NOVEL APPROACHES TO PULMONARY FIBROSIS. Gisli Jenkins FRCP PhD Professor of Experimental Medicine University of Nottingham

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "NOVEL APPROACHES TO PULMONARY FIBROSIS. Gisli Jenkins FRCP PhD Professor of Experimental Medicine University of Nottingham"

Transcription

1 NOVEL APPROACHES TO PULMONARY FIBROSIS Gisli Jenkins FRCP PhD Professor of Experimental Medicine University of Nottingham

2 OVERVIEW Review of ILDs What is pulmonary fibrosis? How should IPF be diagnosed? How should IPF be treated? Is personalised therapy for IPF possible?

3 ILD OLYMPICS Asbestosis CTD IPF Sarcoidosis NSIP The rest HSP Drugs

4 ILD OLYMPICS CTD NSIP Asbestosis IPF The rest Drugs HSP RA Sarcoidosis

5 ILD OLYMPICS Inflammatory Fibrotic Granulomatous

6 CHRONIC PROGRESSIVE FIBROTIC LUNG DISEASE OR INFLAMMATORY INTERSTITIAL LUNG DISEASE Inflammatory Sarcoid CTD-ILD HSP NSIP DIP RBILD LIP Fibrotic IPF Fibrotic HSP Rheumatoid -UIP Asbestosis IPPFE

7 DEFINITELY NOT IPF Sarcoid Hypersensitivity Pneumonitis Metzger F et al. Chest 2010;138: by American College of Chest Physicians

8 NOT IPF AT THE MOMENT NSIP ANA α-dsdna Ribonucleoproteins α-ro and α-la (Sjogrens) α-smith (SLE) α-ro52 (none-specific) α-topoisomerase/scl70 (SSc) α-pm/scl (SSc/PM overlap) α-trna synthetases (PDM) Jo-1 PL-7 PL-12 α-mda5 (CADM) α-igg4 (IG4RD) RA and α CCP (RA) -UIP MPO (Vasculitis) -UIP Marten al Eur Radiol 2009;19:

9 MYCOPHENOLATE MOFETIL VERSUS ORAL CYCLOPHOSPHAMIDE IN SCLERODERMA-RELATED INTERSTITIAL LUNG DISEASE (SLS II):A RANDOMISED CONTROLLED, DOUBLE-BLIND, PARALLEL GROUP TRIAL Donald P Tashkin, Michael D Roth, Philip J Clements, Daniel E Furst, Dinesh Khanna, Eric C Kleerup, Jonathan Goldin, Edgar Arriola, Elizabeth R Volkmann, Suzanne Kafaja, Richard Silver, Virginia Steen, Charlie Strange, Robert Wise, Fredrick Wigley, Maureen Mayes, David J Riley, Sabiha Hussain, Shervin Assassi, Vivien M Hsu, Bela Patel, Kristine Phillips, Fernando Martinez, Jeff rey Golden, M Kari Connolly, John Varga, Jane Dematte, Monique E Hinchcliff, Aryeh Fischer, Jeff rey Swigris, Richard Meehan, Arthur Theodore, Robert Simms, Suncica Volkov, Dean E Schraufnagel, Mary Beth Scholand, Tracy Frech, Jerry A Molitor, Kristin Highland, Charles A Read, Marvin J Fritzler, Grace Hyun J Kim, Chi-Hong Tseng, Robert M Elashoff, for the Sclerodema Lung Study II Investigators* Published online July 25,

10 MIGHT BE IPF Hunninghake et al NEJM 2013

11 DO INTERSTITIAL LUNG ABNORMALITIES REPRESENT EARLY PULMONARY FIBROSIS? Putman et al JAMA 2016

12 IDIOPATHIC PULMONARY FIBROSIS Elderly male ex-smokers Usually 2 year history of: Progressive shortness of breath on exertion Dry non productive cough On examination Bilateral Basal Crepitations Clubbed

13 IPF IS A PROGRESSIVE DISEASE Elicker et al Resp Med 2010 Interstitial Lung Diseases Unit

14 MORTALITY FROM IPF IN THE UK HAS INCREASED IN THE LAST 40 YEARS ICD-10 (2000) ICD-9 (1979) Navaratnam Thorax. 2011;66(6):462-7.

15 5 year survival rates from IPF compared with various cancers.. Vancheri ERJ (3):

16 CAUSES OF IPF Idiopathic (and cryptogenic) means we don t know Genetics responsible for about 30% Other hypotheses include: Viral infection Gastro-Oesophageal Reflux Disease Inhaled dust/smoke

17 A POLYMORPHISM IN THE COMMON VARIANT OF MUC5B PROMOTES SUSCEPTIBILITY TO IPF Fingerlin et al Nat Genet 2013

18 RARE VARIANTS ARE ASSOCIATED WITH FAMILIAL PULMONARY FIBROSIS Telomerase TERT, TERC DKC1, PARN, NAF1 RTEL1, TINF2 Epithelial Cell Function SFTPA1 SFPTA2 SFPTC ABC3 6% patients in UK with IPF have 1 relative Currently we do not recommend genetic screening These patients are eligible for 100k Genome Project

19 DIAGNOSING IPF HRCT Reticulation Honeycombing Traction Basal Peripheral Subpleural (ATS/ERS Criteria AJRCCM 2011)

20 LUNG FUNCTION

21 SHOULD VATS BIOPSIES BE PERFORMED? Leads to acute excarbations Mortality rate between % Hutchinson et al Am J Respir Crit Care Med 2016, Hutchinson Eur Respir J 2016 Ventilation promotes TGFβ activation in the lung. Jenkins et al JCI 2006, John et al Science Signalling 2016 Mechanical stretch of IPF tissue has enhanced TGFβ activation. Froese et al Am J Respir Crit Care Med 2016

22 IPF MANAGEMENT NICE IPF Guidelines (CG163) Put the MDT at the heart of management NICE IPF Quality Standard (QS79) Patients should be diagnosed with IPF by MDT All patients should have access to a Specialist Nurse Should have ambulatory Oxygen assessments Should have access to Pulmonary Rehabilitation Should have access to Palliative Care 2 NICE approved drugs for IPF Pirfenidone (TA282) Nintedanib (TA379)

