Interstitial lung disease in rheumatoid arthritis.
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.
Ascherman
Dana P
DP
Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, BST S707, 3500 Terrace Street, Pittsburgh, PA 15261, USA. ascher@pitt.edu
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000963:Antimetabolites / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D002956:Citrulline / Q000378:metabolism; D003520:Cyclophosphamide / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011506:Proteins / Q000378:metabolism; D011658:Pulmonary Fibrosis / Q000209:etiology; D011859:Radiography; D012907:Smoking / Q000009:adverse effects
D000305:Adrenal Cortex Hormones; D000963:Antimetabolites; D015415:Biomarkers; D007166:Immunosuppressive Agents; D011506:Proteins; D002956:Citrulline; D003520:Cyclophosphamide; D009173:Mycophenolic Acid