Personalized medicine and idiopathic pulmonary fibrosis [Medicina personalizzata e fibrosi polmonare idiopatica]

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause, occurring primarily in older adults, limited to the lungs, and associated with the histopathologic and/or radiologic pattern of usual interstitial pneumonia (UIP). IPF shows a high variability in the evolution from one patient to another, and between different periods in time in a given individual, showing great clinical heterogeneity. Therefore, predicting the outcome and the response to treatment in IPF is challenging, but potentially very useful, particularly in the single IPF patient. In the last decade, with the common use of proteomic and genomic technologies, our knowledge about the pathogenesis of the disease dramatically improved and it has led to the recognition of various treatment targets and numerous potential biomarkers. Molecular biomarkers are needed in IPF, where they can simplify drug development, facilitate early detection, increase prognostic accuracy and inform treatment recommendations. Although there are not yet validated biomarkers in IPF, some of them are in the proximity to be validated and have demonstrated their potential to improve clinical predictors beyond that of routine clinical practice.