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Impact of inhaled corticosteroid use on elderly chronic pulmonary disease patients with community acquired pneumonia

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Chinese Medical Journal 2024年第2期137卷 241-243页

作者： Xiudi Han Hong Wang Liang Chen Yimin Wang Hui Li Fei Zhou Xiqian Xing Chunxiao Zhang Lijun suo Jinxiang Wang Guohua Yu Guangqiang Wang Xuexin Yao Hongxia Yu Lei Wang Meng Liu Chunxue Xue Bo Liu Xiaoli Zhu Yanli Li Ying Xiao Xiaojing Cui Lijuan Li Xuedong Liu Bin Cao department of Pulmonary and critical care medicine Qingdao Municipal HospitalQingdaoShandong 266011China department of Nosocomial Infection Qingdao Municipal HospitalQingdaoShandong 266011China department of Infectious Diseases Nanjing Lishui People’s HospitalNanjingJiangsu 211213China department of Pulmonary and critical care medicine National Clinical Research Center of Respiratory DiseasesCenter for Respiratory DiseasesChina-Japan Friendship HospitalBeijing 100020China department of respiratory medicine Yan’an Hospital Affiliated to Kunming Medical UniversityKunmingYunnan 652199China department of respiratory medicine Beijing Huimin HospitalBeijing 100054China department of Pulmonary and critical care medicine Zibo Municipal HospitalZiboShandong 255000China department of respiratory medicine Beijing Luhe HospitalCapital Medical UniversityBeijing 101149China department of Pulmonary and critical care medicine Weifang No.2 People’s HospitalWeifangShandong 261599China department of respiratory medicine Shandong University Affiliated Qilu Hospital(Qingdao)QingdaoShandong 266035China department of respiratory medicine the 2nd Hospital of Beijing CorpsChinese Armed Police ForcesBeijing 100044China department of Infectious Disease Qingdao University Medical College Affiliated Yantai Yuhuangding HospitalYantaiShandong 100191China department of respiratory medicine Rizhao Chinese Medical Hospital Affiliated to Shandong Chinese Medical UniversityRizhaoShandong 276800China department of respiratory medicine Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical UniversityBeijing 100010China department of Occupational medicine and Toxicology Beijing Chao-Yang HospitalCapital Medical UniversityBeijing 100020China

To the Editor:With an aging global population,the incidences of community-acquired pneumonia(CAP)and chronic obstructive pulmonary disease(COPD)have signicantly increased.[1]Previous studies have conrmed that COPD and asthma are independently associated with the prevalence of CAP.The use of inhaled corticosteroid(ICs),the cornerstone of treatment for asthma,COPD with frequent acute exacerbations,and asthma-COPD overlap(ACO)may induce changes in the local lung microbiome and abnormal lung immunity,ultimately,causing a signicantly increased risk of pneumonia.However,in cases of pneumonia,the effect of the use of ICs on CAP mortality remains controversial.While data from one study favored the prior use of ICs,which was associated with a signicantly lower short-term mortality rate,[2]other studies have identied no impact on mortality.To date,data on the impact of the use of ICs on mortality,prehospitalization or during hospitalization,are scarce,particularly in the older population.Therefore,this multicenter,retrospective study explored the association between the use of ICs during hospitalization and short-term mortality in older patients with CAP and those with chronic pulmonary disease(CPD).

关键词： pneumonia patients immunity

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Analysis of the Efficacy,Progression-Free survival,and safety of Anlotinib in Advanced Lung Cancer Treatment

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Proceedings of Anticancer Research 2024年第1期8卷 105-111页

作者： Jie shen Cheng Meng Xiaoyan Zhang Rong Lei Liyun Hao department of respiratory and critical care medicine Yan’an People’s HospitalYan’an 716000Shaanxi ProvinceChina

