The role of precision medicine in interstitial lung disease
Open accessAbstract
The management of interstitial lung disease (ILD) may benefit from a conceptual shift. Increased understanding of this complex and heterogeneous group of disorders over the past 20 years has highlighted the need for individualised treatment strategies that encompass diagnostic classification and disease behaviour. Biomarker-based approaches to precision medicine hold the greatest promise. Robust, large-scale biomarker-based technologies supporting ILD diagnosis have been developed, and future applications relating to staging, prognosis and assessment of treatment response are emerging. Artificial intelligence may redefine our ability to base prognostic evaluation on both diagnosis and underlying disease processes, sharpening individualised treatment algorithms to a level not previously achieved. Compared with therapeutic areas such as oncology, precision medicine in ILD is still in its infancy. However, the heterogeneous nature of ILD suggests that many relevant molecular, environmental and behavioural targets may serve as useful biomarkers if we are willing to invest in their identification and validation.
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IPF biomarkers fall into three broad mechanistic categories: epithelial cell dysfunction and senescence, aberrant immunity, and abnormal lung remodelling.
“With regard to the current evidence, IPF biomarkers fall into three broad mechanistic categories: i) epithelial cell dysfunction and senescence ( e.g. surfactant protein (SP)-A, SP-D, MUC5B , Krebs von den Lungen-6 (KL-6), telomerase reverse transcriptase (TERT) and the tumour markers, CA-125, CA-19 9), ii) aberrant immunity ( e.g. C-C Motif Chemokine Ligand (CCL)-18, heat”
From Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies (2023) · cites this paper as Maher et al., 2022
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Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies
Selvarajah, B., Platé, M., & Chambers, R. C. (2023) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2023.101227 · Cited by 57 · see citing works
- Authors
- Maher, T. M., Nambiar, A. M., & Wells, A. U.
- Affiliations
- University of Southern California (US)
- The University of Texas at San Antonio Health Science Center (US)
- Royal Brompton & Harefield NHS Foundation Trust (GB)
- Corresponding author
- Wells, Athol U.
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2022-02-03
- Volume
- 60
- Issue
- 3
- Pages
- 2102146
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- PMC
- PMC9449482
- OpenAlex
- W4210737252
- Cited by
- 38
- References
- 56
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 8 · 2023: 12 · 2022: 1
- FWCI
- 5.16
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Respiratory Journal (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by-nc)
- Funders
- Veracyte
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Occupational and environmental lung diseases
- Keywords
- interstitial lung disease, precision medicine, biomarkers, personalized treatment, disease classification, prognosis, treatment response assessment, artificial intelligence, disease staging, molecular biomarkers
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