[Rheumatoid arthritis, methothrexate, and pulmonary fibrosis: which evidences?].
Pulmonary fibrosis is an extraarticular manifestation of rheumatoid arthritis (RA), which appears between 20 to 40% of cases. MTX is an ordinary treatment used for patients with RA. It has been suggested in some studies that a link between the use of MTX and the appearance of pulmonary fibrosis exists. Furthermore, the chronic use of MTX has been associated with the development of hepatic cirrhosis. Adenosine, a key molecule in the anti-inflammatory action of MTX seems to have a pro-fibrotic effect in some experimental models, thereby suggesting a mechanism through which MTX could lead to a fibrotic process. However, in spite of these experimental models, clinical studies have not permitted to confirm the pathogenic role of MTX in pulmonary fibrosis.
Schaller
Dorian
D
Service de médecine, Groupement hospitalier de l'ouest lémanique, Site de Nyon, chemin Monastier 10, 1260 Nyon. dorian.schaller@ghol.ch
Nendaz
Mathieu
M
Gabay
Cem
C
D000241:Adenosine / Q000009:adverse effects / Q000378:metabolism; D000818:Animals; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000139:chemically induced; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D011658:Pulmonary Fibrosis / Q000139:chemically induced / Q000209:etiology; D012907:Smoking / Q000009:adverse effects
D000241:Adenosine; D008727:Methotrexate