Objective:To analyze the clinical efficacy,progression-free survival,and safety of anlotinib in the treatment of advanced lung cancer.Methods:A retrospective analysis was conducted using data from 60 patients with advanced lung cancer treated with anlotinib from May 2019 to May 2021.This analysis aimed to comprehensively evaluate the clinical efficacy,progression-free survival,and adverse reactions of anlotinib.Results:The median progression-free survival(PFs)for the 60 patients was 5.79 months,with an overall response rate(ORR)of 21%and a disease control rate(DCR)of 90%.In the first-line group,the median PFs was 6.20 months,ORR was 76.92%,and DCR was 84.61%.The second-line group showed a median PFs of 6.30 months,ORR of 28.57%,and DCR of 90.48%.In the third-line group,the median PFs was 5.34 months,ORR was 19.23%,and DCR was 92.30%.The single-agent group exhibited a median PFs of 5.09 months,ORR of 23.33%,and DCR of 76.67%.In the combination group,the median PFs was 6.53 months,ORR was 46.67%,and DCR was 100%.The combination group demonstrated a significantly higher medication effect than the single-drug group,and adverse drug reactions were mostly grade 1-2.Conclusion:Anlotinib exhibits a better disease control rate and survival benefit in the treatment of advanced lung cancer.The combination effect is superior to monotherapy,with relatively controllable adverse effects.

关键词： Anlotinib Advanced lung cancer Vascular targeted therapy Recent efficacy Drug safety

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Diagnosis,treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children:experts'consensus statement updatedforthe Omicron variant

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World Journal of Pediatrics 2024年第3期20卷 272-286页

作者： Rong-Meng Jiang Zheng-De Xie Yi Jiang Xiao-Xia Lu Run-Ming Jin Yue-Jie Zheng Yun-Xiao shang Bao-Ping Xu Zhi-sheng Liu Gen Lu Ji-Kui Deng Guang-Hua Liu Xiao-Chuan Wang Jian-she Wang Lu-Zhao Feng Wei Liu Yi Zheng sai-Nan shu Min Lu Wan-Jun Luo Miao Liu Yu-Xia Cui Le-Ping Ye A-Dong shen Gang Liu Li-Wei Gao Li-Juan Xiong Yan Bai Li-Kai Lin Zhuang Wei Feng-Xia Xue Tian-You Wang Dong-Chi Zhao Jian-Bo shao Daniel Kwok-keung Ng Gary Wing-kin Wong Zheng-Yan Zhao Xing-Wang Li Yong-Hong Yang Kun-Ling shen Diagnosis and Treatment Center of Infectious Diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Beijing Key Laboratory of Pediatric respiratory Infection Diseases Key Laboratory of Major Diseases in ChildrenMinistry of EducationNational Clinical Research Center for Respiratory DiseasesResearch Unit of Critical Infection in ChildrenChinese Academy of Medical Sciences2019RU016Laboratory of Infection and VirologyBeijing Pediatric Research InstituteBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijing 100045China department of Pediatrics Renmin Hospital of Wuhan UniversityWuhan 430060China department of respiratory Wuhan Children's HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430016China department of Pediatrics Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China department of respiratory Shenzhen Children's HospitalShenzhen 518038China department of Pediatric respiratory Shengjing Hospital Affiliated to China Medical UniversityShenyang 110004China department of respiratory Beijing Children's HospitalCapital Medical UniversityNational Clinical Research Center for Respiratory DiseasesNational Center for Children's HealthBeijing 100045China department of Neurology Wuhan Children's HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430016China department of respiratory Guangzhou Women and Children's Medical CenterGuangzhou 510623China department of Infectious Diseases Shenzhen Children's HospitalShenzhen 518038China department of Pediatrics Fujian Branch of Shanghai Children's Medical CenterFujian Children's HospitalFuzhou350005China department of Clinical Immunology and Allergy Children's Hospital of Fudan UniversityNational Center for Children's HealthShanghai 201102China department of Infectious Diseases Children's Hospital of Fudan UniversityNational Center for Children's Health.Shanghai

It has been more than 3 years since the novel coronavirus(sARs-CoV-2)pandemic raged globally.The coronavirus disease 2019(COVID-19)has greatly influenced human society.According to data from the World Health Organization(WHO),there were over 656 million confirmed cases of COVID-19 in the world as of January 1,2023,including over 6.6 million deaths[1].

