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Review
. 2022 Aug 3;12(8):1275.
doi: 10.3390/jpm12081275.

Towards Treatable Traits for Pulmonary Fibrosis

Thijs W Hoffman  1 , Jan C Grutters  1   2
Affiliations
Review

Towards Treatable Traits for Pulmonary Fibrosis

Thijs W Hoffman et al. J Pers Med. .

Abstract

Interstitial lung diseases (ILD) are a heterogeneous group of disorders, of which many have the potential to lead to progressive pulmonary fibrosis. A distinction is usually made between primarily inflammatory ILD and primarily fibrotic ILD. As recent studies show that anti-fibrotic drugs can be beneficial in patients with primarily inflammatory ILD that is characterized by progressive pulmonary fibrosis, treatment decisions have become more complicated. In this perspective, we propose that the 'treatable trait' concept, which is based on the recognition of relevant exposures, various treatable phenotypes (disease manifestations) or endotypes (shared molecular mechanisms) within a group of diseases, can be applied to progressive pulmonary fibrosis. These targets for medical intervention can be identified through validated biomarkers and are not necessarily related to specific diagnostic labels. Proposed treatable traits are: cigarette smoking, occupational, allergen or drug exposures, excessive (profibrotic) auto- or alloimmunity, progressive pulmonary fibrosis, pulmonary hypertension, obstructive sleep apnea, tuberculosis, exercise intolerance, exertional hypoxia, and anxiety and depression. There are also several potential traits that have not been associated with relevant outcomes or for which no effective treatment is available at present: air pollution, mechanical stress, viral infections, bacterial burden in the lungs, surfactant-related pulmonary fibrosis, telomere-related pulmonary fibrosis, the rs35705950 MUC5B promoter polymorphism, acute exacerbations, gastro-esophageal reflux, dyspnea, and nocturnal hypoxia. The 'treatable traits' concept can be applied in new clinical trials for patients with progressive pulmonary fibrosis and could be used for developing new treatment strategies.

Keywords: interstitial lung disease; progressive pulmonary fibrosis; treatable traits.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Proposed treatable traits for progressive pulmonary fibrosis, divided into pulmonary, environmental, functional, and comorbidity domains. Traits for which either a clear association with relevant outcomes, a clear method for measuring the trait, or a proven treatment is not available are marked in grey.
See this image and copyright information in PMC

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References

    1. Agusti A., Bel E., Thomas M., Vogelmeier C., Brusselle G., Holgate S., Humbert M., Jones P., Gibson P.G., Vestbo J., et al. Treatable traits: Toward precision medicine of chronic airway diseases. Eur. Respir. J. 2016;47:410–419. doi: 10.1183/13993003.01359-2015. - DOI - PubMed
    1. McDonald V.M., Fingleton J., Agusti A., Hiles S.A., Clark V.L., Holland A.E., Marks G.B., Bardin P.P., Beasley R., Pavord I.D., et al. Treatable traits: A new paradigm for 21st century management of chronic airway diseases: Treatable Traits Down Under International Workshop report. Eur. Respir. J. 2019;53:1802058. doi: 10.1183/13993003.02058-2018. - DOI - PubMed
    1. Agustí A. Phenotypes and disease characterization in chronic obstructive pulmonary disease: Toward the extinction of phenotypes? Ann. Am. Thorac. Soc. 2013;10:S125–S130. doi: 10.1513/AnnalsATS.201303-055AW. - DOI - PubMed
    1. Mikolasch T.A., Garthwaite H.S., Porter J.C. Update in diagnosis and management of interstitial lung Disease. Clin. Med. J. R. Coll. Physicians Lond. 2017;17:146–153. doi: 10.7861/clinmedicine.17-2-146. - DOI - PMC - PubMed
    1. Wijsenbeek M., Cottin V. Spectrum of Fibrotic Lung Diseases. N. Engl. J. Med. 2020;8:958–968. doi: 10.1056/NEJMra2005230. - DOI - PubMed

Grants and funding

This research received no external funding.