Angiogenesis, Inflammation & Therapeutics | Online ISSN  2207-872X
REVIEWS   (Open Access)

A Comprehensive Overview of Restrictive Lung Disease: Diagnosis, Management, and Implications in Pulmonary Medicine

Majed Turki Alharbi 1, Osama Ali Albalawi 1, Abdulaziz Abdullatif Alharbi 1, Khalid Rashad A. Binselem 1, Hamad Abdullah Al Salim 1, Ibrahim Abdullah Hamzy 1, Shahad Mohammed Bin Saeed 1, Faiz Thani H. Alanazi 1, Noor Fahad Alshuraim 1, Abdulrahman Abdullah Alorf 1, Mokhld Sanhat Alotaibi 1, Nuri Rawafa Alanazi 1, Ishraq Hassan Almasoudi 1, Alaa Ali Alshehri 1, Norah Mubarak Alomayrah 1, Abdul Rahman Haif Aljish 1*

+ Author Affiliations

Journal of Angiotherapy 7(2) 1-9 https://doi.org/10.25163/angiotherapy.72110109

Submitted: 09 October 2023  Revised: 29 December 2023  Published: 30 December 2023 

Abstract

Background: Restrictive lung diseases (RLDs) encompass a broad spectrum of pulmonary conditions that impair lung expansion and reduce lung volume. These diseases can be caused by various factors including fibrosis, neuromuscular disorders, and thoracic deformities. The pathophysiology of RLDs typically involves the alteration of lung architecture, resulting in impaired gas exchange and decreased respiratory function. The understanding of these diseases has evolved through advances in clinical guidelines and diagnostic methods, particularly for conditions such as idiopathic pulmonary fibrosis (IPF), sarcoidosis, and interstitial lung diseases (ILDs). Methods: A comprehensive review of the current literature was conducted, including data from clinical guidelines, peer-reviewed journals, and recent studies on the pathophysiology, diagnosis, and management of restrictive lung diseases. Emphasis was placed on studies related to the pathogenesis of interstitial lung disease, the impact of genetic factors, and advancements in diagnostic techniques such as spirometry and high-resolution CT imaging. Additionally, guidelines from major respiratory societies such as the American Thoracic Society (ATS) and European Respiratory Society (ERS) were analyzed. Results: The review highlighted the significant advances in understanding restrictive lung diseases, particularly in the context of idiopathic pulmonary fibrosis and other forms of interstitial lung disease. Key findings include the role of genetic predisposition in IPF, the importance of early diagnosis, and the integration of non-invasive diagnostic tools such as high-resolution CT scans. Treatment modalities for RLDs have expanded with new pharmacological agents, including antifibrotic therapies for IPF, as well as advancements in lung transplantation for patients with end-stage disease. Furthermore, bariatric surgery has been identified as a potential therapeutic option in patients with interstitial lung disease and comorbid obesity. Conclusion: Restrictive lung diseases remain a challenging group of conditions with complex pathophysiological mechanisms. However, recent advancements in genetic research, diagnostic imaging, and treatment strategies offer new hope for improving patient outcomes. The continued development of precision medicine, including targeted therapies and individualized treatment plans, is expected to revolutionize the management of RLDs. Further research is needed to refine diagnostic criteria, explore novel therapeutic options, and improve long-term management strategies for these debilitating conditions.

Keywords: Restrictive lung disease, diagnosis, management, pulmonary fibrosis, interstitial lung disease

References

 
Aggarwal, A. N., & Agarwal, R. (2007). The new ATS/ERS guidelines for assessing the spirometric severity of restrictive lung disease differ from previous standards. Respirology, 12(5), 759-762.
https://doi.org/10.1111/j.1440-1843.2007.01117.x
 
American Thoracic Society/European Respiratory Society. (2021). Idiopathic pulmonary fibrosis: Diagnosis and management guidelines. American Journal of Respiratory and Critical Care Medicine, 203(1), 30-47.
 
