ABSTRACT
Identifying genetic determinants of pulmonary fibrotic disorders remains at an early
stage of evolution. It is now well-recognized that “pulmonary fibrosis” covers a broad
range of lung diseases, including most topically the idiopathic interstitial pneumonias
that have been classified recently. Additionally, it is recognized that the fibrosing
lung disorders that are seen in the rheumatological diseases, notably systemic sclerosis,
are quite different from those of the idiopathic variety. Defining clinical phenotype
is an important prerequisite to the identification of genetic determinants associated
with individual diseases, but it is important to acknowledge that there may be determinants
of global lung fibrosis and that other factors drive diseases down specific, more
individual disease pathways. Current association studies are encouraging but far from
conclusive for a variety of reasons, including small numbers, poor controls, and curious
candidate selection. The results of the ongoing multicenter familial linkage study
in the United States should provide several candidate genes that will spur further
studies of sporadic disease in, it is hoped, a more internationally coordinated effort.
KEYWORDS
Genetics - polymorphism - familial - idiopathic pulmonary fibrosis - pulmonary fibrosis
- systemic sclerosis
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Roland M du BoisM.D.
Department of Respiratory Medicine, Royal Brompton Hospital
Sydney St., London SW3 6NP, UK
eMail: r.dubois@rbh.nthames.nhs.uk