotic ILD have a distinct clinical phenotype of progression despite management. This group of patients has been collectively termed the progressive fibrotic phenotype (PFP). Their early recognition may facilitate access to antifibrotic therapies to prevent or slow progression. Macrophages/monocytes within the lung orchestrate the progression and maintenance of fibrosis. A novel role for monocyte-derived macrophages during tissue damage and wound healing is the expression of collagens. We examined Collagen 1a1 expression in airway macrophages from ILD patients at diagnosis. COL1A1 mRNA levels from BAL cells were elevated in IPF and Non-IPF patients. The presence of a UIP pattern and a subsequent progressive phenotype were significantly associated with the higher BAL COL1A1 levels. In Non-IPF patients, higher COL1A1 levels were associated with a more than twofold increase in mortality. The intracellular localisation of COL1A1 in airway macrophages was demonstrated by confocal microscopy in CD45 and CD163 co-staining assays. Additionally, airway macrophages co-expressed COL1A1 with the profibrotic SPP1 gene product osteopontin. The levels of SPP1 mRNA and OPN in the BAL were significantly higher in IPF and Non-IPF patients relative to healthy. Our results suggest that profibrotic airway macrophages are increased in the BAL of patients with IPF and other ILDs and co-express COL1A1 and OPN. Importantly, COL1A1 expression by pro-fibrotic airway macrophages could be a marker of disease progression and poor survival in ILDs.

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“…bronchoalveolar lavage (BAL) and chest high resolution computed tomography (HRCT). For the ILD patients BAL and HRCT were part of the initial diagnostic evaluation (33)(34)(35)(36).…”

Section: Introductionmentioning

confidence: 99%

Collagen 1a1 Expression by Airway Macrophages Increases In Fibrotic ILDs and Is Associated With FVC Decline and Increased Mortality

et al. 2021

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“…HRCT is important for the diagnostic evaluation of fibrosing ILDs, as reviewed by Torres and colleagues [ 41 ]. Moreover, the comparison of follow-up CT scans with initial CT scans is useful for identifying progressive fibrosing ILDs [ 42 ].…”

Section: Progressive Fibrosing Interstitial Lung Diseasementioning

confidence: 99%

Progressive Fibrosing Interstitial Lung Diseases: A Current Perspective

et al. 2021

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Interstitial lung diseases (ILDs) are a large and diverse group of rare and chronic respiratory disorders, with idiopathic pulmonary fibrosis (IPF) being the most common and best-studied member. Increasing interest in fibrosis as a therapeutic target and the appreciation that fibrotic mechanisms may be a treatable target of IPF prompted the development and subsequent approval of the antifibrotics, pirfenidone and nintedanib. The management of ILDs has changed considerably following an understanding that IPF and some ILDs share similar disease behavior of progressive fibrosis, termed “progressive fibrosing phenotype”. Indeed, antifibrotic treatment has shown to be beneficial in ILDs characterized by the progressive fibrosing phenotype. This narrative review summarizes current knowledge in the field of progressive fibrosing ILDs. Here, we discuss the clinical characteristics and pathogenesis of lung fibrosis and highlight relevant literature concerning the mechanisms underlying progressive fibrosing ILDs. We also summarize current diagnostic approaches and the available treatments of progressive fibrosing ILDs and address the optimization of treating progressive fibrosing ILDs with antifibrotics in clinical practice.

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“…The review article by Torres et al, 1 published in the present issue of the Jornal Brasileiro de Pneumologia , emphasizes the role of chest HRCT in the diagnostic workup of ILDs. The first aspect that deserves attention is the methodology, which requires adequate procedural and technical parameters.…”

mentioning

confidence: 99%

“…The authors 1 correctly describe the tomographic features commonly found in fibrosing ILDs and analyze in detail those signs that differentiate the imaging pattern of IPF from that associated with other fibrosing ILDs. On the basis of the most recent international guidelines on the diagnosis of IPF, 2 the authors 1 discuss the new CT classification for IPF in four patterns: UIP, probable UIP, indeterminate for UIP, and alternative diagnosis. There is a certain tendency to consider the first two patterns as only one, because traction bronchiectasis and honeycombing have the same prognostic value regarding the profusion of fibroblastic foci on histology.…”

mentioning

confidence: 99%

“…It does enable the differentiation between nonfibrotic and fibrotic ILDs; among the latter, it allows differentiation between forms with a slow progression and those with a rapid progression. In particular, Torres et al 1 underscore the importance of chest HRCT in the follow-up of progressive forms of fibrosing ILDs, characterized by episodes of acute exacerbation and disease acceleration, in which superimposed ground-glass opacities on the fibrotic background may assume a different value. 7 Currently, the attention paid to the identification of interstitial lung abnormalities (ILAs) is also a topic of interest.…”

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confidence: 99%

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The challenge of diagnosing interstitial lung disease by HRCT: state of the art and future perspectives

Rea

Bocchino

2021

J Bras Pneumol.

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Importance of chest HRCT in the diagnostic evaluation of fibrosing interstitial lung diseases

Cited by 17 publications

References 54 publications

Collagen 1a1 Expression by Airway Macrophages Increases In Fibrotic ILDs and Is Associated With FVC Decline and Increased Mortality

Collagen 1a1 Expression by Airway Macrophages Increases In Fibrotic ILDs and Is Associated With FVC Decline and Increased Mortality

Progressive Fibrosing Interstitial Lung Diseases: A Current Perspective

The challenge of diagnosing interstitial lung disease by HRCT: state of the art and future perspectives

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