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The role of infection in the pathogenesis of idiopathic pulmonary fibrosis

Philip L. Molyneaux, Toby M. Maher
European Respiratory Review 2013 22: 376-381; DOI: 10.1183/09059180.00000713
Philip L. Molyneaux
1Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK. 2National Heart and Lung Institute, Imperial College London, London, and 3Centre for Respiratory Research, University College London, London, UK
1Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK. 2National Heart and Lung Institute, Imperial College London, London, and 3Centre for Respiratory Research, University College London, London, UK
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Toby M. Maher
1Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK. 2National Heart and Lung Institute, Imperial College London, London, and 3Centre for Respiratory Research, University College London, London, UK
1Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK. 2National Heart and Lung Institute, Imperial College London, London, and 3Centre for Respiratory Research, University College London, London, UK
1Dept of Respiratory Medicine, Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK. 2National Heart and Lung Institute, Imperial College London, London, and 3Centre for Respiratory Research, University College London, London, UK
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  • For correspondence: t.maher@rbht.nhs.uk
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Tables

  • Table 1. A synopsis of studies linking viruses with the pathogenesis, progression and (acute) exacerbation of idiopathic pulmonary fibrosis (IPF)
    VirusMajor study findingsComment
    HCV28% of an IPF cohort had evidence of prior HCV compared with 3.6% of controls [8]The lack of a coherent signal across studies suggests that HCV is unlikely to be an important trigger for the development of IPF
    Incidence of IPF higher in cohort of HCV positive individuals compared to cohort with HBV [9]
    No association between IPF and HCV [10]
    Association of HCV with a range of non-fibrotic respiratory conditions [11]
    TTVLower survival rate in IPF patients with presence of TTV-DNA in serum compared to IPF with no TTV-DNA [12]Link to pathogenesis unclear.
    May cause progression of disease or be linked to the development of acute exacerbations
    Detected in BAL during IPF exacerbation and in individuals with acute lung injury [13]
    HHV12 out of 13 IPF patients seropositive for EBV [14]Some conflicting evidence but potential role of HHVs as a co-factor in the initiation and progression of IPF
    Increased EBV in lung biopsy samples and BAL from individuals with IPF compared with controls [15–17]
    At least one HHV detected in 97% of IPF patients compared with 36% controls [18, 19].
    MHV triggers and enhances fibrotic response in mice [20–23]
    • HCV: hepatitis C virus; TTV: transfusion transmitted virus; HHV: human herpes virus; HBV: hepatitis B virus; BAL: bronchoalveolar lavage; EBV: Epstein�–Barr virus; MHV: murine herpes virus.

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The role of infection in the pathogenesis of idiopathic pulmonary fibrosis
Philip L. Molyneaux, Toby M. Maher
European Respiratory Review Sep 2013, 22 (129) 376-381; DOI: 10.1183/09059180.00000713

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The role of infection in the pathogenesis of idiopathic pulmonary fibrosis
Philip L. Molyneaux, Toby M. Maher
European Respiratory Review Sep 2013, 22 (129) 376-381; DOI: 10.1183/09059180.00000713
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  • Article
    • Abstract
    • Introduction
    • Infection and the pathogenesis of IPF
    • Viruses and IPF disease mechanisms
    • Infection and acute exacerbations of IPF
    • The role of bacteria in the pathogenesis of IPF
    • Conclusions
    • Footnotes
    • References
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  • Interstitial and orphan lung disease
  • Mechanisms of lung disease
  • Respiratory infections and tuberculosis
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