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Published on: May 9, 2025
The immunodynamics of pulmonary fibrosis
Cong Xie1, Yuanyuan Ma2, Yunjing Wang3
1Institute for the Modernization of Traditional Chinese Medicine, Pu'er University, Pu'er 665000, PR China; Department of Integrative Medicine, Huashan Hospital Affiliated to Fudan University, Fudan Institutes of Integrative Medicine, Fudan University Shanghai Medical College, Shanghai 200040, PR China; School of Clinical Medicine (Yuquan Hospital), Tsinghua University, Beijing 100040, PR China.
Immune cell interactions, termed immunodynamics, drive lung damage in pulmonary fibrosis. Understanding these dynamics offers new precision treatment strategies for interstitial lung diseases.
Area of Science:
- Pulmonary and immunology research
- Cellular and molecular biology
Background:
- Pulmonary fibrosis, the end-stage of interstitial lung diseases (ILDs), involves alveolar destruction and fatal respiratory failure.
- Idiopathic pulmonary fibrosis (IPF) was historically viewed as non-immune driven, due to failed immunosuppressive therapies.
Purpose of the Study:
- To review the role of immune cell dynamics (immunodynamics) in the pathogenesis of all fibrosing ILDs.
- To evaluate immune-targeted therapies for fibrotic lung diseases.
Main Methods:
- Synthesis of spatiotemporal dynamics of innate and adaptive immune cells.
- Delineation of molecular circuits in immune-epithelial-mesenchymal crosstalk.
- Critical evaluation of immune-targeted therapeutic translation.
Main Results:
- Advances in transcriptomics reveal immune cells are central drivers of lung remodeling in fibrosing ILDs.
- Immunodynamics framework unifies pathogenesis of IPF and secondary fibrotic ILDs.
- Identified actionable therapeutic windows and patient stratification strategies.
Conclusions:
- Immune cell interactions are critical in fibrotic ILD pathogenesis.
- The immunodynamics framework provides a unified view of fibrotic lung diseases.
- This framework enables precision medicine approaches for treating pulmonary fibrosis.
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