关键词： prevention infection statement

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Potential biomarkers for diagnosis and disease evaluation of idiopathic pulmonary fibrosis

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Chinese Medical Journal 2023年第11期136卷 1278-1290页

作者： Qing Wang Zhaoliang Xie Nansheng Wan Lei Yang Zhixian Jin Fang Jin Zhaoming Huang Min Chen Huiming Wang Jing Feng department of respiratory and critical care medicine Tianjin Medical University General HospitalTianjin 300052China department of respiratory and critical care medicine of kunming municipal first people’s hospital KunmingYunnan 650000China respiratory department of sanming Yong’an General hospital SanmingFujian 366000China

Idiopathic pulmonary fibrosis(IPF)is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia.IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration;thus,a differential diagnosis remains challenging.several biomarkers have been identified to achieve a differential diagnosis;however,comprehensive reviews are lacking.This review summarizes over 100 biomarkers which can be divided into six categories according to their functions:differentially expressed biomarkers in the IPF compared to healthy controls;biomarkers distinguishing IPF from other types of interstitial lung disease;biomarkers differentiating acute exacerbation of IPF from stable disease;biomarkers predicting disease progression;biomarkers related to disease severity;and biomarkers related to treatment.specimen used for the diagnosis of IPF included serum,bronchoalveolar lavage fluid,lung tissue,and sputum.IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF.Currently,the physiological measurements used to evaluate the occurrence of acute exacerbation,disease progression,and disease severity have limitations.Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF.Most biomarkers described in this review are not routinely used in clinical practice.Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.

关键词： Alveolar epithelial cell dysfunction Biomarker Diagnosis Fibrogenesis Extracellular matrix remodeling Idiopathic pulmonary fibrosis Immune dysfunction

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Pulmonary artery aneurysm protruding into the bronchus as an endobronchial mass:A case report

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世界临床病例杂志 2023年第28期11卷 6792-6796页

作者： Min Li Wen-Ye Zhu Rong-Rong Wu Le Wang Meng-Ting Mo shi-Nan Liu Dong-Yi Zhu Zhuang Luo department of respiratory and critical care medicine The First Affiliated Hospital of Kunming Medical UniversityKunming 650032Yunnan ProvinceChina department of Pharmacy The First Affiliated Hospital of Kunming Medical UniversityKunming 650032Yunnan ProvinceChina department of Radiology The First People’s Hospital of Yunnan Province/Affiliated Hospital of Kunming University of Science and TechnologyKunming 650034Yunnan ProvinceChina

BACKGROUND Pulmonary artery(PA)aneurysms are usually diagnosed radiographically and present as small or large lesions resembling inflammation or a neoplasm on chest radiography.It has rarely been reported as an endobronchial mass.CAsE sUMMARY We report the case of a 64-year-old man who presented with recurrent hemoptysis.Bronchoscopy revealed a tumorous protrusion blocking the right middle lobe bronchus,which was confirmed to be a PA aneurysm using endobronchial ultrasound bronchoscopy and computed tomography angiography.CONCLUsION Although endobronchial PA aneurysms are rare,bronchoscopists need to add this lesion to the list of endobronchial masses for which a biopsy is to be assiduously avoided.

关键词： Pulmonary artery aneurysm Endobronchial mass Endobronchial ultrasound bronchoscopy Computed tomography angiography Case report

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Heterozygous CARD9 mutation favors the development of allergic bronchopulmonary aspergillosis

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Chinese Medical Journal 2023年第16期136卷 1949-1958页

作者： Xia Xu Haiwen Lu Jianxiong Li Jielin Duan Zhongwei Wang Jiawei Yang shuyi Gu Rongguang Luo shuo Liang Wei Tang Fengying Zhang Jingqing Hang Juan Ge Xin Lin Jieming Qu Xinming Jia Jinfu Xu department of respiratory and critical care medicine Shanghai Pulmonary HospitalInstitute of Respiratory MedicineSchool of MedicineTongji UniversityShanghai 200433China department of Immunology School of Basic Medical SciencesCapital Medical UniversityBeijing 100069China shanghai Tenth people’s hospital Tongji University School of MedicineShanghai 200072China department of respiratory and critical care medicine Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200025China department of respiratory and critical care medicine Shanghai Putuo District People’s HospitalShanghai 200060China department of respiratory and critical care medicine Nantong HospitalShanghai UniversityNantongJiangsu 226007China Institute for Immunology Tsinghua University School of MedicineTsinghua-Peking Center for Life SciencesBeijing 100083China

