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The interplay between rheumatic diseases and pulmonary health

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Abstract

Patients with rheumatic diseases (RDs) are prone to a number of comorbidities, particularly those affecting the respiratory system due to inflammatory and autoimmune mechanisms. Rheumatoid arthritis (RA), systemic sclerosis (SSc), and inflammatory idiopathic myopathies (IIMs) often present with progressive interstitial lung disease (ILD). The prevalence of ILD varies among patients with RDs, with 11% in RA, 47% in SSc, and 41% in IIMs. Some diagnostic markers, including KL-6, cytokines TNF-α and IL-6, and autoantibodies (anti-CCP), play a crucial role in assessing and predicting the course of pulmonary involvement in RDs. Lung fibrosis is a progressive disorder in SSc and RA, limiting the effiency of therapeutic interventions. Re-evaluating treatment approaches with disease-modifying anti-rheumatic drugs (DMARDs) is crucial for understanding their impact on the risk of lung affections. Despite initial concerns surrounding methotrexate, recent evidence points to its benefits in RA-associated interstitial lung disease (RA-ILD). Recognizing the intricate relationship between autoimmune RDs and lung affections is crucial for formulating effective treatment strategies. Emphasis is placed on collaborative efforts of rheumatologists and pulmonologists for early diagnosis, comprehensive care, and optimal patient outcomes in RA-ILD.

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Authors and Affiliations

  1. Department of Pathophysiology, Ivano-Frankivsk National Medical University, Halytska Str. 2, Ivano-Frankivsk, 76018, Ukraine

    Yuliya Fedorchenko, Bohdana Doskaliuk & Liubomyr Zaiats

  2. Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland

    Olena Zimba

  3. National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland

    Olena Zimba

  4. Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

    Olena Zimba

  5. Academician Ye. M. Neiko Department of Internal Medicine #1, Clinical Immunology and Allergology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine

    Roman Yatsyshyn

  6. Department of Internal Medicine # 2 and nursing, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine

    Mykhailo Fedorchenko

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Conceptualization: FY, ZO, YR. Writing—original draft: FY, ZO. Writing—review and editing: FY, ZO, YR, DB, ZL, FM. Approval—FY, ZO, YR, DB, ZL, FM.

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Fedorchenko, Y., Zimba, O., Yatsyshyn, R. et al. The interplay between rheumatic diseases and pulmonary health. Rheumatol Int (2024). https://doi.org/10.1007/s00296-024-05565-w

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