NEW INSIGHTS INTO PATHOGENESIS OF UIP/NSIP. Dr. Derya Gumurdulu Cukurova University, Faculty of Medicine, Department of Pathology, Adana . Interstitial lung disease. Interstitial inflamation and/or fibrosis 30% etiology + 70% idiopathic Open lung biopsy
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NEW INSIGHTS INTO PATHOGENESIS OF UIP/NSIP
Dr. Derya Gumurdulu
Cukurova University, Faculty of Medicine, Department of Pathology, Adana
Classification of idiopathic interstitial pneumonia
*: American Thoracic Society/European Respiratory Society
Visscher DW, Myers JL. Proc Am Thorac Soc 2006; 3: 322-329.
Cellular and fibrotic NSIP
Mean 55 year-old
Polypoid plugs of loose organizing connective tissue in alveoli and/or bronchioli
Mild interstitial inflamation
Lung architecture is preserved.
Mean 50 year-old
Diffuse interstitial lymphoid infiltration
Predominantly T lymphocyte, plasma cells and histiocytes
Peribronchiolar lymphoid aggregates (B lymphocyte)
Crystal RW. et al. N Engl J Med 1984; 310: 235-244.
Noble PW. et. al., Am J Respir Cell Mol Biol 2005; 33: 113-120.
Strieter RM. Chest 2005; 128: 526S-532S.
Noble PW, Homer RJ. Clin Chest Med 2004; 25: 749-758.
White ES, et al. J Pathol 2003; 201: 343-354.
Tip II cells apoptosis and injury
GF activate tyrosine kinase signaling pathways
In fibroblastic foci
The production of new collagen and fibronectin
In normal wound healing, appear transiently
Normal fibroblasts differentiate into myofibroblasts in vivo ?