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Published ahead of print on May 5, 2005, doi:10.1164/rccm.200503-483OE

Am. J. Respir. Crit. Care Med., Volume 172, Number 3, August 2005, 268-279

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Submitted on March 29, 2005
Accepted on April 29, 2005

Centennial Review: Clinical Advances in the Diagnosis and Therapy of the Interstitial Lung Diseases

Talmadge E King Jr.1*

1 Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of California at San Francisco, San Fransisco, CA, United States

* To whom correspondence should be addressed. E-mail: tking{at}medsfgh.ucsf.edu.

The last century experienced remarkable advances in the classification, diagnosis, and our understanding of the pathogenesis of the interstitial lung diseases. Technological advances, particularly physiological testing, lung imaging studies, bronchoalveolar lavage, surgical lung biopsy and histopathological assessment improved our understanding of these entities. In particular, the advent of high-resolution computerized tomography, the narrowed pathologic definition of usual interstitial pneumonia, and recognition of the prognostic importance of separating UIP from other idiopathic interstitial pneumonia patterns have profoundly changed the approach to these processes. Most recently, genetic medicine, the use of new technologies(e.g., microarrays, mass spectroscopic analysis of proteins and laser capture microdissection) and the development of animal models have had a major impact on understanding the pathogenesis and potential molecular targets for interfering with fibrogenesis. This review highlights some of the advances and changes in clinical practice that took place in the management of patients with interstitial lung diseases over the last century.
Key words: interstitial lung disease, usual interstitial pneumonia, non-specific interstitial pneumonia, idiopathic pulmonary fibrosis, sarcoidosis, physiology, HRCT




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