4.5 Review

Understanding idiopathic pulmonary fibrosis-Clinical features, molecular mechanism and therapies

Journal

EXPERIMENTAL GERONTOLOGY
Volume 153, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.exger.2021.111473

Keywords

Idiopathic pulmonary fibrosis; Alveolar epithelial cells; Interstitial lung disease; Inflammation; Myofibroblast; Pirfenidone

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IPF is a chronic lung fibrosing disease with unclear pathogenesis and a poor prognosis. Recent advancements have shed light on the pathobiology of IPF, including specific pathologic and clinical features, and the molecular pathways involved. Internal and external factors play a role in disease disposition, with changes primarily occurring in epithelial cells and fibroblasts leading to profibrotic pathway activation. Treatment options include past and future medications and therapies.
Idiopathic pulmonary fibrosis (IPF) is a chronic lung fibrosing disease with high prevalence that has a prognosis worse than many cancers. There has been a recent influx of new observations aimed at explaining the mechanisms responsible for the initiation and progression of pulmonary fibrosis. However, despite this, the pathogenesis of the disease is largely unclear. Recent progress has been made in the characterization of specific pathologic and clinical features that have enhanced the understanding of pathologically activated molecular pathways during the onset and progression of IPF. This review highlights several of the advances that have been made and focus on the pathobiology of IPF. The work also details the different factors that are responsible for the disposition of the disease - these may be internal factors such as cellular mechanisms and genetic alterations, or they may be external factors from the environment. The changes that primarily occur in epithelial cells and fibroblasts that lead to the activation of profibrotic pathways are discussed in depth. Finally, a complete repertoire of the treatment therapies that have been used in the past as well as future medications and therapies is provided.

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