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      Matrix abnormalities in pulmonary fibrosis

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          Abstract

          Idiopathic pulmonary fibrosis (IPF) is a devastating, progressive disease, marked by excessive scarring, which leads to increased tissue stiffness, loss in lung function and ultimately death. IPF is characterised by progressive fibroblast and myofibroblast proliferation, and extensive deposition of extracellular matrix (ECM). Myofibroblasts play a key role in ECM deposition. Transforming growth factor (TGF)-β1 is a major growth factor involved in myofibroblast differentiation, and the creation of a profibrotic microenvironment. There is a strong link between increased ECM stiffness and profibrotic changes in cell phenotype and differentiation. The activation of TGF-β1 in response to mechanical stress from a stiff ECM explains some of the influence of the tissue microenvironment on cell phenotype and function. Understanding the close relationship between cells and their surrounding microenvironment will ultimately facilitate better management strategies for IPF.

          Abstract

          Cellular changes cause matrix aberrations that further drive cellular changes; this sustains and progresses fibrosis http://ow.ly/TpHq30kgEUX

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          Most cited references49

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          Transforming growth factor beta in tissue fibrosis.

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            TGF-beta-induced epithelial to mesenchymal transition.

            During development and in the context of different morphogenetic events, epithelial cells undergo a process called epithelial to mesenchymal transition or transdifferentiation (EMT). In this process, the cells lose their epithelial characteristics, including their polarity and specialized cell-cell contacts, and acquire a migratory behavior, allowing them to move away from their epithelial cell community and to integrate into surrounding tissue, even at remote locations. EMT illustrates the differentiation plasticity during development and is complemented by another process, called mesenchymal to epithelial transition (MET). While being an integral process during development, EMT is also recapitulated under pathological conditions, prominently in fibrosis and in invasion and metastasis of carcinomas. Accordingly, EMT is considered as an important step in tumor progression. TGF-beta signaling has been shown to play an important role in EMT. In fact, adding TGF-beta to epithelial cells in culture is a convenient way to induce EMT in various epithelial cells. Although much less characterized, epithelial plasticity can also be regulated by TGF-beta-related bone morphogenetic proteins (BMPs), and BMPs have been shown to induce EMT or MET depending on the developmental context. In this review, we will discuss the induction of EMT in response to TGF-beta, and focus on the underlying signaling and transcription mechanisms.
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              Clinical course and prediction of survival in idiopathic pulmonary fibrosis.

              Idiopathic pulmonary fibrosis (IPF) is a progressive, life-threatening, interstitial lung disease of unknown etiology. The median survival of patients with IPF is only 2 to 3 years, yet some patients live much longer. Respiratory failure resulting from disease progression is the most frequent cause of death. To date we have limited information as to predictors of mortality in patients with IPF, and research in this area has failed to yield prediction models that can be reliably used in clinical practice to predict individual risk of mortality. The goal of this concise clinical review is to examine and summarize the current data on the clinical course, individual predictors of survival, and proposed clinical prediction models in IPF. Finally, we will discuss challenges and future directions related to predicting survival in IPF.
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                Author and article information

                Journal
                Eur Respir Rev
                Eur Respir Rev
                ERR
                errev
                European Respiratory Review
                European Respiratory Society
                0905-9180
                1600-0617
                30 June 2018
                27 June 2018
                : 27
                : 148
                : 180033
                Affiliations
                Firestone Institute for Respiratory Health, Dept of Medicine, McMaster University, Hamilton, ON, Canada
                Author notes
                Martin Kolb, Firestone Institute for Respiratory Health, Dept of Medicine, McMaster University, 50 Charlton Ave, Hamilton, ON, L8N 4AP, Canada. E-mail: kolbm@ 123456mcmaster.ca
                Article
                ERR-0033-2018
                10.1183/16000617.0033-2018
                9489108
                29950306
                6e96ee53-315a-4e28-9957-a65963e3ff14
                Copyright ©ERS 2018.

                ERR articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

                History
                : 27 March 2018
                : 29 May 2018
                Funding
                Funded by: Institute of Circulatory and Respiratory Health, doi 10.13039/501100000028;
                Categories
                Lung Science Conference
                7
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