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Updated: Jun 25, 2026

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Non-specific interstitial pneumonia in cigarette smokers: a CT study
Katharina Marten1, David Milne, Katerina M Antoniou
1Department of Radiology, Georg August University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. kmarten@med.uni-goettingen.de
Smoking is linked to non-specific interstitial pneumonia (NSIP). Smokers with NSIP show high rates of emphysema, similar to those with COPD, suggesting smoking may cause some NSIP cases.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Pathogenesis of Lung Diseases
Background:
- Non-specific interstitial pneumonia (NSIP) is an idiopathic interstitial pneumonia.
- The role of smoking as an etiological factor in NSIP remains unclear.
- Emphysema is a common finding in smokers and is associated with chronic obstructive pulmonary disease (COPD).
Purpose of the Study:
- To investigate the association between smoking and the development of non-specific interstitial pneumonia (NSIP).
- To assess the prevalence and extent of emphysema in smokers with NSIP.
- To provide indirect evidence for smoking as a potential cause of NSIP.
Main Methods:
- Comparison of emphysema prevalence in 18 smokers with NSIP against two control groups: smokers with COPD (Group A) and healthy smokers (Group B).
- Utilized logistic regression to analyze the association between NSIP, emphysema, and age.
- Included 137 current smokers without known interstitial lung disease and 11 non-smokers with NSIP for comparison.
Main Results:
- Emphysema was present in 77.8% of smokers with NSIP.
- Emphysema prevalence in NSIP patients (73.5%) was similar to COPD patients (73.5%) but significantly higher than in healthy smokers (17.5%).
- NSIP presence (OR=18.8) and increasing age were associated with a higher likelihood of emphysema.
Conclusions:
- Emphysema is highly prevalent in smokers with NSIP, comparable to smokers with COPD.
- The strong association between NSIP and emphysema supports the hypothesis that smoking contributes to the pathogenesis of some NSIP cases.
- Further research is warranted to elucidate the specific mechanisms linking smoking to NSIP.
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