23 THE PANTHER STUDY Triple therapy with Pred/AZA/NAC for IPF had significantly worse outcome compared with placebo. Death 8 vs 1 p < 0.01 Hospitalisation 23 vs 7 p < Single agent NAC no benefit compared with placebo Raghu et al N Eng J Med 2012 Martinez et al N Eng J Med 2014

24 DISEASE MODIFYING ANTIFIBROTIC DRUGS Pirfenidone Nintedanib King et al NEJM 2014 Richeldi et al NEJM 2014

25 BEST SUPPORTIVE CARE Co-morbidities Withdraw ineffective or harmful therapies Symptom relief Dyspnoea Oxygen Cough PPI Prednisolone Thalidomide Opiates

26 THERE IS STILL CONSIDERABLE PROGRESS NEEDED Strict prescribing criteria for anti-fibrotic therapy IPF only FVC 80-50% Responders only Large number of adverse effects Mechanism of action unclear

27 SAME DISEASE DIFFERENT COURSE Onset of Disease Sub-clinical Period Disease Progression Onset of Symptoms Diagnosis A B C D Pre-diagnosis Period Post-diagnosis Period Death 1 yr 2 yr 3 yr 4 yr 5 yr 6 yr Time Adapted from Ley B et al, Am J Respir Crit Care Med 2011

28 SAME RADIOLOGICAL APPEARANCE DIFFERENT DISEASE? RA-ILD IPF Walsh et al Thorax 2014;69:

29 ARE CURRENT CLINICAL STRATA OF FIBROTIC LUNG DISEASE FIT FOR PURPOSE? Ryerson et al ERJ 2013 Kim et al. Chest. 2009

30 Can Pulmonary Fibrosis be stratified? Protein MicroRNA Transcript Lung Tissue Genome Classical IPF Accelerated IPF Atypical IPF IPF + Emphysema IPF + Lung Cancer IPF + Pulmonary Hypertension IPF + asbestos exposure IPF + RA Interstitial Lung Abnormalities MMP7/ SpD Matrix Neoepitopes mir29 Integrins muc5b Therapy

31 MUC5B AND TOLLIP POLYMORPHISMS ARE ASSOCIATED WITH SLOWER PROGRESSION OF IPF Noth et al Lancet Resp Med 2013 Peljto et al JAMA 2013

32 SERUM BIOMARKERS MAY BE USEFUL IN SCREENING EARLY DISEASE MMP7 SpD Kropski et al Am J Respir Crit Care Med 2015

33 CAN IPF BE STRATIFIED BY RESPONSE TO THERAPY? Responders vs Non-responder The challenge in IPF is defining treatment response We currently use >10% absolute drop in FVC We need more dynamic markers of disease which better reflect disease biology

34 THE PROFILE STUDY

35 MATRIX NEOEPITOPES Karsdal MA et al Assay Drug Dev Technol 2013

36 MATRIX NEOEPITOPES CAN DISTINGUISH PROGRESSIVE FROM STABLE IPF Jenkins et al Lancet Respir Med 2015

37 PATIENTS WITH RISING MATRIX NEOEPITOPES HAVE INCREASED RISK OF MORTALITY Jenkins et al Lancet Respir Med 2015

38 HIGHER RATE OF CHANGE OF MATRIX NEOEPITOPES IS ASSOCIATED WITH INCREASED RISK OF DEATH IN PATIENTS WITH IPF Jenkins et al Lancet Respir Med 2015

39 CAN WE IDENTIFY MOLECULAR ENDOTYPES OF PULMONARY FIBROSIS Identify a subset of pulmonary fibrosis with a specific behaviour Conserved across clinical phenotypes Targetable by specific therapies Identified by specific biomarkers

40 Gq RhoA ROCK X 3 P X P 3 ELK1 4 TGFβ1 X αvβ6 integrin αv integrin P X 3 P Jenkins et al J Clin Invest 2006 Xu et al Am J Pathol 2009 Henderson et al Nat Med 2013 Tatler et al J Biol Chem 2016 Tatler et al Plos One 2016 John et al Science Signalling 2016

41 THE αvβ6 INTEGRIN IS UPREGULATED IN REGIONS OF FIBROSIS IN PATIENTS WITH UIP Xu et al Am J Pathol 2009

42 HIGH LEVELS OF β6 IMMUNOSTAINING ARE ASSOCIATED WITH A WORSE PROGNOSIS Saini et al Eur Resp J 2015

43 THE αvβ6 INTEGRIN IS UPREGULATED FOLLOWING Binding of 111 In-DTPA-A20FMDV2 BLEOMYCIN INDUCED LUNG INJURY (β6 specific peptide) Bleomycin saline bleomycin + anti-αvβ6 αvβ6 Specific peptide Control peptide saline bleo John et al J Nuc Med 2013

44 A β6 TARGETING PEPTIDE CO-LOCALISES WITH AREAS OF FIBROSIS FOLLOWING BLEOMYCIN INSTILLATION John et al J Nuc Med 2013

45 CONCLUSIONS 1 ILDs should be considered inflammatory or fibrotic Inflammatory ILDs can be treated with steroids and immunosuppression Fibrotic ILD should NOT be treated with steroids and immunosuppression

46 CONCLUSIONS 2 Genetics plays a key role in IPF and patients with affected 1 relatives are eligible for 100k genome project The Disease Modifying Anti-fibrotic Drugs pirfenidone and nintedanib slow disease progression but do not cure IPF Serum biomarkers may play a role in monitoring disease progression or therapeutic response Understanding specific endotypes of disease and developing appropriate therapeutics and companion biomarkers will help the majority of patients who are ineligible, intolerant or unresponsive to current therapy

47 THE PULMONARY FIBROSIS GROUP

48 Acknowledgements Nottingham Richard Hubbard Simon Johnson Alan Knox Ian Hall Ian Sayers Bristol Cambridge UCL Ann Millar Helen Parfrey Robin McAnulty Imperial Toby Maher Hull Simon Hart Leicester Queen Mary Martin Tobin Louise Wain Richard Allen John Marshall Edinburgh Nick Hirani Moira Whyte William Wallace Biogen Idec GSK Paul Wienreb Shelia Violette Richard Marshall Andy Blanchard Pauline Lukey

Updates on Familial Interstitial Pneumonias. Dr Helen Parfrey Cambridge ILD Service Papworth Hospital

