| Journal: | Revista de investigación clínica |
| Database: | PERIÓDICA |
| System number: | 000389656 |
| ISSN: | 0034-8376 |
| Authors: | Paulin, Francisco1 Doyle, Tracy J2 Fletcher, Elaine A3 Ascherman, Dana P4 Rosas, Ivan O2 |
| Institutions: | 1Hospital María Ferrer, Buenos Aires. Argentina 2Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts. Estados Unidos de América 3Cornell University, Ithaca, Nueva York. Estados Unidos de América 4University of Miami, Miller School of Medicine, Miami, Florida. Estados Unidos de América |
| Year: | 2015 |
| Season: | Sep-Oct |
| Volumen: | 67 |
| Number: | 5 |
| Pages: | 280-286 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico |
| English abstract | The prevalence of clinically evident interstitial lung disease in patients with rheumatoid arthritis is approximately 10%. An additional 33% of undiagnosed patients have interstitial lung abnormalities that can be detected with high-resolution computed tomography. Rheumatoid arthritis-interstitial lung disease patients have three times the risk of death compared to those with rheumatoid arthritis occurring in the absence of interstitial lung disease, and the mortality related to interstitial lung disease is rising. Rheumatoid arthritis-interstitial lung disease is most commonly classified as the usual interstitial pneumonia pattern, overlapping mechanistically and phenotypically with idiopathic pulmonary fibrosis, but can occur in a non-usual interstitial pneumonia pattern, mainly nonspecific interstitial pneumonia. Based on this, we propose two possible pathways to explain the coexistence of rheumatoid arthritis and interstitial lung disease: (i) Rheumatoid arthritis-interstitial lung disease with a non-usual interstitial pneumonia pattern may come about when an immune response against citrullinated peptides taking place in another site (e.g. the joints) subsequently affects the lungs; (ii) Rheumatoid arthritis-interstitial lung disease with a usual interstitial pneumonia pattern may represent a disease process in which idiopathic pulmonary fibrosis-like pathology triggers an immune response against citrullinated proteins that promotes articular disease indicative of rheumatoid arthritis. More studies focused on elucidating the basic mechanisms leading to different sub-phenotypes of rheumatoid arthritis-interstitial lung disease and the overlap with idiopathic pulmonary fibrosis are necessary to improve our understanding of the disease process and to define new therapeutic targets |
| Disciplines: | Medicina |
| Keyword: | Neumología, Reumatología, Terapéutica y rehabilitación, Artritis reumatoide, Enfermedad intersticial pulmonar, Fibrosis pulmonar idiopática, Citrulina, Fisiopatología |
| Keyword: | Medicine, Pneumology, Rheumatology, Therapeutics and rehabilitation, Rheumatoid arthritis, Interstitial lung disease, Idiopathic pulmonary fibrosis, Citrulline, Physiopathology |
| Full text: | Texto completo (Ver PDF) |
