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Abandoning developmental silos

what can paediatricians and adult interstitial lung disease physicians learn from each other?

Spagnolo, Paoloa; Griese, Matthiasb; Cocconcelli, Elisabettaa; Bernardinello, Nicolc; Bush, Andrewd

Current Opinion in Pulmonary Medicine: September 2019 - Volume 25 - Issue 5 - p 418–425
doi: 10.1097/MCP.0000000000000594
INTERSTITIAL LUNG DISEASE: Edited by Francesco Bonella and Paolo Spagnolo

Purpose of review Interstitial lung disease (ILD) consists of a large and heterogeneous group of disorders that are classified together because of similar clinical, radiographic, physiologic or pathologic manifestations. Overall, although there is overlap between adult and childhood ILD (chILD), there are many differences in disease causes and prevalences.

Recent findings In the last few years, our understanding of adult ILD pathobiology has improved substantially. This is particularly true for idiopathic pulmonary fibrosis, the most common of the idiopathic interstitial pneumonias, wherein recently developed guideline documents provide recommendations for the diagnosis and clinical management of patients. For chILD, similar guidelines are yet to be developed. However, complications and long-term pulmonary outcomes of paediatric disease are better appreciated, which make the implementation of a successful transition program from paediatric to adult care an urgent need. Similarly important is the development of guidelines on performance and interpretation of genetic testing in affected and unaffected relatives of familial cases and in children of adult-onset ILD patients. Lung transplantation appears to be as successful as in adult patients for end-stage disease. Paediatric pulmonologists should engage with the adult multidisciplinary teams and benefit from their much more extensive experience.

Summary Childhood and adult ILD share a number of aspects, which give children and adult ILD specialists exciting opportunities to collaborate and learn from each other. Such collaborative effort between child and adult ILD experts is crucial for successful future development in the field.

aRespiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy

bGerman Center for Lung Research, Hauner Children's Hospital, University of Munich, Munich, Germany

cRespiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy

dDepartment of Paediatrics and Paediatric Respiratory Medicine, Royal Brompton Harefield NHS Foundation Trust and Imperial College, London, UK

Correspondence to Paolo Spagnolo, Prof MD, PhD, Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, via Giustiniani 2, 35128 Padova, Italy. Tel: +39 049 8211272; fax: +39 049 8213110; e-mail:

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