Updates on Familial Interstitial Pneumonias. Dr Helen Parfrey Cambridge ILD Service Papworth Hospital Updates on Familial Interstitial Pneumonias Dr Helen Parfrey Cambridge ILD Service Papworth Hospital " Declarations of Interest Consultancy fees from BI, Roche/Intermune Speaker fees Roche Trustee Action

More information

Disclosures. Traditional Paradigm. Overview 4/17/2010. I have relationships with the following organizations and companies:

Disclosures. Traditional Paradigm. Overview 4/17/2010. I have relationships with the following organizations and companies: Disclosures Pharmacological Therapy for ILD What to Use and How to Use It Harold R Collard MD Interstitial Lung Disease Program University of California San Francisco (UCSF) I have relationships with the

More information

New Horizons The Future of IPF and ILD

New Horizons The Future of IPF and ILD New Horizons The Future of IPF and ILD Talmadge E. King, Jr., M.D. Julius R. Krevans Distinguished Professorship in Internal Medicine Chair, Department of Medicine University of California San Francisco

More information

Diffuse Interstitial Lung Diseases: Is There Really Anything New?

Diffuse Interstitial Lung Diseases: Is There Really Anything New? : Is There Really Anything New? Sujal R. Desai, MBBS, MD ESTI SPEAKER SUNDAY Society of Thoracic Radiology San Antonio, Texas March 2014 Diffuse Interstitial Lung Disease The State of Play DILDs Is There

More information

Idiopathic Pulmonary Fibrosis Treatable and Not Idiopathic

Idiopathic Pulmonary Fibrosis Treatable and Not Idiopathic Idiopathic Pulmonary Fibrosis Treatable and Not Idiopathic Brett Ley, MD University of California San Francisco CTS 1/26/18 Disclosures Speaker s bureau honorarium from Genentech (makers of pirfenidone)

More information

Non-neoplastic Lung Disease II

Non-neoplastic Lung Disease II Pathobasic Non-neoplastic Lung Disease II Spasenija Savic Prince Pathology Program Systematic approach to surgical lung biopsies with ILD Examples (chronic ILD): Idiopathic interstitial pneumonias: UIP,

More information

Progress in Idiopathic Pulmonary Fibrosis

Progress in Idiopathic Pulmonary Fibrosis Progress in Idiopathic Pulmonary Fibrosis David A. Lynch, MB Disclosures Progress in Idiopathic Pulmonary Fibrosis David A Lynch, MB Consultant: t Research support: Perceptive Imaging Boehringer Ingelheim

More information

Pathologic Assessment of Interstitial Lung Disease

Pathologic Assessment of Interstitial Lung Disease Pathologic Assessment of Interstitial Lung Disease Dry and itchy? It could be eczema or fungal infection. We don t need to worry, the drugs aren t that dangerous. Kirk D. Jones, MD UCSF Dept. of Pathology

More information

Disclosures. Integrated Approach to Treating CTD-ILD. Limitations. Relevant items to consider. Other than for SSc-ILD, no controlled data

Disclosures. Integrated Approach to Treating CTD-ILD. Limitations. Relevant items to consider. Other than for SSc-ILD, no controlled data Integrated Approach to Treating CTD-ILD Industry relationships: Disclosures Aryeh Fischer, MD Associate Professor of Medicine Division of Rheumatology Division of Pulmonary Sciences and Critical Care Medicine

More information

Annual Rheumatology & Therapeutics Review for Organizations & Societies

Annual Rheumatology & Therapeutics Review for Organizations & Societies Annual Rheumatology & Therapeutics Review for Organizations & Societies A Rheumatologist s Approach to Interstitial Lung Disease Outline ILD classification and patterns in CTD The clinical landscape and

More information

4/17/2010 C ini n ca c l a Ev E a v l a ua u t a ion o n of o ILD U dat a e t e i n I LDs

4/17/2010 C ini n ca c l a Ev E a v l a ua u t a ion o n of o ILD U dat a e t e i n I LDs Update in ILDs Diagnosis 101: Clinical Evaluation April 17, 2010 Jay H. Ryu, MD Mayo Clinic, Rochester MN Clinical Evaluation of ILD Outline General aspects of ILDs Classification of ILDs Clinical evaluation

More information

DIAGNOSTIC NOTE TEMPLATE

DIAGNOSTIC NOTE TEMPLATE DIAGNOSTIC NOTE TEMPLATE SOAP NOTE TEMPLATE WHEN CONSIDERING A DIAGNOSIS OF IDIOPATHIC PULMONARY FIBROSIS (IPF) CHIEF COMPLAINT HISTORY OF PRESENT ILLNESS Consider IPF as possible diagnosis if any of the

More information

Perspectives ILD Diagnosis and Treatment in 5-10 years

Perspectives ILD Diagnosis and Treatment in 5-10 years Perspectives ILD Diagnosis and Treatment in 5-10 years Brett Ley, MD Department of Medicine The (Near) Future of ILD Diagnosis and Treatment 1. Combination therapy for Idiopathic Pulmonary Fibrosis 2.

More information

IPF AND OTHER FIBROSING LUNG DISEASE: WHAT DRUGS MIGHT WORK AND ON WHOM DO THEY W ORK?

IPF AND OTHER FIBROSING LUNG DISEASE: WHAT DRUGS MIGHT WORK AND ON WHOM DO THEY W ORK? IPF AND OTHER FIBROSING LUNG DISEASE: WHAT DRUGS MIGHT WORK AND ON WHOM DO THEY W ORK? KEVIN K. BROWN, MD PROFESSOR AND VICE CHAIRMAN, DEPARTMENT OF MEDICINE NATIONAL JEWISH HEALTH DENVER, CO Kevin K.

