PT  - JOURNAL ARTICLE
AU  - Peter J. Barnes
AU  - Gary P. Anderson
AU  - Malin Fagerås
AU  - Maria G. Belvisi
TI  - Chronic lung diseases: prospects for regeneration and repair
AID  - 10.1183/16000617.0213-2020
DP  - 2021 Mar 31
TA  - European Respiratory Review
PG  - 200213
VI  - 30
IP  - 159
4099  - http://err.ersjournals.com/content/30/159/200213.short
4100  - http://err.ersjournals.com/content/30/159/200213.full
SO  - EUROPEAN RESPIRATORY REVIEW2021 Mar 31; 30
AB  - COPD and idiopathic pulmonary fibrosis (IPF) together represent a considerable unmet medical need, and advances in their treatment lag well behind those of other chronic conditions. Both diseases involve maladaptive repair mechanisms leading to progressive and irreversible damage. However, our understanding of the complex underlying disease mechanisms is incomplete; with current diagnostic approaches, COPD and IPF are often discovered at an advanced stage and existing definitions of COPD and IPF can be misleading. To halt or reverse disease progression and achieve lung regeneration, there is a need for earlier identification and treatment of these diseases. A precision medicine approach to treatment is also important, involving the recognition of disease subtypes, or endotypes, according to underlying disease mechanisms, rather than the current “one-size-fits-all” approach. This review is based on discussions at a meeting involving 38 leading global experts in chronic lung disease mechanisms, and describes advances in the understanding of the pathology and molecular mechanisms of COPD and IPF to identify potential targets for reversing disease degeneration and promoting tissue repair and lung regeneration. We also discuss limitations of existing disease measures, technical advances in understanding disease pathology, and novel methods for targeted drug delivery.Treatment outcomes with COPD and IPF are suboptimal. Better understanding of the diseases, such as targetable repair mechanisms, may generate novel therapies, and earlier diagnosis and treatment is needed to stop or even reverse disease progression. https://bit.ly/2Ga8J1g