特发性肺纤维化:当前知识回顾

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-08-31
J Muri, B Durcová, R Slivka, A Vrbenská, M Makovická, P Makovický, J Škarda, P Delongová, V Kamarád, J Vecanová
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引用次数: 0

摘要

特发性肺纤维化(IPF)是一种目前无法治愈的严重疾病,与肺实质不可逆转的纤维化重塑有关。肺部的病理重塑导致肺泡-毛细血管屏障受损。肺对呼吸气体的弥散能力下降。随后,肺组织的机械特性发生变化--顺应性降低,呼吸功增加。呼吸气体交换受损和限制性通气功能衰竭导致组织缺氧和肌肉无力。逐渐出现呼吸功能不全。肺部纤维化重塑的诱因以及使这一过程持续活跃的病理机制目前尚不清楚。IPF 只能通过药物减缓,而不能逆转。因此,尽早开始治疗非常重要。早期发现 IPF 患者需要采用多学科方法。在专业中心进行诊断、开始治疗和监测,是减缓疾病进展、提高生活质量和延长患者生存期的最佳途径。除了抗纤维化治疗外,良好的生活方式管理、保持身体健康以及治疗糖尿病和心脏病等相关慢性疾病也很重要。肺移植是一些 IPF 患者的选择。这是一种具有挑战性的治疗方式,需要与移植中心密切合作,并由专家选择合适的候选者,这主要受到是否有合适的供肺的影响。本文旨在提供有关 IPF 的最新信息,重点关注其功能性后果和临床表现。我们讨论了可能参与 IPF 发展的分子和细胞机制,以及在肺活检和高分辨率计算机断层扫描(HRCT)图像中观察到的形态学变化。最后,我们总结了现有的治疗方案。关键词:特发性肺纤维化特发性肺纤维化 肺活检 高分辨计算机断层扫描 抗纤维化治疗 肺移植
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Idiopathic Pulmonary Fibrosis: Review of Current Knowledge.

Idiopathic pulmonary fibrosis (IPF) is a severe and currently incurable disease that is associated with irreversible fibrotic remodeling of the lung parenchyma. Pathological remodeling of the lung leads to damage of the alveolo-capillary barrier. There is a reduction in the diffusing capacity of the lungs for respiratory gases. Later, changes in the mechanical properties of lung tissue occur - their compliance decreases and respiratory work increases. Impaired respiratory gases exchange with restrictive ventilatory failure lead to tissue hypoxia and muscle weakness. Progressive respiratory insufficiency develops. The triggers of fibrotic remodeling of the lung are currently unknown, as are the pathomechanisms that keep this process active. IPF can only be slowed pharmacologically, not reversed. It is therefore very important to start its treatment as soon as possible. Early detection of IPF patients requires a multidisciplinary approach. Diagnosis, treatment initiation, and monitoring in specialized centers offer the best chance of slowing disease progression, enhancing quality of life, and extending patient survival. In addition to antifibrotic therapy, good lifestyle management, maintenance of physical fitness and treatment of associated chronic diseases such as diabetes and cardiac comorbidities are important. Lung transplantation is an option for some patients with IPF. This is a challenging treatment modality, requiring close collaboration with transplant centers and expert selection of suitable candidates, influenced, among other things, by the availability of suitable donor lungs. Our article aims to provide current information about IPF, focusing on its functional consequences and clinical manifestation. We discuss the molecular and cellular mechanisms potentially involved in IPF development, as well as the morphological changes observed in lung biopsies and high-resolution computed tomography (HRCT) images. Finally, we summarize the existing treatment options. Key words: Idiopathic pulmonary fibrosis, Lung biopsy, HRCT, Antifibrotic therapy, Lung transplantation.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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