More information

New Horizons in the Diagnosis & Management of Idiopathic Pulmonary Fibrosis (IPF) CME Learning Objectives

New Horizons in the Diagnosis & Management of Idiopathic Pulmonary Fibrosis (IPF) CME Learning Objectives New Horizons in the Diagnosis & Management of Idiopathic Pulmonary Fibrosis (IPF) Improving Outcomes in IPF Leann Silhan, MD 1 CME Learning Objectives Assess and apply guideline recommendations for the

More information

INTERSTITIAL LUNG DISEASE. Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018

INTERSTITIAL LUNG DISEASE. Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018 INTERSTITIAL LUNG DISEASE Radhika Reddy MD Pulmonary/Critical Care Long Beach VA Medical Center January 5, 2018 Interstitial Lung Disease Interstitial Lung Disease Prevalence by Diagnosis: Idiopathic Interstitial

More information

New Therapies and Trials in IPF

New Therapies and Trials in IPF Conflict of interest disclosure I have the following real or perceived conflicts of interest that relate to this presentation: New Therapies and Trials in IPF Talmadge E. King, Jr., M.D. Julius R. Krevans

More information

FROM ARK TO MARS: IDIOPATHIC PULMONARY FIBROSIS

FROM ARK TO MARS: IDIOPATHIC PULMONARY FIBROSIS FROM ARK TO MARS: IDIOPATHIC PULMONARY FIBROSIS Dr Huzaifa I Adamali Bristol Interstitial Lung Disease Service North Bristol Lung Centre Southmead Hospital Quiz: The Romans named Mars after God of War?

More information

Diagnosis of Connective Tissue Disease Interstitial Lung Disease in 2016

Diagnosis of Connective Tissue Disease Interstitial Lung Disease in 2016 Diagnosis of Connective Tissue Disease Interstitial Lung Disease in 2016 A/Prof Tamera Corte TSANZ Annual Conference: Perth 2016 Royal Prince Alfred Hospital, Sydney, Australia Sydney Medical School, University

More information

ERS 2016 Congress Highlights Interstitial Lung Disease (ILD)

ERS 2016 Congress Highlights Interstitial Lung Disease (ILD) ERS 216 Congress Highlights Interstitial Lung Disease (ILD) London, UK September 3 rd 7 th 216 The 26 th European Respiratory Society International Congress, (ERS) the largest respiratory meeting in the

More information

A Review of Interstitial Lung Diseases. Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco

A Review of Interstitial Lung Diseases. Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco A Review of Interstitial Lung Diseases Paul J. Wolters, MD Associate Professor Department of Medicine University of California San Francisco Outline Overview of diagnosis in ILD Why it is important Definition/Classification

More information

Interstitial Lung Disease (ILD)

Interstitial Lung Disease (ILD) Interstitial Lung Disease (ILD) ILD comprises more than 130 distinct disorders Characterized by cellular proliferation, cellular infiltration, and/or fibrosis of the lung parenchyma not due to infection

More information

Management of Co morbidities in Idiopathic Pulmonary Fibrosis. Disclosures

Management of Co morbidities in Idiopathic Pulmonary Fibrosis. Disclosures Management of Co morbidities in Idiopathic Pulmonary Fibrosis Joyce S. Lee, MD MAS Director, Interstitial Lung Disease Clinic University of California, San Francisco Disclosures Intermune, advisory board

More information

Presente e futuro della terapia della fibrosi polmonare idiopatica

Presente e futuro della terapia della fibrosi polmonare idiopatica Presente e futuro della terapia della fibrosi polmonare idiopatica Antonella Caminati U.O. di Pneumologia e Terapia Semi Intensiva Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare Osp.

More information

UIP Possibile e Probabile

UIP Possibile e Probabile UIP Possibile e Probabile Sergio Harari U.O. di Pneumologia e UTIR Servizio di Emodinamica e Fisiopatologia Respiratoria Ospedale San Giuseppe - Milano Current definition of IPF IPF is a distinct type

More information

Interstitial Lung Diseases: Respiratory Review of 2013

Interstitial Lung Diseases: Respiratory Review of 2013 REVIEW http://dx.doi.org/10.4046/trd.2013.75.2.47 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2013;75:47-51 Interstitial Lung Diseases: Respiratory Review of 2013 Yong Hyun Kim, M.D. and

More information

Epidemiology and classification of smoking related interstitial lung diseases

Epidemiology and classification of smoking related interstitial lung diseases Epidemiology and classification of smoking related interstitial lung diseases Šterclová M. Department of Respiratory Diseases, Thomayer Hospital, Prague, Czech Republic Supported by an IGA Grant No G 1207

More information

PFF HEALTH CARE PROFESSIONAL WEBINAR SERIES. Welcome!

PFF HEALTH CARE PROFESSIONAL WEBINAR SERIES. Welcome! PFF HEALTH CARE PROFESSIONAL WEBINAR SERIES Welcome! AGENDA TOPICS Welcome & Introduction Dr. Gregory Cosgrove, MD Chief Medical Officer Pulmonary Fibrosis Foundation PFF Resources Dolly Kervitsky, RCP,

More information

Nintedanib and Pirfenidone: New Medications in the Management of Idiopathic Pulmonary Fibrosis

Nintedanib and Pirfenidone: New Medications in the Management of Idiopathic Pulmonary Fibrosis Nintedanib and Pirfenidone: New Medications in the Management of Idiopathic Pulmonary Fibrosis Brad Zimmermann, PharmD, MBA Pharmacy Grand Rounds May 02, 2017 Rochester, Minnesota 2017 MFMER slide-1 Objectives

More information

Interstitial lung disease in 2015: where are we now?

Interstitial lung disease in 2015: where are we now? FOCUS Interstitial lung disease in 2015: where are we now? Lauren Troy, Tamera Corte Background Interstitial lung disease (ILD) includes a diverse group of respiratory conditions characterised by inflammation

More information

Challenges in the Diagnosis of Interstitial Lung Disease

Challenges in the Diagnosis of Interstitial Lung Disease Challenges in the Diagnosis of Interstitial Lung Disease Kirk D. Jones, MD UCSF Dept. of Pathology kirk.jones@ucsf.edu Overview New Classification of IIP Prior classification Modifications for new classification

More information

TBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than

TBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than TBLB is not recommended as the initial biopsy option in cases of suspected IPF and is unreliable in the diagnosis of rare lung disease (other than PAP) BAL is not required as a diagnostic tool in patients

More information

Idiopathic Pulmonary Fibrosis: The Importance of Qualitative and Quantitative Phenotyping

Idiopathic Pulmonary Fibrosis: The Importance of Qualitative and Quantitative Phenotyping Idiopathic Pulmonary Fibrosis: The Importance of Qualitative and Quantitative Phenotyping K. R. Flaherty Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor,

More information

Multidisciplinary Diagnosis in Action: Challenging Case Presentations

Multidisciplinary Diagnosis in Action: Challenging Case Presentations Multidisciplinary Diagnosis in Action: Challenging Case Presentations Interstitial Lung Disease: Advances in Diagnosis and Management UCSF CME November 8, 2014 Case 1 69 yo M 3 year history of intermittent