Background:Previous research demonstrated that a homozygous mutation of g.136372044G>A(s12N)in caspase recruitment domain family member 9(CARD9)is critical for producing Aspergillus fumigatus-induced(Af-induced)T helper 2(T_(H)2)-mediated responses in allergic bronchopulmonary aspergillosis(ABPA).However,it remains unclear whether the CARD9^(s12N)mutation,especially the heterozygous occurrence,predisposes the host to ABPA.Methods:A total of 61 ABPA patients and 264 controls(including 156 healthy controls and 108 asthma patients)were recruited for sequencing the CARD9 locus to clarify whether patients with this heterozygous single-nucleotide polymorphisms are predisposed to the development of ABPA.A series of in vivo and in vitro experiments,such as quantitative real-time polymerase chain reaction,flow cytometry,and RNA isolation and quantification,were used to illuminate the involved mechanism of the disease.Results:The presence of the p.s12N mutation was associated with a significant risk of ABPA in ABPA patients when compared with healthy controls and asthma patients,regardless of Aspergillus sensitivity.Relative to healthy controls without relevant allergies,the mutation of p.s12N was associated with a significant risk of ABPA(OR:2.69 and 4.17 for GA and AA genotypes,P=0.003 and 0.029,respectively).Compared with patients with asthma,ABPA patients had a significantly higher heterozygous mutation(GA genotype),indicating that p.s12N might be a significant ABPA-susceptibility locus(aspergillus sensitized asthma:OR:3.02,P=0.009;aspergillus unsensitized asthma:OR:2.94,P=0.005).The mutant allele was preferentially expressed in ABPA patients with heterozygous CARD9^(s12N),which contributes to its functional alterations to facilitate Af-induced T_(H)2-mediated ABPA development.In terms of mechanism,Card9 wild-type(Card9^(WT))expression levels decreased significantly due to Af-induced decay of its messenger RNA compared to the heterozygous Card9 s12N.In addition,ABPA patients with heterozygous CARD9^(s12N)had increased

关键词： Allergic bronchopulmonary aspergillosis polymorphism Allelic expression imbalance Asthma

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Oncology Research 2023年第5期31卷 697-714页

作者： XUEFENG WANG sICONG JIANG XINHONG ZHOU XIAOFENG WANG LAN LI JIANJUN TANG department of respiratory and critical care medicine The First Affiliated Hospital of Nanchang UniversityNational Regional Center for Respiratory MedicineNanchang330006China Division of Thoracic and Endocrine surgery University Hospitals and University of GenevaGenevaSwitzerland department of Hepatobiliary surgery Xiantao First People’s Hospital of Yangtze UniversityXiantao433099China department of Gastrointestinal surgery The First Affiliated HospitalSun Yat-sen UniversityGuangzhou510062China department of Radiation Oncology The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer HospitalKunming650118China

Pancreatic cancer is associated with high mortality and is one of the most aggressive of malignancies,but studies have not fully evaluated its molecular subtypes,prognosis and response to immunotherapy of different subtypes.The purpose of this study was to explore the molecular subtypes and the key genes associated with the prognosis of pancreas cancer patients and study the clinical phenotype,prognosis and response to immunotherapy using single-cell seq data and bulk RNA seq data,and data retrieved from GEO and TCGA databases.Methods:single-cell seq data and bioinformatics methods were used in this study.Pancreatic cancer data were retrieved from GEO and TCGA databases,the molecular subtypes of pancreatic cancer were determined using the six cGAs-sTING related pathways,and the clinical phenotype,mutation,immunological characteristics and pathways related to pancreatic cancer were evaluated.Results:Pancreatic cancer was classified into 3 molecular subtypes,and survival analysis revealed that patients in Cluster3(C3)had the worst prognosis,whereas Cluster1(C1)had the best prognosis.The clinical phenotype and gene mutation were statistically different among the three molecular subtypes.Analysis of immunotherapy response revealed that most immune checkpoint genes were differentially expressed in the three subtypes.A lower risk of immune escape was observed in Cluster1(C1),indicating higher sensitivity to immunotherapeutic drugs and subjects in this Cluster are more likely to benefit from immunotherapy.The pathways related to pancreatic cancer were differentially enriched among the three subtypes.Five genes,namely sFRP1,GIPR,EMP1,COL17A and CXCL11 were selected to construct a prognostic signature.Conclusions:single-cell seq data were to classify pancreatic cancer into three molecular subtypes based on differences in clinical phenotype,mutation,immune characteristics and differentially enriched pathways.Five prognosis-related genes were identified for prediction of survival of pancreatic cancer patients and to evaluat

