Idiopathic pulmonary fibrosis is one of the subtype of IIP. Although the aetiology of IPF is unknown but there are certain risk factors linked with IPF, which could be intrinsic risk factors, extrinsic risk factors or associated comorbidities.
Smoking can lead to Idiopathic pulmonary fibrosis
Interstitial lung diseases (ILD) are heterogeneous lung disorders with distinctive features and are classified on the basis of clinical, radiographic, physiologic or pathological factors. ILD could be caused due to external or internal factors and ILD without identifiable cause are termed as idiopathic interstitial pneumonia.
Dr Narasimhan (Senior Respiratory Physician, Apollo Hospitals, Chennai), says - Idiopathic interstitial pneumonia (IIP) are ILD of unknown aetiology but they do have certain clinical and radiological features similar to the other ILDs. On the basis of histology they are further classified into eight subtypes and all are characterized by varying degree of inflammation and fibrosis. Idiopathic pulmonary fibrosis is one of the subtype of IIP. Although the aetiology of IPF is unknown but there are certain risk factors linked with IPF, which could be intrinsic risk factors, extrinsic risk factors or associated comorbidities.
Senior Respiratory Physician, Apollo Hospitals, Chennai
Extrinsic risk factors such as cigarette smoking, environmental exposure to wood dust, metal dust, stone/sand, agricultural/farming and livestock or air pollution have also been associated with IPF. Intrinsic factors which could increase the risk of IPF are; older age, male sex and genetic polymorphism (MUC5B, TOLLIP and surfactant protein A & C). Other comorbidities such as Chronic Gastroesophageal reflux disease (GERD), which could leads to chronic micro-aspiration of food particles is considered as one of the risk factors for IPF. Chronic viral infection with Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus-7 (HHV-7), and human herpesvirus-8 (HHV-8), are also considered as the risk factor for IPF but the exact mechanism by which this leads to alveolar epithelial injury in still unknown.
Dr.PAJANIVEL.R ( Professor & Head of Pulmonary Medicine, Department of Pulmonary Medicine, MGMCRI-SBV, Puducherry), says- Connective tissue diseases (CTD) are a group of diseases with heterogeneous systemic features and ILD is common manifestation in systemic sclerosis (SSc) and rheumatoid arthritis (RA) patient. Although the time for involvement of lung and development of ILD may vary with different CTD. There are certain risk factors which could increase the risk of lung involvement and development of progressive ILD. In SSc patient, older age, male gender, anti Scl-70 antibodies and absence of anti-centromere antibodies increases the risk of development of progressive systemic sclerosis associated ILD (SSc-ILD). Similarly, Smoking, elderly age, male gender, high titre of serum anticyclic citrullinated protein antibody (ACPAs) and rheumatoid factor (RF) are identified as risk factors for rheumatoid arthritis associated ILD (RA-ILD).
Professor And Head of Pulmonary Medicine, Department of Pulmonary Medicine, MGMCRI-SBV, Puducherry
Dr Sudipto Dasgupta (Chest Physician at Inlaks and Budhrani Hospital, Pune), says air pollution and exposure to certain environmental factors are well established risk factors for respiratory disease such as asthma, COPD and interstitial lung disease. Hypersensitivity pneumonitis (HP) is one of the ILD, which primarily occurs to the persons who are exposed to certain organic dust or other substances to which they are sensitized and hyper responsive. People who are at more risk of development of (HP)are the ones working in the environment with substances such as; avian dust, mold, paint catalyst, sugar cane dust, hay dust, mushrooms, rat or gerbil urine, tobacco, heating and cooling systems water, maple bark dust, redwood bark dust, beer brewing, cork dust, plastic residue, epoxy resin, enzyme detergents, wheat mold or dust. Patients at risk of hypersensitivity pneumonitis, if screened and diagnosed early can be prevented from development of further progressive disease.
Chest Physician at Inlaks and Budhrani Hospital, Pune
Certain type of ILDs are developed due to exposure to particular antigen and if we remove the causative antigen early or take necessary precaution, then the prognosis in these patients could be improved. In other ILDs, for which the exact aetiology is not known, regular screening in high-risk patients, early diagnosis and appropriate intervention at right time could increase the quality of life as well as life expectancy.
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