More information

Scleroderma in African Americans. Virginia Steen, MD Professor of Medicine Georgetown University

Scleroderma in African Americans. Virginia Steen, MD Professor of Medicine Georgetown University Scleroderma in African Americans Virginia Steen, MD Professor of Medicine Georgetown University Scleroderma in African Americans Frequency and outcomes of Scleroderma in African Americans Specific clinical

More information

Current Management of IPF and. Dr R Lakshmi Narasimhan Dept of Pulmonary Medicine

Current Management of IPF and. Dr R Lakshmi Narasimhan Dept of Pulmonary Medicine Current Management of IPF and fibrosing ILDs Dr R Lakshmi Narasimhan Dept of Pulmonary Medicine Introduction Idiopathic pulmonary fibrosis clinical course is variable and long term survival is poor Therapy

More information

Article (Accepted version) (Refereed)

Article (Accepted version) (Refereed) Charles Sharp, Melanie McCabe, Nick Dodds, Anthony Edey, Lloyd Mayers, Huzaifa Adamali, Ann B. Millar and Harsha Gunawardena Rituximab in autoimmune connective tissue disease associated interstitial lung

More information

Outline Definition of Terms: Lexicon. Traction Bronchiectasis

Outline Definition of Terms: Lexicon. Traction Bronchiectasis HRCT OF IDIOPATHIC INTERSTITIAL PNEUMONIAS Disclosures Genentech, Inc. Speakers Bureau Tadashi Allen, MD University of Minnesota Assistant Professor Diagnostic Radiology 10/29/2016 Outline Definition of

More information

UC Davis UC Davis Previously Published Works

UC Davis UC Davis Previously Published Works UC Davis UC Davis Previously Published Works Title Characterisation of patients with interstitial pneumonia with autoimmune features Permalink https://escholarship.org/uc/item/0n40x0jb Journal European

More information

Bronchoalveolar Lavage and Histopathologic Diagnosis Based on Biopsy

Bronchoalveolar Lavage and Histopathologic Diagnosis Based on Biopsy Idiopathic Pulmonary Fibrosis Bronchoalveolar Lavage and Histopathologic Diagnosis Based on Biopsy JMAJ 46(11): 469 474, 2003 Yukihiko SUGIYAMA Professor, Division of Pulmonary Medicine, Department of

More information

Interstitial Pneumonia Related to Undifferentiated Connective Tissue Disease Pathologic Pattern and Prognosis

Interstitial Pneumonia Related to Undifferentiated Connective Tissue Disease Pathologic Pattern and Prognosis [ Original Research Diffuse Lung Disease ] Interstitial Pneumonia Related to Undifferentiated Connective Tissue Disease Pathologic Pattern and Prognosis Ho-Cheol Kim, MD ; Wonjun Ji, MD ; Mi Young Kim,

More information

Guide to Clinical Management of Idiopathic Pulmonary Fibrosis

Guide to Clinical Management of Idiopathic Pulmonary Fibrosis Guide to Clinical Management of Idiopathic Pulmonary Fibrosis Steven D Nathan A Whitney Brown Christopher S King Guide to Clinical Management of Idiopathic Pulmonary Fibrosis Steven D Nathan Inova Fairfax

More information

UNRAVELING THE ETIOLOGY OF FAMILIAL INTERSTITIAL PNEUMONIA: GENETIC INVESTIGATIONS OF A COMPLEX DISEASE. Anastasia Leigh Wise

UNRAVELING THE ETIOLOGY OF FAMILIAL INTERSTITIAL PNEUMONIA: GENETIC INVESTIGATIONS OF A COMPLEX DISEASE. Anastasia Leigh Wise UNRAVELING THE ETIOLOGY OF FAMILIAL INTERSTITIAL PNEUMONIA: GENETIC INVESTIGATIONS OF A COMPLEX DISEASE by Anastasia Leigh Wise University Program in Genetics and Genomics & Integrated Toxicology and Environmental

More information

Prise en charge globale du patient dans la Fibrose interstitielle diffuse Comprehensive care for patients with pulmonary fibrosis

Prise en charge globale du patient dans la Fibrose interstitielle diffuse Comprehensive care for patients with pulmonary fibrosis Prise en charge globale du patient dans la Fibrose interstitielle diffuse Comprehensive care for patients with pulmonary fibrosis Marlies Wijsenbeek Centre of Interstitial Lung Diseases Erasmus MC, Rotterdam,

More information

Interstitial Lung Disease ILD: Definition

Interstitial Lung Disease ILD: Definition Interstitial Lung Disease 2007 Paul F. Simonelli,, MD, PhD, FCCP Clinical Director Center for Interstitial Lung Disease Columbia University Medical Center 1. ILD is not one disorder ILD: Definition 2.

More information

Evidence Review: Title. Month/ Year. Evidence Review:

Evidence Review: Title. Month/ Year. Evidence Review: Evidence Review: Title Month/ Year Evidence Review: Rituximab for connective tissue disease associated interstitial lung disease October 2014 Standard Operating Procedure: NHS England Evidence Review:

More information

An earlier and more confident diagnosis of idiopathic pulmonary fibrosis

An earlier and more confident diagnosis of idiopathic pulmonary fibrosis Eur Respir Rev 2012; 21: 124, 141 146 DOI: 10.1183/09059180.00000812 CopyrightßERS 2012 REVIEW: IPF An earlier and more confident diagnosis of idiopathic pulmonary fibrosis Roland M. du Bois ABSTRACT:

More information

Interstitial Lung Diseases(ILD) By : Dr. Shaher M. Samrah Done by : Ibrahim M. sun

Interstitial Lung Diseases(ILD) By : Dr. Shaher M. Samrah Done by : Ibrahim M. sun Interstitial Lung Diseases(ILD) By : Dr. Shaher M. Samrah Done by : Ibrahim M. sun. 26.11.11 Introduction Interstitial Lung Diseases (ILD) are group of diseases that affect the interstitium of the lungs,

More information

Usual Interstitial Pneumonia (UIP)

Usual Interstitial Pneumonia (UIP) , NSIP and their differential diagnoses Belfast Pathology Belfast Tuesday 20 th June 2017 Professor Andrew G Nicholson, DM, FRCPath Usual Interstitial Pneumonia () Consultant Histopathologist, Royal Brompton

