Personalized medicine in interstitial lung diseases

Spagnolo, Paolo; Oldham, Justin M.; Jones, Mark G.; Lee, Joyce

doi:10.1097/mcp.0000000000000370

Cited by 9 publications

(8 citation statements)

References 61 publications

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“…Recently, much research effort has been put into new “omic” techniques and the identification of biomarkers to predict disease progression in sarcoidosis to determine who is likely to have spontaneous resolution, who should be treated, and who will respond to therapy. However, there is still a long way to go before this could possibly be used to enable personalized treatment [6,7]. Personalized medicine should not only take these biological factors into account but also patient factors, such as preferences, lifestyle, comorbidities, and response to treatment [8,9].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a Comprehensive Home Monitoring Program for Sarcoidosis

Moor

Gür-Demirel

Wijsenbeek

2019

JPM

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Sarcoidosis is a chronic, heterogeneous disease which most commonly affects the lungs. Currently, evidence-based and individually tailored treatment options in sarcoidosis are lacking. We aimed to evaluate patient experiences with a home monitoring program for sarcoidosis and assess whether home monitoring is a feasible tool to enhance personalized treatment. Outpatients with pulmonary sarcoidosis tested the home monitoring program “Sarconline” for one month. This is a secured personal platform which consists of online patient-reported outcomes, real-time wireless home spirometry, an activity tracker, an information library, and an eContact option. Patients wore an activity tracker, performed daily home spirometry, and completed patient-reported outcomes at baseline and after one month. Patient experiences were evaluated during a phone interview. Ten patients were included in the study. Experiences with the home monitoring program were positive; 90% of patients considered the application easy to use, none of the patients found daily measurements burdensome, and all patients wished to continue the home monitoring program after the study. Mean adherence to daily spirometry and activity tracking was, respectively, 94.6% and 91.3%. In conclusion, a comprehensive home monitoring program for sarcoidosis is feasible and can be used in future research and clinical practice.

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Section: Introductionmentioning

confidence: 99%

Feasibility of a Comprehensive Home Monitoring Program for Sarcoidosis

Moor

Gür-Demirel

Wijsenbeek

2019

JPM

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“…The non-inflammatory model is the result of an early aging process in susceptible individuals associated with altered lung homeostasis based on the uncontrolled proliferation of fibroblasts due to epigenetic and genetic changes such as short telomeres, alteration of telomerase, alteration of alveolar surfactant, and pulmonary mucins (15). The new frontier in IPF is represented by the effort to find specific biomarkers involved in the complex mechanism of the pathogenesis and progression of disease (16,17) for personalized therapy (18–20) and a better comprehension and prediction of several consequences and co-morbidities that share some pathobiological pathway with IPF.…”

Section: Pathogenesis Of Ipfmentioning

confidence: 99%

Highlights of high-resolution computed tomography imaging in evaluation of complications and co-morbidities in idiopathic pulmonary fibrosis

et al. 2019

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Idiopathic pulmonary fibrosis (IPF) represents a condition included in the heterogeneous group of interstitial lung diseases without known causes. The recent ATS/ERS/JRS/ALAT guidelines and the white paper published by the Fleischner Society have well-defined diagnosis and management of idiopathic pulmonary fibrosis. Idiopathic pulmonary fibrosis management is complex because it is also influenced by several co-morbidities and complications. The new frontier in idiopathic pulmonary fibrosis is represented by the effort to understand the complex mechanism of the pathogenesis and progression of disease in order to predict several consequences and co-morbidities. In our review, we tried to distinguish co-morbidities from complications of idiopathic pulmonary fibrosis. In each complication, we have reviewed the existing literature and we have emphasized the complex pathobiological pathway which links the progression of idiopathic pulmonary fibrosis to the development of the complication itself. For every co-morbidity, we tried to identify share common risk factors which explain the coexistence of idiopathic pulmonary fibrosis with its co-morbidities. We then analyzed high-resolution computed tomography (CT) aspects of co-morbidities and complications of idiopathic pulmonary fibrosis that the radiologist should be aware of. In this review, we focused on the role of high-resolution CT imaging in the evaluation of co-morbidities and complications in idiopathic pulmonary fibrosis because their early diagnosis and treatment could change the prognosis in patients with idiopathic pulmonary fibrosis. We have also pointed out that in some cases the final combined quantitative CT tools and conventional visual CT score would allow to get an accurate analysis and quantification of disease progression, co-morbidities, and complications of idiopathic pulmonary fibrosis in order to improve staging systems in idiopathic pulmonary fibrosis.

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“…Although the drugs now used in IPF are anti-fibrotics and no biomarkers for diagnosis or prognosis have yet been identified, several works identified molecules included in the pathogenesis and progression of disease that may be therapeutic targets and molecules translated from other diseases such as severe asthma (8); other authors identified a specific polymorphism of the TOLLIP gene that determines a different response to N-Acetylcysteine therapy (9). As in other ILDs where there is a therapy based on pathogenesis and immunosuppressants, in IPF, biomarkers are being searched for with the aim of a targeted and personalized therapy (10).…”

Section: Introductionmentioning

confidence: 99%

Radiological pitfalls associated with the diagnosis of usual interstitial pneumonia pattern on high-resolution computed tomography and associated findings: experience from a single Italian center

et al. 2020

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Background The diagnostic algorithm for idiopathic pulmonary fibrosis (IPF) based on high-resolution computed tomography (HRCT) findings and multidisciplinary discussion (MDD) has been well established. Purpose To identify the causes of disagreement between non-thoracic and thoracic radiologist involved in MDD for the imaging diagnosis of usual interstitial pneumonia (UIP) patterns and associated findings on HRCT and to improve the understanding of IPF by non-expert radiologists through a more systematic approach to HRCT. Material and Methods This study included 68 patients who underwent MDD for suspected IPF. We compared the first reports generated before MDD by non-expert radiologists with the CT pattern and associated findings of IPF reported by thoracic radiologist involved in MDD. Results Regarding the diagnosis of CT pattern by non-expert radiologists, 30/68 patients received a discordant diagnosis, and in another 28 reports, all features of the CT pattern were described without reaching a diagnostic conclusion. The first report was concordant in only 10 patients. For 63 cases in which associated findings were reported by expert radiologists in MDD, we documented discrepancies in 47 cases where associated findings were considered absent by the first non-thoracic radiologist. Conclusion We found significant discrepancies in the imaging diagnosis of UIP patterns and associated findings on HRCT between non-expert and thoracic radiologists included in MDD. Therefore, in this study, we analyzed and suggested diagnostic strategies to improve non-expert radiologists’ approach to HRCT.

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Personalized medicine in interstitial lung diseases

Cited by 9 publications

References 61 publications

Feasibility of a Comprehensive Home Monitoring Program for Sarcoidosis

Feasibility of a Comprehensive Home Monitoring Program for Sarcoidosis

Highlights of high-resolution computed tomography imaging in evaluation of complications and co-morbidities in idiopathic pulmonary fibrosis

Radiological pitfalls associated with the diagnosis of usual interstitial pneumonia pattern on high-resolution computed tomography and associated findings: experience from a single Italian center

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