Interstitial lung disease in rheumatoid arthritis.
Interstitial lung disease in rheumatoid arthritis.
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DOI：
10.1007/s11926-010-0116-z
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发表时间：
2010-10-01
影响因子：
5
通讯作者：
Ascherman, Dana P
中科院分区：
文献类型：
--
作者：
Ascherman, Dana P
风湿性关节炎（RA）是美国最常见的全身性自身免疫性疾病，影响1%至2%的成年人口。尽管关节和滑膜是这种疾病的主要目标，但涉及肺部的关节外表现可能导致显着的发病率和过高的死亡率。在RA中发生的各种肺部并发症中，间质性肺病（ILD）是最具破坏性的，其影响范围从亚临床炎症/瘢痕形成到终末期肺纤维化。过去几年的新见解强调了具有临床/功能意义的RA相关ILD（RA-ILD）的流行病学影响，并已开始确定导致这种潜在破坏性RA并发症发病的因素。尽管取得了这些进展，但RA-ILD的复杂性和缺乏疾病进展的可靠预测因素突出了改进生物标志物开发的必要性。建立这种详细的分子特征将最终指导包括免疫调节剂以及新研究的抗纤维化药物在内的治疗药物的应用和时机。
Rheumatoid arthritis (RA) is the most common systemic autoimmune disease in the United States, affecting 1% to 2% of the adult population. Although joints and synovium are the primary targets in this disorder, extra-articular manifestations involving the lungs can lead to significant morbidity and excess mortality. Among the various pulmonary complications that occur in RA, interstitial lung disease (ILD) is the most damaging, with effects ranging from subclinical inflammation/scarring to end-stage pulmonary fibrosis. New insights during the past several years have underscored the epidemiologic impact of clinically/functionally significant RA-associated ILD (RA-ILD) and have begun to identify factors contributing to the pathogenesis of this potentially devastating complication of RA. Despite these advancements, the complexity of RA-ILD and the lack of reliable predictors for disease progression highlight the need for improved biomarker development. Establishing such detailed molecular signatures will ultimately guide the application and timing of therapeutic agents that include immunomodulators as well as newly studied antifibrotic agents.