More information

Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT

Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT Thoracic lung involvement in rheumatoid arthritis: Findings on HRCT Poster No.: C-2488 Congress: ECR 2015 Type: Educational Exhibit Authors: R. E. Correa Soto, M. J. Martín Sánchez, J. M. Fernandez 1 1

More information

CT Scan Findings of Probable Usual Interstitial Pneumonitis Have a High Predictive Value for Histologic Usual Interstitial Pneumonitis

CT Scan Findings of Probable Usual Interstitial Pneumonitis Have a High Predictive Value for Histologic Usual Interstitial Pneumonitis [ Original Research Diffuse Lung Disease ] CT Scan Findings of Probable Usual Interstitial Pneumonitis Have a High Predictive Value for Histologic Usual Interstitial Pneumonitis Jonathan H. Chung, MD ;

More information

Clinical course and outcome of rheumatoid arthritis-related usual interstitial pneumonia

Clinical course and outcome of rheumatoid arthritis-related usual interstitial pneumonia Original article: Clinical research SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2013; 30; 103-112 Mattioli 1885 Clinical course and outcome of rheumatoid arthritis-related usual interstitial pneumonia

More information

Idiopathic Pulmonary Fibrosis in Switzerland: Diagnosis and Treatment

Idiopathic Pulmonary Fibrosis in Switzerland: Diagnosis and Treatment Guidelines Received: November 7, 2016 Accepted after revision: February 20, 2017 Published online: March 25, 2017 Idiopathic Pulmonary Fibrosis in Switzerland: Diagnosis and Treatment Position Paper of

More information

Replacement of air with fluid, inflammatory. cells or cellular debris. Parenchymal, Interstitial (Restrictive) and Vascular Diseases.

Replacement of air with fluid, inflammatory. cells or cellular debris. Parenchymal, Interstitial (Restrictive) and Vascular Diseases. Parenchymal, Interstitial (Restrictive) and Vascular Diseases Alain C. Borczuk, M.D. Dept of Pathology Replacement of air with fluid, inflammatory cells Pulmonary Edema Pneumonia Hemorrhage Diffuse alveolar

More information

The diagnostic and prognostic utility of

The diagnostic and prognostic utility of Eur Respir Rev 2010; 19: 117, 237 241 DOI: 10.1183/09059180.00005510 CopyrightßERS 2010 REVIEW: ENDOSCOPY The clinical utility of bronchoalveolar lavage in diffuse parenchymal lung disease A.U. Wells ABSTRACT:

More information

CCLI. Bronchiectasis Treatment Antibiotics. Charles Haworth. Physician / Patient Conference, Georgetown University, May 2017

CCLI. Bronchiectasis Treatment Antibiotics. Charles Haworth. Physician / Patient Conference, Georgetown University, May 2017 Physician / Patient Conference, Georgetown University, May 2017 Bronchiectasis Treatment Antibiotics Charles Haworth CCLI Cambridge Centre for Lung Infection Disclosures Educational talks and / or consultancy

More information

National Jewish Health. Idiopathic Pulmonary Fibrosis: A Guide for Providers

National Jewish Health. Idiopathic Pulmonary Fibrosis: A Guide for Providers National Jewish Health Idiopathic Pulmonary Fibrosis: A Guide for Providers Table of Contents National Jewish Health Materials were developed through a partnership between National Jewish Health and PVI,

More information

Combined Unclassifiable Interstitial Pneumonia and Emphysema: A Report of Two Cases

Combined Unclassifiable Interstitial Pneumonia and Emphysema: A Report of Two Cases CASE REPORT Combined Unclassifiable Interstitial Pneumonia and Emphysema: A Report of Two Cases Nobuhiko Nagata 1, Kentaro Watanabe 2, Michihiro Yoshimi 3, Hiroshi Okabayashi 4, Katsuo Sueishi 5, Kentaro

More information

Cardiopulmonary Imaging Review

Cardiopulmonary Imaging Review Cardiopulmonary Imaging Review Chung and Lynch Multidisciplinary Approach to UIP and IPF Diagnosis Cardiopulmonary Imaging Review FOCUS ON: Jonathan H. Chung 1 David A. Lynch 2 Chung JH, Lynch DA Keywords:

More information

Idiopathic pulmonary fibrosis: pathogenesis and management

Idiopathic pulmonary fibrosis: pathogenesis and management Sgalla et al. Respiratory Research (2018) 19:32 https://doi.org/10.1186/s12931-018-0730-2 REVIEW Open Access Idiopathic pulmonary fibrosis: pathogenesis and management Giacomo Sgalla 1*, Bruno Iovene 1,

More information

[ Original Research Diffuse Lung Disease ]

[ Original Research Diffuse Lung Disease ] [ Original Research Diffuse Lung Disease ] Predicting Mortality in Systemic Sclerosis-Associated Interstitial Lung Disease Using Risk Prediction Models Derived From Idiopathic Pulmonary Fibrosis Christopher

More information

Interstitial Pneumonia With Autoimmune Features. Value of Histopathology

Interstitial Pneumonia With Autoimmune Features. Value of Histopathology Interstitial Pneumonia With Autoimmune Features Value of Histopathology Ayodeji Adegunsoye, MD, MS; Justin M. Oldham, MD, MS; Eleanor Valenzi, MD; Cathryn Lee, MD; Leah J. Witt, MD; Lena Chen, BS; Steven

More information

Case Presentation. Case Presentation (continued) PHYSICAL EXAMINATION. 60 year old college professor dyspnea with exertion dry cough, throat clearing

Case Presentation. Case Presentation (continued) PHYSICAL EXAMINATION. 60 year old college professor dyspnea with exertion dry cough, throat clearing Primary Care Medicine: Concepts and Controversies Thursday, February 18, 21 Fiesta Americana Puerto Vallarta, Mexico Interstitial Lung Disease: A Clinician s Approach to Diagnosis and Management Talmadge

More information

Interstitial Lung Disease in Systemic Sclerosis A Simple Staging System

Interstitial Lung Disease in Systemic Sclerosis A Simple Staging System Interstitial Lung Disease in Systemic Sclerosis A Simple Staging System Nicole S. L. Goh 1, Sujal R. Desai 2, Srihari Veeraraghavan 1, David M. Hansell 1, Susan J. Copley 3, Toby M. Maher 1, Tamera J.

