Idiopathic pulmonary fibrosis: Disease mechanisms and drug development

P Spagnolo, JA Kropski, MG Jones, JS Lee… - Pharmacology & …, 2021 - Elsevier
Pharmacology & therapeutics, 2021Elsevier
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive disease of unknown cause
characterized by relentless scarring of the lung parenchyma leading to reduced quality of life
and earlier mortality. IPF is an age-related disorder, and with the population aging
worldwide, the economic burden of IPF is expected to steadily increase in the future. The
mechanisms of fibrosis in IPF remain elusive, with favored concepts of disease
pathogenesis involving recurrent microinjuries to a genetically predisposed alveolar …
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive disease of unknown cause characterized by relentless scarring of the lung parenchyma leading to reduced quality of life and earlier mortality. IPF is an age-related disorder, and with the population aging worldwide, the economic burden of IPF is expected to steadily increase in the future. The mechanisms of fibrosis in IPF remain elusive, with favored concepts of disease pathogenesis involving recurrent microinjuries to a genetically predisposed alveolar epithelium, followed by an aberrant reparative response characterized by excessive collagen deposition. Pirfenidone and nintedanib are approved for treatment of IPF based on their ability to slow functional decline and disease progression; however, they do not offer a cure and are associated with tolerability issues. In this review, we critically discuss how cutting-edge research in disease pathogenesis may translate into identification of new therapeutic targets, thus facilitate drug discovery. There is a growing portfolio of treatment options for IPF. However, targeting the multitude of profibrotic cytokines and growth factors involved in disease pathogenesis may require a combination of therapeutic strategies with different mechanisms of action.
Elsevier