Ardila-Gatas, J., Sharma, G., Nor Hanipah, Z., Tu, C., Brethauer, S. A., Aminian, A., Tolle, L., & Schauer, P. R. (2019). Bariatric surgery in patients with interstitial lung disease. Surgical Endoscopy, 33(6), 1952-1958.
https://doi.org/10.1007/s00464-018-6475-7
 
Baha, A., Yildirim, F., Köktürk, N., Galata, Z., Akyürek, N., Demirci, N. Y., Türktas, H. (2018). Cryptogenic and secondary organizing pneumonia: Clinical presentation, radiological and laboratory findings, treatment, and prognosis in 56 cases. Turkish Thoracic Journal, 19(4), 201-208.
https://doi.org/10.5152/TurkThoracJ.2018.18008
 
Baughman, R. P., Valeyre, D., & Wuyts, W. A. (2020). Sarcoidosis. Lancet, 395(10240), 1441-1453.
 
Belloli, E. A., Beckford, R., Hadley, R., & Flaherty, K. R. (2016). Idiopathic non-specific interstitial pneumonia. Respirology, 21(2), 259-268.
https://doi.org/10.1111/resp.12674
 
Bouros, D., Nicholson, A. C., Polychronopoulos, V., & du Bois, R. M. (2000). Acute interstitial pneumonia. European Respiratory Journal, 15(2), 412-418.
https://doi.org/10.1034/j.1399-3003.2000.15b31.x
 
Burke, R. R., Stone, C. H., & Havstad, S. (2009). Racial differences in sarcoidosis granuloma density. Lung, 187(1), 1-7.
https://doi.org/10.1007/s00408-008-9111-9
 
Chandra, D., Maini, R., & Hershberger, D. M. (2022). Cryptogenic organizing pneumonia. In StatPearls [Internet]. StatPearls Publishing.
 
Esposito, D. B., et al. (2015). Idiopathic pulmonary fibrosis in United States automated claims. American Journal of Respiratory and Critical Care Medicine, 192(10), 1200-1207.
https://doi.org/10.1164/rccm.201504-0818OC
 
Faverio, P., De Giacomi, F., Bonaiti, G., Stainer, A., Sardella, L., Pellegrino, G., … & Pesci, A. (2019). Management of chronic respiratory failure in interstitial lung diseases: Overview and clinical insights. International Journal of Medical Sciences, 16(7), 967-980.
https://doi.org/10.7150/ijms.32752
 
Fiorentino, G., & Esquinas, A. M. (2017). Restrictive lung disease: Low EPAP - Good ventilation. Chronic Respiratory Disease, 14(3), 321-322.
https://doi.org/10.1177/1479972317702142
 
Global Initiative for Chronic Obstructive Lung Disease. (2020). GOLD report: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease.
 
Hariri, L. P., et al. (2020). Pulmonary Pathology Society Perspective on the 2018 American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society Idiopathic Pulmonary Fibrosis Clinical Practice Guidelines. Annals of the American Thoracic Society, 17(5), 550-554.
https://doi.org/10.1513/AnnalsATS.201910-801PS
 
Johari, J., Sharifudin, M. A., Ab Rahman, A., Omar, A. S., Abdullah, A. T., Nor, S., et al. (2016). Relationship between pulmonary function and degree of spinal deformity, location of apical vertebrae, and age among adolescent idiopathic scoliosis patients. Singapore Medical Journal, 57(1), 33-38.
https://doi.org/10.11622/smedj.2016009
 
Johnson, J. D., & Theurer, W. M. (2014). A stepwise approach to the interpretation of pulmonary function tests. American Family Physician, 89(5), 359-366.
 
Jones, R., & Smith, A. (2018). Pathophysiology of restrictive lung diseases. Thoracic Medicine, 75(4), 345-358.
 
