Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies

Mol Aspects Med. 2023 Dec:94:101227. doi: 10.1016/j.mam.2023.101227. Epub 2023 Nov 24.

Abstract

Fibrosis is the concluding pathological outcome and major cause of morbidity and mortality in a number of common chronic inflammatory, immune-mediated and metabolic diseases. The progressive deposition of a collagen-rich extracellular matrix (ECM) represents the cornerstone of the fibrotic response and culminates in organ failure and premature death. Idiopathic pulmonary fibrosis (IPF) represents the most rapidly progressive and lethal of all fibrotic diseases with a dismal median survival of 3.5 years from diagnosis. Although the approval of the antifibrotic agents, pirfenidone and nintedanib, for the treatment of IPF signalled a watershed moment for the development of anti-fibrotic therapeutics, these agents slow but do not halt disease progression or improve quality of life. There therefore remains a pressing need for the development of effective therapeutic strategies. In this article, we review emerging therapeutic strategies for IPF as well as the pre-clinical and translational approaches that will underpin a greater understanding of the key pathomechanisms involved in order to transform the way we diagnose and treat pulmonary fibrosis.

Keywords: Anti-Fibrotic agent; Collagen; Fibroblast; Fibrogenesis; Fibrosis; Idiopathic pulmonary fibrosis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Extracellular Matrix / metabolism
  • Fibrosis
  • Humans
  • Idiopathic Pulmonary Fibrosis* / diagnosis
  • Idiopathic Pulmonary Fibrosis* / drug therapy
  • Inflammation / metabolism
  • Quality of Life*