Unmet needs and perspectives in rheumatoid arthritis-associated interstitial lung disease: A critical review

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by synovitis as the most common clinical manifestation, and interstitial lung disease (RA-ILD) represents one of the most common and potentially severe extra-articular features. Our current understanding of the mechanis...

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Published in:Frontiers in medicine Vol. 10; p. 1129939
Main Authors: Stainer, Anna, Tonutti, Antonio, De Santis, Maria, Amati, Francesco, Ceribelli, Angela, Bongiovanni, Gabriele, Torrisi, Chiara, Iacopino, Antonio, Mangiameli, Giuseppe, Aliberti, Stefano, Selmi, Carlo
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media SA 16.03.2023
Frontiers Media S.A
Subjects:
Biomarkers
Chronic obstructive pulmonary disease
COVID-19
Health risk assessment
immunology
interstitial lung disease
Lung cancer
Lung diseases
Medical diagnosis
Medical prognosis
Medicine
Mortality
Pneumonia
precision medicine
progressive pulmonary fibrosis
Pulmonary fibrosis
Pulmonary hypertension
Quality of life
Rheumatic diseases
Rheumatoid arthritis
Risk factors
Sleep disorders
interstitial lung disease
biomarkers
precision medicine
clinical trials
progressive pulmonary fibrosis
immunology
rheumatoid arthritis
lung ultrasonography
ISSN:2296-858X, 2296-858X
Online Access:Get full text
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Summary:Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by synovitis as the most common clinical manifestation, and interstitial lung disease (RA-ILD) represents one of the most common and potentially severe extra-articular features. Our current understanding of the mechanisms and predictors of RA-ILD is limited despite the demonstration that an early identification of progressive fibrosing forms is crucial to provide timely treatment with antifibrotic therapies. While high resolution computed tomography is the gold standard technique for the diagnosis and follow-up of RA-ILD, it has been hypothesized that serum biomarkers (including novel and rare autoantibodies), new imaging techniques such as ultrasound of the lung, or the application of innovative radiologic algorithms may help towards predicting and detecting early forms of diseases. Further, while new treatments are becoming available for idiopathic and connective tissue disease-associated forms of lung fibrosis, the treatment of RA-ILD remains anecdotal and largely unexplored. We are convinced that a better understanding of the mechanisms connecting RA with ILD in a subgroup of patients as well as the creation of adequate diagnostic pathways will be mandatory steps for a more effective management of this clinically challenging entity.
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Edited by: Makon-Sébastien Njock, University of Liège, Belgium
Reviewed by: Paola Parronchi, University of Florence, Italy; Christian Ascoli, University of Illinois at Chicago, United States
These authors share first authorship
This article was submitted to Pulmonary Medicine, a section of the journal Frontiers in Medicine
ISSN:2296-858X
2296-858X
DOI:10.3389/fmed.2023.1129939