Interstitial lung disease in systemic sclerosis: Pathophysiology, current and new advances in therapy

Snigdha Jain, Anupama Shahane, Chris T. Derk

Research output: Contribution to journalReview article

10 Scopus citations

Abstract

Systemic sclerosis is an autoimmune connective tissue disorder characterized by fibrosis of the skin and visceral organs. Interstitial lung disease (ILD) is a major complication of this disease and along with pulmonary arterial hypertension is the leading cause of mortality in scleroderma patients. The pathogenesis of pulmonary fibrosis is characterized by epithelial cell injury, activation of the coagulation pathway and inflammation, which create a profibrogenic environment in the lung in the setting of autoimmunity. The current standard of treatment for ILD in systemic sclerosis is cyclophosphamide. In view of the modest benefits in pulmonary function seen with cyclophosphamide in two recent trials and its significant toxicity, the search for alternative treatments is ongoing. With the advances in our understanding of the pathogenic mechanisms of pulmonary fibrosis, many promising therapeutic agents have come into view, but their efficacy needs to be evaluated before they can be recommended clinically. This review discusses the pathogenesis of pulmonary fibrosis with a focus on the potential target pathways, the current treatment options and recent advances in the treatment of ILD in systemic sclerosis.

Original languageEnglish (US)
Pages (from-to)266-277
Number of pages12
JournalInflammation and Allergy - Drug Targets
Volume11
Issue number4
DOIs
Publication statusPublished - Nov 29 2012

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Keywords

  • Interstitial lung disease
  • Lung
  • Pathophysiology
  • Scleroderma
  • Systemic sclerosis
  • Therapy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pharmacology

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