Genetics and Genomics of Pulmonary Fibrosis : Charting the Molecular Landscape and Shaping Precision Medicine

Recent genetic and genomic advancements have elucidated the complex etiology of idiopathic pulmonary fibrosis (IPF) and other progressive fibrotic interstitial lung diseases (ILDs), emphasizing the contribution of heritable factors. This state-of-the-art review synthesizes evidence on significant genetic contributors to pulmonary fibrosis (PF), including rare genetic variants and common single nucleotide polymorphisms (SNPs). The MUC5B promoter variant is unusual, a common SNP that markedly elevates the risk of early and established PF. We address the utility of genetic variation in enhancing understanding of disease pathogenesis, clinical phenotypes, improving disease definitions, and informing prognosis and treatment response. Critical research gaps are highlighted, particularly the underrepresentation of non-European ancestries in PF genetic studies and the exploration of PF phenotypes beyond usual interstitial pneumonia (UIP)/IPF. We discuss the role of telomere length, often critically short in PF, and its link to progression and mortality, underscoring the genetic complexity involving telomere biology genes (TERT, TERC) and others like SFTPC and MUC5B. Additionally, we address the potential of gene-by-environment interactions to modulate disease manifestation, advocating for precision medicine in PF. Insights from gene expression profiling studies and multi-omic analyses highlight the promise for understanding disease pathogenesis and offer new approaches to clinical care, therapeutic drug development, and biomarker discovery. Finally, we discuss the ethical, legal, and social implications of genomic research and therapies in PF, stressing the need for sound practices and informed clinical genetic discussions. Looking forward, we advocate for comprehensive genetic testing panels and polygenic risk scores to improve the management of PF and related ILDs across diverse populations.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

American journal of respiratory and critical care medicine - (2024) vom: 04. Apr.

Sprache:

Englisch

Beteiligte Personen:

Adegunsoye, Ayodeji [VerfasserIn]
Kropski, Jonathan A [VerfasserIn]
Behr, Juergen [VerfasserIn]
Blackwell, Timothy S [VerfasserIn]
Corte, Tamera J [VerfasserIn]
Cottin, Vincent [VerfasserIn]
Glanville, Allan [VerfasserIn]
Glassberg, Marilyn K [VerfasserIn]
Griese, Matthias [VerfasserIn]
Hunninghake, Gary M [VerfasserIn]
Johannson, Kerri A [VerfasserIn]
Keane, Michael P [VerfasserIn]
Kim, John S [VerfasserIn]
Kolb, Martin [VerfasserIn]
Maher, Toby M [VerfasserIn]
Oldham, Justin M [VerfasserIn]
Podolanczuk, Anna J [VerfasserIn]
Rosas, Ivan O [VerfasserIn]
Martinez, Fernando J [VerfasserIn]
Noth, Imre [VerfasserIn]
Schwartz, David A [VerfasserIn]

Links:

Volltext

Themen:

Genetic Variants
Interstitial Lung Diseases
Journal Article
MUC5B Promoter Variant
Precision Medicine
Pulmonary Fibrosis

Anmerkungen:

Date Revised 17.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1164/rccm.202401-0238SO

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370624971