Interstitial Lung Disease in Patients With Systemic Sclerosis: Toward Personalized-Medicine-Based Prediction and Drug Screening Models of Systemic Sclerosis-Related Interstitial Lung Disease (SSc-ILD)

被引:16
|
作者
Khedoe, Padmini [1 ]
Marges, Emiel [1 ]
Hiemstra, Pieter [1 ]
Ninaber, Maarten [1 ]
Geelhoed, Miranda [1 ]
机构
[1] Leiden Univ Med Ctr LUMC, Dept Pulmonol, Leiden, Netherlands
来源
FRONTIERS IN IMMUNOLOGY | 2020年 / 11卷
关键词
systemic sclerosis; interstitial lung disease; idiopathic pulmonary fibrosis; pathogenesis; organoids; human disease models; IDIOPATHIC PULMONARY-FIBROSIS; MUC5B PROMOTER POLYMORPHISM; PLURIPOTENT STEM-CELLS; SURFACTANT PROTEIN-D; SCLERODERMA LUNG; NITRIC-OXIDE; RISK-FACTORS; SERUM-LEVELS; TGF-BETA; MECHANISMS;
D O I
10.3389/fimmu.2020.01990
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Systemic sclerosis (SSc) is an autoimmune connective tissue disease, characterized by immune dysregulation and progressive fibrosis. Interstitial lung disease (ILD) is the most common cause of death among SSc patients and there are currently very limited approved disease-modifying treatment options for systemic sclerosis-related interstitial lung disease (SSc-ILD). The mechanisms underlying pulmonary fibrosis in SSc-ILD are not completely unraveled, and knowledge on fibrotic processes has been acquired mostly from studies in idiopathic pulmonary fibrosis (IPF). The incomplete knowledge of SSc-ILD pathogenesis partly explains the limited options for disease-modifying therapy for SSc-ILD. Fibrosis in IPF appears to be related to aberrant repair following injury, but whether this also holds for SSc-ILD is less evident. Furthermore, immune dysregulation appears to contribute to pro-fibrotic responses in SSc-ILD, perhaps more than in IPF. In addition, SSc-ILD patient heterogeneity complicates the understanding of the underlying mechanisms of disease development, and more importantly, limits correct clinical diagnosis and treatment effectivity. Therefore, there is an unmet need for patient-relevant (in vitro) models to examine patient-specific disease pathogenesis, predict disease progression, screen appropriate treatment regimens and identify new targets for treatment. Technological advances inin vitropatient-relevant disease modeling, including (human induced pluripotent stem cell (hiPSC)-derived) lung epithelial cells, organoids and organ-on-chip technology offer a platform that has the potential to contribute to unravel the underlying mechanisms of SSc-ILD development. Combining these models with state-of-the-art analysis platforms, including (single cell) RNA sequencing and (imaging) mass cytometry, may help to delineate pathogenic mechanisms and define new treatment targets of SSc-ILD.
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页数:10
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