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Interstitial Lung Diseases: New Treatments Based on Treatable Traits

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: 25 May 2026 | Viewed by 602

Special Issue Editor


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Guest Editor
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
Interests: interstitial lung disease; pulmonary fibrosis; orphan lung diseases; non-cystic fibrosis bronchiectasis; pneumonia/ pulmonary infection; sarcoidosis

Special Issue Information

Dear Colleagues,

Interstitial lung diseases (ILDs) represent a heterogeneous group of several entities in which heterogeneity manifests at many levels, including symptoms, disease courses, radiological and histological features, and biological underpinnings. This heterogeneity has been a substantial barrier to understanding disease mechanisms and developing effective and personalized treatments, leading to suboptimal patient management.

Recent data suggest that different ILDs can share similar pathogenetic and biological pathways, and thus be amenable to the same treatments. A paradigmatic example is the progressive pulmonary fibrosis phenotype, in which nintedanib has shown efficacy regardless of ILD etiology.

A growing amount of evidence points towards the subgroup characterization of ILDs through endotypes, which are defined by specific genetic and molecular biomarkers. Advancing our understanding of pathophysiology through additional key genetic and etiological components is needed to identify endotypes and improve clinical care for these patients. To implement this strategy, a multidisciplinary approach focusing not only on systemic and pathophysiological aspects but also on somatic and psychosocial aspects of the disease is needed.

Thus, the future of ILDs lies in precision medicine approaches based on phenotypic and endotypic features, named treatable traits (TTs). Further RCTs based on relevant TTs are needed to optimize the use of both non-pharmacological and pharmacological interventions targeting phenotype- and endotype-driven mechanisms to improve the quality of life and outcome of ILD patients.

The aim of this Special Issue, “Interstitial Lung Diseases: New Treatments Based on Treatable Traits”, is to outline the status of knowledge in this field.

Dr. Francesco Amati
Guest Editor

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Keywords

  • interstitial lung diseases
  • progressive pulmonary fibrosis
  • phenotypes
  • endotypes
  • treatment
  • precision medicine

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Published Papers (1 paper)

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Review

18 pages, 1199 KB  
Review
Treatable Traits in Pediatric Interstitial Lung Diseases: Bridging the Gap to Tailored Therapeutics
by Giuseppe Fabio Parisi, Maria Papale, Giulia Pecora, Santiago Presti, Monica Tosto and Salvatore Leonardi
J. Clin. Med. 2025, 14(22), 8190; https://doi.org/10.3390/jcm14228190 - 19 Nov 2025
Viewed by 327
Abstract
Pediatric interstitial lung diseases (chILD) are a diverse and complex group of rare but impactful disorders characterized by heterogeneous etiologies and variable clinical courses. Traditional diagnosis-based management often delays targeted treatment, underscoring the need for a more precise therapeutic approach. The “treatable traits” [...] Read more.
Pediatric interstitial lung diseases (chILD) are a diverse and complex group of rare but impactful disorders characterized by heterogeneous etiologies and variable clinical courses. Traditional diagnosis-based management often delays targeted treatment, underscoring the need for a more precise therapeutic approach. The “treatable traits” framework, originally developed in adult respiratory medicine, offers a novel paradigm for personalized care by focusing on identifying and modifying discrete, clinically relevant features in each child. This narrative review synthesizes existing evidence and expert consensus to define key treatable traits in pediatric ILD, encompassing genetic and surfactant dysfunction, immune dysregulation, pulmonary hypertension, hypoxemia, aspiration, growth deficits, and environmental exposures. For each trait, we describe diagnostic pathways—including genetic testing, bronchoalveolar lavage, imaging, and functional assessments—and outline targeted management strategies. The implementation of a trait-based approach necessitates multidisciplinary collaboration, standardized protocols, and ongoing research to validate biomarkers and optimize therapies. By adopting this personalized strategy, clinicians can improve early diagnosis, tailor interventions, and potentially alter disease trajectories. Our discussion highlights the current limitations and future priorities, emphasizing the importance of pediatric-specific studies and international networks to fully realize the promise of precision medicine in pediatric ILD. Full article
(This article belongs to the Special Issue Interstitial Lung Diseases: New Treatments Based on Treatable Traits)
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