Kaur, A., Mathai, S. K., & Schwartz, D. A. (2017). Genetics in idiopathic pulmonary fibrosis pathogenesis, prognosis, and treatment. Frontiers in Medicine, 4, 154.
https://doi.org/10.3389/fmed.2017.00154
 
Kishaba, T. (2019). Acute exacerbation of idiopathic pulmonary fibrosis. Medicina (Kaunas), 55(3), 128-130.
https://doi.org/10.3390/medicina55030070
 
Kurth, L., & Hnizdo, E. (2015). Change in prevalence of restrictive lung impairment in the U.S. population. Multidisciplinary Respiratory Medicine, 10(1), 7.
https://doi.org/10.1186/s40248-015-0003-6
 
Lapinsky, S. E., Tram, C., Mehta, S., & Maxwell, C. V. (2014). Restrictive lung disease in pregnancy. Chest, 145(2), 394-398.
https://doi.org/10.1378/chest.13-0587
 
Laveneziana, P. (2010). Qualitative aspects of exertional dyspnea in patients with restrictive lung disease. Multidisciplinary Respiratory Medicine, 5(3), 211-215.
https://doi.org/10.1186/2049-6958-5-3-211
 
Mangera, Z., Panesar, G., & Makker, H. (2012). Practical approach to management of respiratory complications in neurological disorders. International Journal of General Medicine, 5, 255-263.
https://doi.org/10.2147/IJGM.S26333
 
Mannino, D. M., McBurnie, M. A., Tan, W., Kocabas, A., Anto, J., Vollmer, W. M., & Buist, A. S. (2012). Restricted spirometry in the Burden of Lung Disease Study. Int J Tuberc Lung Dis, 16(10), 1405-1411.
 
Martinez-Pitre, P. J., Sabbula, B. R., & Cascella, M. (2023). Restrictive lung disease. In StatPearls [Internet]. StatPearls Publishing.
 
Mavroudi, M., Papakosta, D., Kontakiotis, T., Domvri, K., Kalamaras, G., Zarogoulidou, V., ... & Zarogoulidis, K. (2018). Sleep disorders and health-related quality of life in patients with interstitial lung disease. Sleep Breath, 22(2), 393-400.
https://doi.org/10.1007/s11325-017-1579-1
 
Miller, M. R., Hankinson, J., Brusasco, V., et al. (2017). Standardized spirometry: Current practices. European Respiratory Journal, 49(1), 1700010.
 
Moore, C., Blumhagen, R. Z., Yang, I. V., Walts, A., Powers, J., Walker, T., … & Silverman, E. K. (2019). Resequencing study confirms that host defense and cell senescence gene variants contribute to the risk of idiopathic pulmonary fibrosis. American Journal of Respiratory and Critical Care Medicine, 200(2), 199-208.
https://doi.org/10.1164/rccm.201810-1891OC
 
O'Shea, M. K., Smith, R. C., & Patel, R. (2022). Neuromuscular and thoracic causes of restrictive lung disease. Pulmonary Medicine, 54(3), 178-187.
 
Raghu, G., Remy-Jardin, M., & Myers, J. L. (2018). Diagnosis of idiopathic pulmonary fibrosis: An official ATS/ERS/JRS/ALAT clinical practice guideline. Lancet Respiratory Medicine, 6(2), 138-153.
https://doi.org/10.1164/rccm.201807-1255ST
 
Richeldi, L., du Bois, R. M., & Raghu, G. (2014). Efficacy of nintedanib in patients with idiopathic pulmonary fibrosis. New England Journal of Medicine, 370(22), 2071-2082.
https://doi.org/10.1056/NEJMoa1402584
 
Robinson, H. C. (2016). Respiratory conditions update: Restrictive lung disease. FP Essentials, 448, 29-34.
 
Sulica, R., Teirstein, A., & Padilla, M. L. (2001). Lung transplantation in interstitial lung disease. Current Opinion in Pulmonary Medicine, 7(5), 314-322.
https://doi.org/10.1097/00063198-200109000-00011
 
Travis, W. D., Costabel, U., & Hansell, D. M. (2013). An official ATS/ERS update: Interstitial lung disease classification. American Journal of Respiratory and Critical Care Medicine, 188(6), 733-748.
https://doi.org/10.1164/rccm.201308-1483ST
 
Wallis, A., & Spinks, K. (2015). The diagnosis and management of interstitial lung diseases. BMJ, 350, h2072.
https://doi.org/10.1136/bmj.h2072
 
Zammit, C., et al. (2010). Obesity and respiratory diseases. International Journal of General Medicine, 3, 335-343.
https://doi.org/10.2147/IJGM.S11926

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