关键词： Pancreatic cancer Molecular subtypes single-cell sequencing Immune microenvironment Tumor immunity

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Eligibility of C-BIOPRED severe asthma cohort for type-2 biologic therapies

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Chinese Medical Journal 2023年第2期136卷 230-232页

作者： Zhenan Deng Meiling Jin Changxing Ou Wei Jiang Jianping Zhao Xiaoxia Liu shenghua sun Huaping Tang Bei He shaoxi Cai Ping Chen Penghui Wu Yujing Liu Jian Kang Yunhui Zhang Mao Huang Jinfu Xu Kewu Huang Qiang Li Xiangyan Zhang Xiuhua Fu Changzheng Wang Huahao shen Lei Zhu Guochao shi Zhongmin Qiu Zhongguang Wen Xiaoyang Wei Wei Gu Chunhua Wei Guangfa Wang Ping Chen Lixin Xie Jiangtao Lin Yuling Tang Zhihai Han Kian Fan Chung Qingling Zhang Nanshan Zhong C-BIOPRED Consortium Pulmonary and critical care medicine Guangzhou Institute of Respiratory HealthNational Clinical Research Center for Respiratory DiseaseNational Center for Respiratory MedicineState Key Laboratory of Respiratory DiseasesThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdong 510120China department of respiratory medicine Zhongshan HospitalShanghai 200433China Guangzhou Medical University GuangzhouGuangdong 510180China AstraZeneca Shanghai 200085China department of respiratory medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China department of respiratory medicine Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China department of respiratory medicine The Third Xiangya Hospital of Central South UniversityChangshaHunan 410013China department of respiratory medicine Qingdao Municipal HospitalQingdaoShandong 266001China department of respiratory medicine Peking University Third HospitalBeijing 100191China department of respiratory medicine Nanfang Hospital of Southern Medical UniversityGuangzhouGuangdong 510515China department of respiratory medicine General Hospital of Northern Theater CommandShenyangLiaoning 110016China department of respiratory medicine The First Hospital of China Medical UniversityShenyangLiaoning 110001China department of respiratory medicine The First people’s Hospital of Yunnan ProvinceKunmingYunnan 363880China department of respiratory medicine The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China department of respiratory medicine Shanghai Pulmonary HospitalShanghai 200433China department of respiratory medicine Beijing Chao-Yang HospitalBeijing 100020China department of respiratory medicine Shanghai General HospitalShanghai 200080China department of respiratory medicine Guizhou Province People’s HospitalGuiyangGuizhou 550002China department of respiratory medicine The Affiliated Hospital of Inner Mongolia Me

To the Editor:Patients with severe persistent asthma experience greater morbidity with more impairment in quality of life despite higher use of health care resources and being treated with existing asthma treatments such as inhaled corticosteroids and b-agonists,and sometimes oral corticosteroid(OCs)therapy.Type-2(T2)high asthma has been identified as a phenotype that responds to targeted T2 biologic therapies such as anti-IgE,anti-interleukin(IL)5,or anti-IL5Ra and anti-IL4Ra monoclonal antibodies,which are currently available in Europe and North America,and are currently introduced in the rest of the world.[1]

关键词： asthma therapies impairment

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Gli1 promotes epithelial-mesenchymal transition and metastasis of non-small cell lung carcinoma by regulating snail transcriptional activity and stability

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Acta Pharmaceutica sinica B 2022年第10期12卷 3877-3890页

作者： Xueping Lei Zhan Li Yihang Zhong songpei Li Jiacong Chen Yuanyu Ke sha Lv Lijuan Huang Qianrong Pan Lixin Zhao Xiangyu Yang Zisheng Chen Qiudi Deng Xiyong Yu Guangzhou municipal and Guangdong Provincial Key Laboratory of Molecular Target&Clinical Pharmacology the NMPA and State Key Laboratory of Respiratory DiseaseSchool of Pharmaceutical Sciences and the Fifth Affiliated HospitalGuangzhou Medical UniversityGuangzhou 511436China department of respiratory and critical care medicine the Sixth Affiliated Hospital of Guangzhou Medical UniversityQingyuan People’s HospitalQingyuan 511518China GMU-GIBH Joint school of Life sciences Guangzhou Medical UniversityGuangzhou 511436China