More information

Journal of Nuclear Medicine, published on October 28, 2013 as doi: /jnumed

Journal of Nuclear Medicine, published on October 28, 2013 as doi: /jnumed Journal of Nuclear Medicine, published on October 28, 2013 as doi:10.2967/jnumed.113.120592 Preclinical SPECT/CT Imaging of avb6 Integrins for Molecular Stratification of Idiopathic Pulmonary Fibrosis

More information

NATIONAL ASSOCIATION FOR CONTINUING EDUCATION

NATIONAL ASSOCIATION FOR CONTINUING EDUCATION Outcome Report Update on Idiopathic Pulmonary Fibrosis: State of the Art and the New Guidelines NATIONAL ASSOCIATION FOR CONTINUING EDUCATION Presented at: Cleveland Clinic Florida Weston, Florida December

More information

Incidence and prevalence of idiopathic pulmonary fibrosis: review of the literature

Incidence and prevalence of idiopathic pulmonary fibrosis: review of the literature Eur Respir Rev 12; 21: 126, 355 361 DOI: 1.1183/95918.2512 CopyrightßERS 12 REVIEW Incidence and prevalence of idiopathic pulmonary fibrosis: review of the literature Luba Nalysnyk*, Javier Cid-Ruzafa

More information

Management of suspected monogenic lung fibrosis in a specialised centre

Management of suspected monogenic lung fibrosis in a specialised centre FRONTIERS IN CLINICAL PRACTICE PULMONARY FIBROSIS Management of suspected monogenic lung fibrosis in a specialised centre Raphael Borie 1,2,3,4, Caroline Kannengiesser 4,5, Flore Sicre de Fontbrune 6,

More information

Statins in lung disease

Statins in lung disease Statins in lung disease Associate Professor Robert Young BMedSc, MBChB, DPhil (Oxon), FRACP, FRCP University of Auckland, New Zealand Smoking and its complications Respiratory COPD Cardiovascular CAD Smoking

More information

CT in Idiopathic Pulmonary Fibrosis: Diagnosis and Beyond

CT in Idiopathic Pulmonary Fibrosis: Diagnosis and Beyond Cardiopulmonary Imaging Review Gruden CT of Idiopathic Pulmonary Fibrosis Cardiopulmonary Imaging Review James F. Gruden 1 Gruden JF FOCUS ON: Keywords: CT, diagnosis, high-resolution CT, idiopathic pulmonary

More information

Survival in Patients With Cryptogenic Fibrosing Alveolitis*

Survival in Patients With Cryptogenic Fibrosing Alveolitis* Survival in Patients With Cryptogenic Fibrosing Alveolitis* A Population-Based Cohort Study Richard Hubbard, DM; Ian johnston, MD; and john Britton, MD Study objectives: To determine the median survival

More information

Exercise peripheral oxygen saturation (SpO 2 ) accurately reflects arterial oxygen saturation (SaO 2 ) and predicts mortality in systemic sclerosis

Exercise peripheral oxygen saturation (SpO 2 ) accurately reflects arterial oxygen saturation (SaO 2 ) and predicts mortality in systemic sclerosis 1 Interstitial Lung Disease Program and Autoimmune Lung Center, National Jewich Health, Denver, Colorado, USA; 2 Division of Psychosocial Medicine, National Jewish Health, Denver, Colorado, USA; 3 Division

More information

COPD: early detection, screening and case-finding: what is the evidence? Prof. Jan-Willem Lammers, Md PhD Department of Respiratory Diseases

COPD: early detection, screening and case-finding: what is the evidence? Prof. Jan-Willem Lammers, Md PhD Department of Respiratory Diseases COPD: early detection, screening and case-finding: what is the evidence? Prof. Jan-Willem Lammers, Md PhD Department of Respiratory Diseases «If you test one smoker with cough every day You will diagnose

More information

Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias

Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias Respiratory Medicine (2007) 101, 655 660 Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias Yon Ju Ryu a, Man Pyo Chung b,, Joungho Han c, Tae Sung Kim d, Kyung Soo Lee d, Eun-Mi Chun

More information

Original Article. Keywords: Systemic sclerosis (SSc); mixed connective tissue disease (MCTD); interstitial lung disease (ILD); biomarker

Original Article. Keywords: Systemic sclerosis (SSc); mixed connective tissue disease (MCTD); interstitial lung disease (ILD); biomarker Original Article Serum KL-6 and surfactant protein-d as monitoring and predictive markers of interstitial lung disease in patients with systemic sclerosis and mixed connective tissue disease Hideaki Yamakawa

More information

Combined pulmonary fibrosis and emphysema

Combined pulmonary fibrosis and emphysema Curr Respir Care Rep (2013) 2:254 259 DOI 10.1007/s13665-013-0059-8 INTERSTITIAL LUNG DISEASE (G TINO, SECTION EDITOR) Combined pulmonary fibrosis and emphysema Rachel Jen & Christopher J. Ryerson Published

More information

Supported by an educational grant from

Supported by an educational grant from IDIOPATHIC PULMONARY FIBROSIS: PATIENT INFORMATION BROCHURE Supported by an educational grant from 08232-106 CONTENTS What is Pulmonary Fibrosis?.......................................................

More information

Radiologic Approach to Smoking Related Interstitial Lung Disease

Radiologic Approach to Smoking Related Interstitial Lung Disease Radiologic Approach to Smoking Related Interstitial Lung Disease Poster No.: C-1854 Congress: ECR 2013 Type: Educational Exhibit Authors: K.-N. Lee, J.-Y. Han, E.-J. Kang, J. Kang; Busan/KR Keywords: Toxicity,

More information

Significance of granulomatous inflammation in usual interstitial pneumonia

Significance of granulomatous inflammation in usual interstitial pneumonia Case report SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2015; 32; 160-166 Mattioli 1885 Significance of granulomatous inflammation in usual interstitial pneumonia R. Tomic 1, H.J. Kim 1, M. Bors 1,

More information

Palliative and Supportive Care in Cystic Fibrosis

Palliative and Supportive Care in Cystic Fibrosis Palliative and Supportive Care in Cystic Fibrosis Dr William Flight Consultant in Respiratory Medicine Oxford Adult Cystic Fibrosis Centre 27 th January 2017 Overview 1. Cystic Fibrosis Clinical Aspects

More information

Careful histopathological evaluation has shown the traditionally clinical diagnosis of

