title: Personalized medicine in interstitial lung diseases.
abstract: A number of recent studies have explored the possibility to apply personalized medicine to interstitial lung diseases (ILDs), particularly idiopathic pulmonary fibrosis (IPF), the most common and deadly of the idiopathic interstitial pneumonias. In our review, we summarize and discuss the most recent literature on personalized medicine in IPF as well as hypersensitivity pneumonitis and sarcoidosis, with emphasis on patient subgroups for which a personalized approach to disease prognostication and management may become a reality in the near future.
  
  
  
  Most of the studies that have explored the applicability of personalized medicine to ILDs have been conducted in patients with IPF. Such studies have suggested the existence of several distinct disease subgroups defined by similar genetic profiles, molecular pathways, exposures and individual lifestyles. Personalized medicine in hypersensitivity pneumonitis is in its infancy. The development and applicability of personalized medicine to sarcoidosis, on the other hand, remains problematic for several reasons, including the lack of a diagnostic gold standard, the highly variable and unpredictable disease course, particularly across patients of different ethnicities, the poor correlation between disease activity and disease severity and the lack of a validated management algorithm.
  
  
  
  A number of distinct patient subgroups have been identified in ILDs. Although available data need to be validated longitudinally, the possibility to study homogeneous groups of patients may allow prediction of disease behavior and response to treatment with dramatic clinical implications.
authors.affiliation: aDepartment of Cardiac, Thoracic and Vascular Sciences, Section of Respiratory Diseases, University of Padova, Padova, Italy bDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, The University of California at Davis, Sacramento, California, USA cNational Institute for Health Research Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences, University of Southampton, Southampton, UK dDepartment of Medicine, University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Paolo
authors.initials: P
authors.lastname: Spagnolo
authors.forename: Justin M
authors.initials: JM
authors.lastname: Oldham
authors.forename: Mark G
authors.initials: MG
authors.lastname: Jones
authors.forename: Joyce S
authors.initials: JS
authors.lastname: Lee
mesh_terms: D018450:Disease Progression; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000188:drug therapy*; D057285:Precision Medicine; D012507:Sarcoidosis