Metastasis is crucial for the mortality of non-small cell lung carcinoma(NsCLC) patients.The epithelial-mesenchymal transition(EMT) plays a critical role in regulating tumor metastasis.Glioma-associated oncogene 1(Gli1) is aberrantly active in a series of tumor tissues. However, the molecular regulatory relationships between Gli1 and NsCLC metastasis have not yet been identified. Herein,we reported Gli1 promoted NsCLC metastasis. High Gli1 expression was associated with poor survival of NsCLC patients. Ectopic expression of Gli1 in low metastatic A549 and NCI-H460 cells enhanced their migration, invasion abilities and facilitated EMT process, whereas knock-down of Gli1 in high metastatic NCI-H1299 and NCI-H1703 cells showed an opposite effect. Notably, Gli1 overexpression accelerated the lung and liver metastasis of NsCLC in the intravenously injected metastasis model. Further research showed that Gli1 positively regulated snail expression by binding to its promoter and enhancing its protein stability, thereby facilitating the migration, invasion and EMT of NsCLC. In addition, administration of GANT-61, a Gli1 inhibitor, obviously suppressed the metastasis of NsCLC. Collectively, our study reveals that Gli1 is a critical regulator for NsCLC metastasis and suggests that targeting Gli1 is a prospective therapy strategy for metastatic NsCLC.

关键词： Non-small cell lung carcinoma Metastasis Epithelialemesenchymal transition Glioma-associated oncogene 1 Promote snail Protein stability GANT-61

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Role of various imbalances centered on alveolar epithelial cell/fibroblast apoptosis imbalance in the pathogenesis of idiopathic pulmonary fibrosis

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Chinese Medical Journal 2021年第3期134卷 261-274页

作者： Qing Wang Zhao-Liang Xie Qi Wu Zhi-Xian Jin Chao Yang Jing Feng department of respiratory and critical care medicine of kunming municipal first people’s hospital KunmingYunnan 650000China Graduate school Tianjin Medical UniversityTianjin 300070China respiratory department of sanming Yongan General hospital SanmingFujian 366000China Medical school Tianjin University SchoolTianjin 300072China department of respiratory and critical care medicine Tianjin Medical University General HospitalTianjin 300052China

There have been recent extensive studies and rapid advancement on the pathogenesis underlying idiopathic pulmonary fibrosis(IPF),and intricate pathogenesis of IPF has been suggested.The purpose of this study was to clarify the logical relationship between these mechanisms.An extensive search was undertaken of the PubMed using the following keywords:"etiology,""pathogenesis,""alveolar epithelial cell(AEC),""fibroblast,""lymphocyte,""macrophage,""epigenomics,""histone,"acetylation,""methylation,""endoplasmic reticulum stress,""mitochondrial dysfunction,""telomerase,""proteases,""plasminogen,""epithelial-mesenchymal transition,""oxidative stress,""inflammation,""apoptosis,"and"idiopathic pulmonary fibrosis."This search covered relevant research articles published up to April 30,2020.Original articles,reviews,and other articles were searched and reviewed for content;240 highly relevant studies were obtained after screening.IPF is likely the result of complex interactions between environmental,genetic,and epigenetic factors:environmental exposures affect epigenetic marks;epigenetic processes translate environmental exposures into the regulation of chromatin;epigenetic processes shape gene expression profiles;in turn,an individual’s genetic background determines epigenetic marks;finally,these genetic and epigenetic factors act in concert to dysregulate gene expression in IPF lung tissue.The pathogenesis of IPF involves various imbalances including endoplasmic reticulum,telomere length homeostasis,mitochondrial dysfunction,oxidant/antioxidant imbalance,Th1/Th2 imbalance,M1-M2 polarization of macrophages,protease/antiprotease imbalance,and plasminogen activation/inhibition imbalance.These affect each other,promote each other,and ultimately promote AEC/fibroblast apoptosis imbalance directly or indirectly.Excessive AEC apoptosis and impaired apoptosis of fibroblasts contribute to fibrosis.IPF is likely the result of complex interactions between environmental,genetic,and epigenetic factors.The pathogenesis of IPF involves

关键词： Alveolar epithelial cell Apoptosis Idiopathic pulmonary fibrosis Fibroblast Pathogenesis

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