Mecanismos fisiopatológicos da fibrose pulmonar induzida por fármacos
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2018
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Os pulmões são um alvo para uma variedade de substâncias tóxicas possíveis devido à sua grande superfície de contacto, sendo que os fármacos podem induzir lesões através de mecanismos directos, dose-dependentes por acção citotóxicas ou imuno-mediada, descritos por Gell e Coombs, maioritariamente mediados por células T, dando origem a doenças intersticiais pulmonares induzidas por fármacos. A fibrose pulmonar é uma patologia pulmonar intersticial, que se caracteriza pela destruição progressiva e irreversível do parênquima pulmonar com quadros inflamatórios crónicos condicionados pela activação e proliferação de fibroblastos e acumulação de colagénio e componentes da matriz extracelular através de desequilíbrios de citocinas ou processos de stress oxidativo. Existem mais de 380 medicamentos conhecidos como causa de fibrose pulmonar, e a verdadeira frequência é desconhecida. O diagnóstico das doenças pulmonares intersticiais é difícil, sendo maioritariamente diagnóstico de exclusão. A identificação do fármaco causador é essencial para impedir o progresso do processo de fibrose pulmonar e a variabilidade na resposta medicamentosa é multifactorial. Para minimizar potenciais morbilidades e mortalidade por doenças respiratórias induzidas por medicamentos, como a fibrose pulmonar, todos os profissionais de saúde devem estar familiarizados com os possíveis efeitos adversos dos medicamentos.
The lungs are a target for a variety of possible toxic substances because of their large contact surface, and the drugs can induce lesions through direct, dose-dependent cytotoxic or immuno-mediated mechanisms, described by Gell and Coombs, for the most part mediated by T cells, giving rise to drug-induced interstitial lung diseases. Pulmonary fibrosis is an interstitial pulmonary pathology characterized by the progressive and irreversible destruction of the pulmonary parenchyma with chronic inflammatory conditions conditioned by the activation and proliferation of fibroblasts and the accumulation of collagen and extracellular matrix components through cytokine imbalances or oxidative stress processes. There are more than 380 medications known to cause lung fibrosis, and the true frequency is unknown. The diagnosis of interstitial lung diseases is difficult, and is mostly diagnostic of exclusion. The identification of the causative drug is essential to prevent the progression of the pulmonary fibrosis process and the variability in drug response is multifactorial. To minimize potential morbidity and mortality from drug-induced respiratory diseases, such as pulmonary fibrosis, all health professionals should be familiar with the possible adverse effects of medications.
The lungs are a target for a variety of possible toxic substances because of their large contact surface, and the drugs can induce lesions through direct, dose-dependent cytotoxic or immuno-mediated mechanisms, described by Gell and Coombs, for the most part mediated by T cells, giving rise to drug-induced interstitial lung diseases. Pulmonary fibrosis is an interstitial pulmonary pathology characterized by the progressive and irreversible destruction of the pulmonary parenchyma with chronic inflammatory conditions conditioned by the activation and proliferation of fibroblasts and the accumulation of collagen and extracellular matrix components through cytokine imbalances or oxidative stress processes. There are more than 380 medications known to cause lung fibrosis, and the true frequency is unknown. The diagnosis of interstitial lung diseases is difficult, and is mostly diagnostic of exclusion. The identification of the causative drug is essential to prevent the progression of the pulmonary fibrosis process and the variability in drug response is multifactorial. To minimize potential morbidity and mortality from drug-induced respiratory diseases, such as pulmonary fibrosis, all health professionals should be familiar with the possible adverse effects of medications.
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Orientação: Filipe Inácio
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MESTRADO INTEGRADO EM CIÊNCIAS FARMACÊUTICAS, CIÊNCIAS FARMACÊUTICAS, PULMÕES, FIBROSE PULMONAR, MEDICAMENTOS, EFEITOS SECUNDÁRIOS, FISIOPATOLOGIA, TERAPÊUTICAS, PHARMACEUTICAL SCIENCES, LUNGS, PULMONARY FIBROSIS, DRUGS, SIDE EFFECTS, PHYSIOPATHOLOGY, THERAPEUTICS