Letter to the Editor
Idiopathic pulmonary fibrosis and serological determinations of autoimmunity
Fibrosis pulmonar idiopática y determinaciones serológicas de autoinmunidad
María Montes Ruiz Cabelloa, Jose Luis Callejas Rubiob,
, Paloma García Villanovac
Corresponding author
a Unidad Multidisciplinar Enfermedad Pulmonar Intersticial, Servicio de Neumología, Hospital Clínico Universitario San Cecilio, Granada, Spain
b Unidad Multidisciplinar Enfermedad Pulmonar Intersticial, Unidad de Enfermedades Sistémicas, Servicio de Medicina Interna, Hospital Clínico Universitario San Cecilio, Granada, Spain
c Unidad Multidisciplinar Enfermedad Pulmonar Intersticial, Servicio de Radiodiagnóstico, Hospital Clínico Universitario San Cecilio, Granada, Spain
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"referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Jose Luis" "apellidos" => "Callejas Rubio" "email" => array:1 [ 0 => "jlcalleja@telefonica.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Paloma" "apellidos" => "García Villanova" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad Multidisciplinar Enfermedad Pulmonar Intersticial, Servicio de Neumología, Hospital Clínico Universitario San Cecilio, Granada, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad Multidisciplinar Enfermedad Pulmonar Intersticial, Unidad de Enfermedades Sistémicas, Servicio de Medicina Interna, Hospital Clínico Universitario San Cecilio, Granada, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad Multidisciplinar Enfermedad Pulmonar Intersticial, Servicio de Radiodiagnóstico, Hospital Clínico Universitario San Cecilio, Granada, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fibrosis pulmonar idiopática y determinaciones serológicas de autoinmunidad" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A superb review on idiopathic pulmonary fibrosis by León Rama et al. has recently been published in your journal.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In the diagnostic section, the authors recommend autoimmune serology, even if there is no suspicion of connective tissue disease, with an initial basic test including, among others, <span class="elsevierStyleItalic">anti-neutrophil cytoplasmic antibodies</span> (ANCA). We fully agree with the authors in this respect, although in the recommendations of some societies, both in the study of <span class="elsevierStyleItalic">interstitial pneumonia with autoimmune features</span> and in idiopathic pulmonary fibrosis, this request is not included or is questioned.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The relationship between interstitial lung disease and ANCA has been the subject of increasing research in recent years. A recent review on this topic<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> concluded that: (a) ANCA-positive cases range from 2 to 36%, mainly with specificity against myeloperoxidase; (b) although initially negative, approximately 10% may become positive during follow-up; (c) the pathogenic mechanism is not well understood but a direct role of myeloperoxidase on fibrosis is postulated; (d) ANCA-positive cases may have prognostic implications by increasing the risk of developing systemic vasculitis, as well as therapeutic implications as immunosuppressive drugs may be used. In fact, a consensus meeting on ANCA recommends its application in all patients with idiopathic interstitial lung disease and suggests that it should be included among the serological criteria for <span class="elsevierStyleItalic">interstitial pneumonia with autoimmune features</span>.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We believe that knowing this association is important and that it is necessary to identify which patient profile and radiological patterns would benefit most from its application, as well as to better understand their progress with treatment.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0020" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiopathic pulmonary fibrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. León-Román" 1 => "C. Valenzuela" 2 => "M. Molina-Molina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2022.02.020" "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2022" "volumen" => "159" "paginaInicial" => "189" "paginaFinal" => "194" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35659420" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "“ERS/ATS Task Force on Undifferentiated Forms of CTD-ILD”. An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Fischer" 1 => "K.M. Antoniou" 2 => "K.K. Brown" 3 => "J. Cadranel" 4 => "T.J. Corte" 5 => "R.M. du Bois" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/13993003.00150-2015" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "976" "paginaFinal" => "987" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26160873" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Raghu" 1 => "M. Remy-Jardin" 2 => "J.L. Myers" 3 => "L. Richeldi" 4 => "C.J. Ryerson" 5 => "D.J. Lederer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201807-1255ST" "Revista" => array:7 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2018" "volumen" => "198" "paginaInicial" => "e44" "paginaFinal" => "e68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30168753" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0091674920324064" "estado" => "S300" "issn" => "00916749" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antineutrophil cytoplasmic antibody-associated interstitial lung disease: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Kadura" 1 => "G. Raghu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/16000617.0123-2021" "Revista" => array:4 [ "tituloSerie" => "Eur Respir Rev" "fecha" => "2021" "volumen" => "30" "itemHostRev" => array:3 [ "pii" => "S0092867420310084" "estado" => "S300" "issn" => "00928674" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2020 international consensus on ANCA testing beyond systemic vasculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Moiseev" 1 => "J.W. Cohen Tervaert" 2 => "Y. Arimura" 3 => "D.P. Bogdanos" 4 => "E. Csernok" 5 => "J. Damoiseaux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.autrev.2020.102618" "Revista" => array:3 [ "tituloSerie" => "Autoimmun Rev" "fecha" => "2020" "volumen" => "19" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016000000004/v1_202302191857/S2387020623000359/v1_202302191857/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016000000004/v1_202302191857/S2387020623000359/v1_202302191857/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623000359?idApp=UINPBA00004N" ]
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