Personalized medicine in idiopathic pulmonary fibrosis

Spagnolo, Paolo; Τzouvelekis, Αrgyris; Maher, Toby M.

doi:10.1097/mcp.0000000000000187

Cited by 46 publications

(31 citation statements)

References 83 publications

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“…Obtaining representative and diagnostic lung tissue samples with less risk of morbidity and mortality could expand indications and augment the possibility of adding morphological information to data already acquired by clinical investigation, laboratory tests, and HRCT scan [38].…”

Section: Methodsmentioning

confidence: 99%

“…For example, SLB is typically not indicated in subjects having HRCT images demonstrating a typical UIP pattern. However, the availability of TBCB and its lower morbidity compared to SLB could potentially broaden the indication for lung biopsy such as in DPLD patients with equivocal exposures or suspicion of an occult collagen vascular disease who may exhibit histopathological clues to alternative diagnoses (e.g., small granulomas, foci of organizing pneumonia, lymphoid follicles, pulmonary and pleural chronic inflammation) on cryobiopsy that might add weight to other diagnoses [30,38,39]. Therefore, TBCB could sometimes be proposed in patients with a typical radiological UIP pattern, with the aim of collecting more definitive data suggesting occult exposures or collagen vascular diseases.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Transbronchial Cryobiopsies for the Diagnosis of Diffuse Parenchymal Lung Diseases: Expert Statement from the Cryobiopsy Working Group on Safety and Utility and a Call for Standardization of the Procedure

et al. 2018

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Transbronchial cryobiopsies (TBCB) have recently been introduced as a promising and safer alternative to surgical lung biopsy in the diagnostic approach to diffuse parenchymal lung diseases (DPLD). Despite a substantial and expanding body of literature, the technique has not yet been standardized and its place in the diagnostic algorithm of DPLD remains to be defined. In part, this reflects concerns over the diagnostic yield and safety of the procedure, together with the rapid spread of the technique without competency and safety standards; furthermore, there is a substantial procedural variability among centers and interventional pulmonologists. We report this expert statement proposed during the third international conference on “Transbronchial Cryobiopsy in Diffuse Parenchymal Lung Disease” (Ravenna, October 27–28, 2016), which formulates evidence- and expert-based suggestions on the indications, contraindications, patient selection, and procedural aspects of the procedure. The following 5 domains were reviewed: (1) what is the role of TBCB in the diagnostic evaluation of DPLD: patient selection; (2) pathological considerations; (3) contraindications and safety considerations; (4) how should TBCB be performed and in what procedural environment; and (5) who should perform TBCB. Finally, the existence of white paper recommendations may also reassure local hospital credentialing committees tasked with endorsing an adoption of the technique.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Transbronchial Cryobiopsies for the Diagnosis of Diffuse Parenchymal Lung Diseases: Expert Statement from the Cryobiopsy Working Group on Safety and Utility and a Call for Standardization of the Procedure

et al. 2018

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“…Fibrosis is a common cause of organ failure in many disease settings, including idiopathic pulmonary fibrosis (Spagnolo et al, 2015), liver cirrhosis (Schuppan, 2015), kidney disease (Ballermann and Obeidat, 2014) and systemic sclerosis (Ebmeier and Horsley, 2015), among others. It is predicted that nearly 45% of all deaths in the developed world are related to chronic fibrosis (Wynn, 2008).…”

Section: Perspectives From Other Organsmentioning

confidence: 99%

View from the heart: cardiac fibroblasts in development, scarring and regeneration

et al. 2016

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In the adult, tissue repair after injury is generally compromised by fibrosis, which maintains tissue integrity with scar formation but does not restore normal architecture and function. The process of regeneration is necessary to replace the scar and rebuild normal functioning tissue. Here, we address this problem in the context of heart disease, and discuss the origins and characteristics of cardiac fibroblasts, as well as the crucial role that they play in cardiac development and disease. We discuss the dual nature of cardiac fibroblasts, which can lead to scarring, pathological remodelling and functional deficit, but can also promote heart function in some contexts. Finally, we review current and proposed approaches whereby regeneration could be fostered by interventions that limit scar formation.

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“…This approach has garnered increasing attention in the pulmonary community, given its revolutionary impact on the fields of lung cancer, cystic fibrosis, and asthma (9). The term "endotype" was coined by Dr. Gary Anderson to refer to these molecularly defined subgroups, and many investigators now believe that IPF likely contains distinct endotypes that may be identified through biomarker profiles (10)(11)(12).…”

Section: The Promise Of Precision Medicinementioning

confidence: 99%