title: Smoking-related idiopathic interstitial pneumonia.
abstract: Cigarette smoking is a key factor in the development of numerous pulmonary diseases. An international group of clinicians, radiologists and pathologists evaluated patients with previously identified idiopathic interstitial pneumonia (IIP) to determine unique features of cigarette smoking. Phase 1 (derivation group) identified smoking-related features in patients with a history of smoking (n=41). Phase 2 (validation group) determined if these features correctly predicted the smoking status of IIP patients (n=100) to participants blinded to smoking history. Finally, the investigators sought to determine if a new smoking-related interstitial lung disease phenotype could be defined. Phase 1 suggested that preserved forced vital capacity with disproportionately reduced diffusing capacity of the lung for carbon monoxide, and various radiographic and histopathological findings were smoking-related features. In phase 2, the kappa coefficient among clinicians was 0.16 (95% CI 0.11-0.21), among the pathologists 0.36 (95% CI 0.32-0.40) and among the radiologists 0.43 (95% CI 0.35-0.52) for smoking-related features. Eight of the 100 cases were felt to represent a potential smoking-related interstitial lung disease. Smoking-related features of interstitial lung disease were identified in a minority of smokers and were not specific for smoking. This study is limited by its retrospective design, the potential for recall bias in smoking history and lack of information on second-hand smoke exposure. Further research is needed to understand the relationship between smoking and interstitial lung disease.
authors: Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA Both authors contributed equally.
authors: Kevin R
authors: KR
authors: Flaherty
authors: Division of Respiratory Medicine, University of Calgary, Calgary, AB, Canada Both authors contributed equally.
authors: Charlene
authors: C
authors: Fell
authors: Dept of Pathology, Mayo Clinic, Rochester, MN, USA.
authors: Marie-Christine
authors: MC
authors: Aubry
authors: Division of Pulmonary Medicine, National Jewish Medical and Research Center, Denver, CO, USA.
authors: Kevin
authors: K
authors: Brown
authors: Dept of Pathology, Mayo Clinic, Scottsdale, AZ, USA.
authors: Thomas
authors: T
authors: Colby
authors: Dept of Pneumology/Allergy, Ruhrlandklinik, University Hospital, Essen, Germany.
authors: Ulrich
authors: U
authors: Costabel
authors: Dept of Pulmonary and Mediastinal Pathology, The Joint Pathology Center, Silver Spring, MD, USA.
authors: Teri J
authors: TJ
authors: Franks
authors: Dept of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors: Barry H
authors: BH
authors: Gross
authors: Dept of Radiology, Royal Brompton Hospital, London, UK.
authors: David M
authors: DM
authors: Hansell
authors: Dept of Radiology, University of Michigan, Ann Arbor, MI, USA.
authors: Ella
authors: E
authors: Kazerooni
authors: Dept of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors: Dong Soon
authors: DS
authors: Kim
authors: Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, CA, USA.
authors: Talmadge E
authors: TE
authors: King
authors: National Hospital Organization Kinki-Chuo, Osaka, Japan.
authors: Masanori
authors: M
authors: Kitachi
authors: Dept of Radiology, National Jewish Medical and Research Center, Denver, CO, USA.
authors: David
authors: D
authors: Lynch
authors: Dept of Pathology, University of Michigan, Ann Arbor, MI, USA.
authors: Jeff
authors: J
authors: Myers
authors: Respiratory Medicine, Kyoto University, Kyoto, Japan.
authors: Sonoko
authors: S
authors: Nagai
authors: Dept of Histopathology, Royal Brompton Hospital, London, UK.
authors: Andrew G
authors: AG
authors: Nicholson
authors: Dipartimento di Malattie del Torace, Universita di Parma, Forli, Italy.
authors: Venerino
authors: V
authors: Poletti
authors: Division of Pulmonary Medicine, University of Washington, Seattle, WA, USA.
authors: Ganesh
authors: G
authors: Raghu
authors: Instituto Nacional de Enfermedades Respiratorias, Mexico DF, Mexico.
authors: Moises
authors: M
authors: Selman
authors: Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
authors: Galen
authors: G
authors: Toews
authors: Dept of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: William
authors: W
authors: Travis
authors: Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK.
authors: Athol U
authors: AU
authors: Wells
authors: Division of Pulmonary, Allergy and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Robert
authors: R
authors: Vassallo
authors: Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA Dept of Medicine, Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical Center, New York, NY, USA fjm2003@med.cornell.edu.
authors: Fernando J
authors: FJ
authors: Martinez
mesh_terms: D000328:Adult; D000368:Aged; D002248:Carbon Monoxide / Q000737:chemistry; D005260:Female; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000139:chemically induced* / Q000453:epidemiology*; D007391:International Cooperation; D008297:Male; D011939:Mental Recall; D008800:Mexico; D008875:Middle Aged; D017146:Models, Organizational; D011379:Prognosis; D015272:Pulmonary Medicine / Q000458:organization & administration / Q000592:standards; D011871:Radiology; D056910:Republic of Korea; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D014028:Tobacco Smoke Pollution; D006113:United Kingdom; D014481:United States
chemical_list: D014028:Tobacco Smoke Pollution; D002248:Carbon Monoxide