Diagnosis and Treatment of Interstitial Lung Disease

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 2098

Special Issue Editor


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Guest Editor
Department of Internal Medicine, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
Interests: respiratory diseases; respiratory pathophysiology; COPD; interstitial lung diseases; pulmonary hypertension; lung transplantation
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Special Issue Information

Dear Colleagues,

Interstitial lung disease (ILD) comprises a large group of over 200 parenchymal pulmonary diseases characterized by progressive lung fibrosis. The most common ILDs are non-specific interstitial pneumonia, usual interstitial pneumonia/idiopathic pulmonary fibrosis (UIP/IPF), hypersensitivity pneumonia, and pulmonary sarcoidosis, while rare forms include desquamative interstitial pneumonia, pulmonary Langerhans cell histiocytosis, and lymphangio-leiomyomatosis. Each ILD subtype has distinctive radiographic and pathologic features, with interventional endoscopic procedures such as bronchoscopy, allowing for trans-bronchial biopsies, broncho-alveolar lavage fluid recovery, and cryo-biopsy facilitating accurate diagnoses. Pulmonary arterial hypertension (Group 1) and pulmonary hypertension (Group 3) are frequently detected in patients with ILDs. Treatment includes high steroid doses, antibiotics such as azithromycin, high-flow O2 support, non-invasive ventilation, and, more recently, anti-fibrotic drugs, like pirfenidone and nintedanib. Meanwhile, lung transplantation is the elective treatment for end-stage ILDs.

Current problems include the following: (1) difficulty to control severe exacerbations; (2) analysis of disease progression and outcomes; (3) efficacy of vaso-dilator drugs in pulmonary hypertension; and (4) identification of an accurate composite allocation score.

This Special Issue aims to focus on recent aspects of basic and clinical ILD research.

Suggested topics include the following:

  • UIP/IPF genome analysis;
  • IPF epigenetics;
  • Artificial intelligence in high-resolution computed tomography (HRCT) for ILD diagnosis;
  • Endobronchial ultrasound and cryo-biopsy in ILD;
  • Connective tissue disease-associated ILD;
  • Post-COVID19 ILD;
  • Interstitial lung abnormalities (ILAs).

Prof. Dr. Roberto G. Carbone
Guest Editor

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Keywords

  • interstitial lung disease
  • echocardiography
  • right heart catheterization
  • bronchoscopy
  • HRCT

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Published Papers (2 papers)

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Research

7 pages, 1422 KiB  
Article
Exploring the Potential of a P2X3 Receptor Antagonist: Gefapixant in the Management of Persistent Cough Associated with Interstitial Lung Disease
by Tomoyuki Takahashi, Atsushi Saito, Takafumi Yorozuya, Hirotaka Nishikiori, Koji Kuronuma and Hirofumi Chiba
Medicina 2025, 61(5), 892; https://doi.org/10.3390/medicina61050892 - 14 May 2025
Viewed by 258
Abstract
Background: Interstitial lung disease (ILD) is characterized by pulmonary inflammation and fibrosis associated with persistent and refractory cough that significantly hinders quality of life. Conventional treatments for ILD-associated cough have shown limited efficacy, necessitating alternative therapeutic approaches. Gefapixant, a P2X3 receptor antagonist, can [...] Read more.
Background: Interstitial lung disease (ILD) is characterized by pulmonary inflammation and fibrosis associated with persistent and refractory cough that significantly hinders quality of life. Conventional treatments for ILD-associated cough have shown limited efficacy, necessitating alternative therapeutic approaches. Gefapixant, a P2X3 receptor antagonist, can potentially alleviate chronic cough by inhibiting the ATP-mediated activation of sensory C-fibers, but its efficacy in ILD-associated cough remains unclear. This study observed the effects of gefapixant on ILD-associated refractory chronic cough. Methods: This prospective study enrolled patients with ILD-associated refractory chronic cough who received gefapixant at Sapporo Medical University Hospital between July 2022 and November 2023. Cough frequency, Leicester Cough Questionnaire (LCQ) score, cough severity visual analog scale (Cough VAS), and taste VAS were evaluated at baseline and at 2, 4, and 8 weeks after gefapixant administration. Results: Six patients completed the study. Their ILD subtypes included idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonia (NSIP), and connective tissue disease-associated ILDs (CTD-ILDs). After 8 weeks, the cough frequency decreased from 88.5 to 44.3 episodes per 30 min, LCQ scores increased from 8.3 to 13.6, and cough VAS scores decreased from 75.8 to 40.2. However, statistical significance was not reached due to high interindividual variability, with gefapixant being effective in some and ineffective in others. The most common adverse event was taste disorder, leading to discontinuation in one patient, but symptoms tended to lessen over the course of treatment. Conclusions: Gefapixant appears to be effective in reducing refractory cough related to ILD, although these results were not statistically significant because its effectivity widely varied across individuals. Further investigation is needed to identify patient subgroups with the greatest potential for treatment responsiveness. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Interstitial Lung Disease)
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9 pages, 1883 KiB  
Article
Comparison of the Effects of Nintedanib and Pirfenidone on Pulmonary Function Test Parameters and Radiological Findings in Patients with Idiopathic Pulmonary Fibrosis: A Real-Life Study
by Olcay Aycicek, Serra Keskin, Muhammed Haciosmanoglu, Funda Oztuna, Yilmaz Bulbul and Tevfik Ozlu
Medicina 2025, 61(2), 283; https://doi.org/10.3390/medicina61020283 - 6 Feb 2025
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Abstract
Background and Objectives: The aim of our study is to compare the effects of pirfenidone and nintedanib on lung function and radiologic findings in Idiopathic Pulmonary Fibrosis and to identify which drug is more appropriate for which patient group. Materials and Methods: The [...] Read more.
Background and Objectives: The aim of our study is to compare the effects of pirfenidone and nintedanib on lung function and radiologic findings in Idiopathic Pulmonary Fibrosis and to identify which drug is more appropriate for which patient group. Materials and Methods: The data of patients who were treated in our department for at least one year between 1 January 2010 and 31 December 2022 and who were started on pirfenidone or nintedanib treatment with the diagnosis of Idiopathic Pulmonary Fibrosis were retrospectively reviewed. The patients were divided into two groups—the nintedanib and pirfenidone groups—and both groups were compared in terms of progression in lung function tests (changes in FEV1, FVC, 6 MWT and DLCO values at the 3rd, 6th, 9th and 12th months compared to baseline values) and radiological findings (the presence of progression in findings such as ground-glass opacity, reticulation, honeycomb and traction bronchiectasis) within 1 year after diagnosis. Results: The study included 109 patients. The number of patients treated with pirfenidone (IPF patients) was 82 (75.2%) and the number of patients treated with nintedanib was 27 (24.8%). When the PFT values at 3, 6, 9 and 12 months were compared with the baseline values in both groups, there was no statistically significant difference in any parameter between the two groups. No significant difference was found in terms of radiological progression at the end of 1 year in both groups. Conclusions: The results of our study show that pirfenidone and nintedanib are equivalent in their effectiveness in preventing disease progression in patients with IPF. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Interstitial Lung Disease)
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