Lung Fibrosis, Premature Graying, and Macrocytosis

School of Medicine, The University of Queensland, Brisbane, Australia.
American Journal of Respiratory and Critical Care Medicine (Impact Factor: 13). 09/2012; 186(5):e8-9. DOI: 10.1164/rccm.201112-2175IM
Source: PubMed
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    ABSTRACT: This perspective highlights some evidence that have hitherto been neglected especially because they may not have been sufficiently explicited in the clinical respiratory medicine literature. Idiopathic pulmonary fibrosis (IPF) has appeared only in the second half of the twentieth century and may be, as lung cancer and chronic obstructive pulmonary disease, a direct consequence of the cigarette smoking epidemics. It is a disease of lung aging, with most affected patients being older than 70 years. The relationship between lung aging and pulmonary fibrosis is further illustrated in the bleomycin mouse model, in which older males develop more fibrosis than young female mice.An earlier diagnosis of IPF is a prerequisite for significant progress to be made in the long-term outcome and prognosis.The present authors consider that only two different yet complementary and realistic approaches could lead to diagnosing IPF earlier and possibly to allowing a more efficient disease management: (i) investigating any patients with early Velcro crackles at lung auscultation through proactive education of - and commitment from - primary care physicians; (ii) and using current large-scale lung cancer screening strategies with low-dose high-resolution computed tomography in smokers for the detection of subclinical interstitial lung disease and especially early IPF.
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    ABSTRACT: Telomeres are DNA-protein structures that cap the ends of chromosomes; telomerase is the enzyme that ensures their integrity. Telomere biology has recently been implicated in the pathogenesis of a variety of lung diseases, including idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease/emphysema, and lung cancer. This review highlights recent discoveries pertaining to the role of telomere biology in lung disease.
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