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Smoking related interstitial lung disease

Cigarette smoking may cause various adverse effects on pulmonary tissue.

• Cigarette smoke might injure alveolar epithelial cells leading to in diffuse infiltration and subsequently parenchymal fibrosis.
• Alveolar epithelial cells are the main cells that involve in the pathogenesis of emphysema as well as lung fibrosis following smoking.
• Cigarette smoking may predispose alveolar epithelial cells to cellular senescence and apoptosis that leads to emphysema or lung fibrosis.
• There is a well-known association with tobacco smoking and some types of interstitial lung disease such as:
  • Desquamative interstitial pneumonia
  • Respiratory bronchiolitis-associated interstitial lung disease
  • Pulmonary Langerhans cell granulomatosis
  • Acute eosinophilic pneumonia

Idiopathic interstitial pneumonias

The idiopathic interstitial pneumonias (IIP) are a broad range of interstitial lung diseases of unknown etiology.

• Pathogenesis of all idiopathic interstitial pneumonias are fibroblasts proliferation and collagen deposition leading to inflammation and fibrosis.
• Patients with idiopathic interstitial pneumonias generally manifests as a gradual dyspnea and dry cough.
• On chest imagings it is characterized by bilateral abnormal opacities of various types.
• The most common is chronic Idiopathic pulmonary fibrosis. However, the worst prognosis is the acute interstitial pneumonia.
• The diagnosis can only be reached correctly with a multidisciplinary approach after excluding known causes.
• The new classification of idiopathic interstitial pneumonias is as follow:
  • Major idiopathic interstitial pneumonias
    • Idiopathic pulmonary fibrosis
    • Idiopathic nonspecific interstitial pneumonia
    • Respiratory bronchiolitis-interstitial lung disease
    • Desquamative interstitial pneumonia
    • Cryptogenic organizing pneumonia
    • Acute interstitial pneumonia
  • Rare idiopathic interstitial pneumonias
    • Idiopathic lymphoid interstitial pneumonia
    • Idiopathic pleuroparenchymal fibroelastosis
  • Unclassifiable idiopathic interstitial pneumonias

For more information about Idiopathic interstitial pneumonia, click here.

For more information about idiopathic pulmonary fibrosis, click here.

For more information about Cryptogenic organizing pneumonia, click here.

Pulmonary alveolar proteinosis

For more information about pulmonary alveolar proteinosis, click here. 

Lymphocytic infiltrative disorders

• Lymphocytic interstitial pneumonitis
• Pulmonary lymphomatoid granulomatosis

For more information about lymphocytic interstitial pneumonitis, click here.

Pulmonary lymphangioleiomyomatosis

• For more information about pulmonary lymphangioleiomyomatosis, click here.

Pulmonary hemorrhage syndromes

• Goodpasture syndrome
• Idiopathic pulmonary hemosiderosis
• Isolated pulmonary capillaritis

Granulomatous lung response

• Hypersensitivity pneumonitis 
• Sarcoidosis
• Granulomatous vasculitides
  • Granulomatosis with polyangiitis (Wegener)
  • Eosinophilic granulomatosis with polyangiitis (ChurgStrauss)
• Bronchocentric granulomatosis

For more information about hypersensitivity pneumonitis, click here.

Interstitial lung disease associated with systemic diseases

Interstitial lung disease associated with connective tissue diseases

• Systemic lupus erythematosus
• Rheumatoid arthritis
• Ankylosing spondylitis
• Systemic sclerosis
• Sjögren syndrome
• Polymyositis/dermatomyositis

Interstitial lung disease associated with inherited diseases

• Tuberous sclerosis
• Neurofibromatosis
• Niemann−Pick disease
• Gaucher disease
• Hermansky−Pudlak syndrome

Interstitial lung disease associated with gastrointestinal or liver diseases

• Crohn disease
• Primary biliary cirrhosis
• Chronic active hepatitis
• Ulcerative colitis

Interstitial lung disease associated with graft−versus−host disease

• Bone marrow transplantation
• Solid organ transplantation