J Korean Med Assoc.  2021 Apr;64(4):264-276. 10.5124/jkma.2021.64.4.264.

Current advances in the treatment of autoimmune-associated interstitial lung diseases

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Korea
  • 2Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Korea

Abstract

Autoimmune-associated interstitial lung disease (ILD) is a widespread and clinically significant form of autoimmune diseases. ILD can be present in most type of autoimmune diseases. Scleroderma, Sjogren syndrome, rheumatoid arthritis, inflammatory myositis, systemic lupus erythematosus, and mixed connective tissue disease are all examples of autoimmune disorders that can cause ILD. Treatment and prognosis vary from that of other forms of ILD depending on the etiology and pathogenesis of the autoimmune disease. As a result, glucocorticoids and immunosuppressive agents are the mainstays of treatment for autoimmune-associated ILD, despite the fact that there is little high-level evidence to guide the treatment owing to limited data from randomized controlled trials. Immunosuppressive agents including cyclophosphamide, tacrolimus, azathioprine, and mycophenolate mofetil can be used to reduce the dose of glucocorticoids and the inflammatory cascade and inhibit various pro-inflammatory cytokines. Studies have also started alternative therapeutic approaches, such as biological and antifibrotic agents, and traditional immunosuppressive agents. In this review, we summarize available treatment options and recent advances in therapeutic strategies for patients with autoimmune-associated ILD.

Keyword

Autoimmune diseases; Glucocorticoids; Immunosuppressive agents; Interstitial lung diseases; 자가면역질환; 글루코코티코이드; 면역억제제; 사이질폐질환
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