Careful histopathological evaluation has shown the traditionally clinical diagnosis of Demystifying Idiopathic Interstitial Pneumonia Harold R. Collard, MD; Talmadge E. King, Jr, MD REVIEW ARTICLE Careful histopathological evaluation has shown the traditionally clinical diagnosis of idiopathic

More information

Treatment Guide Interstitial Lung Disease

Treatment Guide Interstitial Lung Disease Treatment Guide Interstitial Lung Disease Since interstitial lung disease (ILD) is not a single disease but a group of more than 200 different pulmonary disorders, it can be confusing to understand exactly

More information

Test Name Results Units Bio. Ref. Interval

Test Name Results Units Bio. Ref. Interval LL - LL-ROHINI (NATIONAL REFERENCE 135091593 Age 25 Years Gender Male 30/8/2017 91600AM 30/8/2017 93946AM 31/8/2017 84826AM Ref By Final COLLAGEN DISEASES ANTIBODY ANEL ANTI NUCLEAR ANTIBODY / FACTOR (ANA/ANF),

More information

Combined pulmonary fibrosis and emphysema: a retrospective analysis of clinical characteristics, treatment and prognosis

Combined pulmonary fibrosis and emphysema: a retrospective analysis of clinical characteristics, treatment and prognosis Zhang et al. BMC Pulmonary Medicine (2016) 16:137 DOI 10.1186/s12890-016-0300-7 RESEARCH ARTICLE Open Access Combined pulmonary fibrosis and emphysema: a retrospective analysis of clinical characteristics,

More information

Idiopathic Pulmonary of Care

Idiopathic Pulmonary of Care Chapter 6.1 Living Medical etextbook A Digital Tool at the Point of Care From Projects In Knowledge Pulmonology Idiopathic Pulmonary Fibrosis @Point of Care IPF Case Study: Typical Presentation, Role of

More information

Review. Systemic sclerosis-associated interstitial lung disease proposed recommendations for future randomised clinical trials

Review. Systemic sclerosis-associated interstitial lung disease proposed recommendations for future randomised clinical trials Review Systemic sclerosis-associated interstitial lung disease proposed recommendations for future randomised clinical trials D. Khanna 1, K.K. Brown 5, P.J. Clements 1, R. Elashoff 2, D.E. Furst 1, J.

More information

Combined Pulmonary Fibrosis and Emphysema - A Case Series

Combined Pulmonary Fibrosis and Emphysema - A Case Series IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 1 Ver. III (January. 2017), PP 15-19 www.iosrjournals.org Combined Pulmonary Fibrosis and Emphysema

More information

Diagnostic Approach to Advanced Fibrotic Interstitial Lung Disease. Bringing Together Clinical, Radiologic, and Histologic Clues

Diagnostic Approach to Advanced Fibrotic Interstitial Lung Disease. Bringing Together Clinical, Radiologic, and Histologic Clues Diagnostic Approach to Advanced Fibrotic Interstitial Lung Disease Bringing Together Clinical, Radiologic, and Histologic Clues Brandon T. Larsen, MD, PhD; Maxwell L. Smith, MD; Brett M. Elicker, MD; Jessica

More information

CONNECTIONS. New Hope for Prevention of Childhood Food Allergies

CONNECTIONS. New Hope for Prevention of Childhood Food Allergies National Jewish Health A newsletter for physicians CONNECTIONS Summer 2015 New Hope for Prevention of Childhood Food Allergies Emerging evidence suggests that early introduction of potentially allergenic

More information

USEFULNESS OF HRCT IN DIAGNOSIS AND FOLLOW UP OF PULMONARY INVOLVEMENT IN SYSTEMIC SCLEROSIS

USEFULNESS OF HRCT IN DIAGNOSIS AND FOLLOW UP OF PULMONARY INVOLVEMENT IN SYSTEMIC SCLEROSIS USEFULNESS OF HRCT IN DIAGNOSIS AND FOLLOW UP OF PULMONARY INVOLVEMENT IN SYSTEMIC SCLEROSIS Brestas P., Vergadis V., Emmanouil E., Malagari K. 2 nd Dept of Radiology, University of Athens, Greece ABSTRACT

More information

Eosinophilia Associated Lung Diseases

Eosinophilia Associated Lung Diseases Eosinophilia Associated Lung Diseases Stephen P. Peters, MD, PhD, FAAAAI, FACP, FCCP, FCPP Thomas H. Davis Chair in Pulmonary Medicine Chief, Section on Pulmonary Critical Care, Allergy & Immunologic Diseases

More information

Idiopathic pulmonary fibrosis in Saudi Arabia: Demographic, clinical, and survival data from two tertiary care hospitals

Idiopathic pulmonary fibrosis in Saudi Arabia: Demographic, clinical, and survival data from two tertiary care hospitals Original Article Idiopathic pulmonary fibrosis in Saudi Arabia: Demographic, clinical, and survival data from two tertiary care hospitals Nahid Sherbini, Maun N Feteih 1, Siraj O Wali 2, Omer S Alamoudi

More information

DIA Oligonucleotide-Based Therapeutics Conference

DIA Oligonucleotide-Based Therapeutics Conference DIA Oligonucleotide-Based Therapeutics Conference North Bethesda MD October 25-27 Translating PD Biomarkers From Preclinical Studies to Clinical Trials: MRG-201, an Oligonucleotide Mimic of mir- 29, Inhibits

More information

Life-long asthma and its relationship to COPD. Stephen T Holgate School of Medicine University of Southampton

Life-long asthma and its relationship to COPD. Stephen T Holgate School of Medicine University of Southampton Life-long asthma and its relationship to COPD Stephen T Holgate School of Medicine University of Southampton Definitions COPD is a preventable and treatable disease with some significant extrapulmonary

More information

PHARMACOLOGICAL TREATMENT OF IDIOPATHIC PULMONARY FIBROSIS - AN UPDATE

PHARMACOLOGICAL TREATMENT OF IDIOPATHIC PULMONARY FIBROSIS - AN UPDATE PHARMACOLOGICAL TREATMENT OF IDIOPATHIC PULMONARY FIBROSIS - AN UPDATE Paolo Spagnolo, 1 Hilario Nunes, 2 Wim A. Wuyts 3 1. Centre for Rare Lung Diseases, Respiratory Disease Unit, Department of Medical

More information