The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective study
Fibrotic hypersensitivity pneumonitis (f-HP) is an interstitial lung disease in which various antigens in susceptible individuals may play a pathogenetic role. This study evaluates the role of transbronchial lung cryobiopsy (TBLC) and bronchoalveolar lavage (BAL) in identifying a UIP-like pattern an...
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Taylor & Francis
2025-12-01
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| Series: | Pulmonology |
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| Online Access: | http://dx.doi.org/10.1080/25310429.2024.2425503 |
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| author | Simone Petrarulo Claudia Ravaglia Sissel Kronborg White Line Bille Madsen Frederik Lex Alessandra Dubini Elisabetta Fabbri Elisabeth Bendstrup Paolo Spagnolo Sara Piciucchi Venerino Poletti |
| author_facet | Simone Petrarulo Claudia Ravaglia Sissel Kronborg White Line Bille Madsen Frederik Lex Alessandra Dubini Elisabetta Fabbri Elisabeth Bendstrup Paolo Spagnolo Sara Piciucchi Venerino Poletti |
| author_sort | Simone Petrarulo |
| collection | DOAJ |
| description | Fibrotic hypersensitivity pneumonitis (f-HP) is an interstitial lung disease in which various antigens in susceptible individuals may play a pathogenetic role. This study evaluates the role of transbronchial lung cryobiopsy (TBLC) and bronchoalveolar lavage (BAL) in identifying a UIP-like pattern and its association with fibrosis progression. We conducted a multicentre retrospective cohort study of patients diagnosed with f-HP who underwent BAL and TBLC between 2011 and 2023. A UIP-like pattern was defined by the presence of (A) patchy fibrosis and fibroblastic foci or (B) honeycombing ± (A). We investigated BAL’s role in predicting UIP-like patterns within a clinical-radiological-serological framework, examining disease progression in these patients using spirometry and mortality data. A total of 195 patients were enrolled, 59 (30%) of whom exhibited a UIP-like pattern. These patients showed greater lung function decline, lower BAL lymphocytosis (14.4% vs. 37.4%, p < 0.001), higher nintedanib prescription (35% vs. 14%, p < 0.001), and higher 10-year mortality (HR 2.8, 95% CI 1.3–5.8, p = 0.004). f-HP patients with a UIP-like pattern exhibit worse clinical outcomes and higher mortality. In cases of low BAL lymphocytosis with a high pre-test clinical suspicion of f-HP, lung biopsy may not be necessary as it increases the likelihood of identifying a UIP-like pattern. |
| format | Article |
| id | doaj-art-eec2c58c4b66405cb26cdb65f6a96e40 |
| institution | Kabale University |
| issn | 2531-0429 2531-0437 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis |
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| series | Pulmonology |
| spelling | doaj-art-eec2c58c4b66405cb26cdb65f6a96e402024-11-15T10:42:42ZengTaylor & FrancisPulmonology2531-04292531-04372025-12-0131110.1080/25310429.2024.24255032425503The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective studySimone Petrarulo0Claudia Ravaglia1Sissel Kronborg White2Line Bille Madsen3Frederik Lex4Alessandra Dubini5Elisabetta Fabbri6Elisabeth Bendstrup7Paolo Spagnolo8Sara Piciucchi9Venerino Poletti10GB Morgagni—L. Pierantoni HospitalGB Morgagni—L. Pierantoni HospitalAarhus University HospitalAarhus University HospitalAarhus UniversityGB Morgagni - L. Pierantoni HospitalAzienda USL della RomagnaAarhus University HospitalUniversity of PadovaGB Morgagni - L.Pierantoni HospitalGB Morgagni—L. Pierantoni HospitalFibrotic hypersensitivity pneumonitis (f-HP) is an interstitial lung disease in which various antigens in susceptible individuals may play a pathogenetic role. This study evaluates the role of transbronchial lung cryobiopsy (TBLC) and bronchoalveolar lavage (BAL) in identifying a UIP-like pattern and its association with fibrosis progression. We conducted a multicentre retrospective cohort study of patients diagnosed with f-HP who underwent BAL and TBLC between 2011 and 2023. A UIP-like pattern was defined by the presence of (A) patchy fibrosis and fibroblastic foci or (B) honeycombing ± (A). We investigated BAL’s role in predicting UIP-like patterns within a clinical-radiological-serological framework, examining disease progression in these patients using spirometry and mortality data. A total of 195 patients were enrolled, 59 (30%) of whom exhibited a UIP-like pattern. These patients showed greater lung function decline, lower BAL lymphocytosis (14.4% vs. 37.4%, p < 0.001), higher nintedanib prescription (35% vs. 14%, p < 0.001), and higher 10-year mortality (HR 2.8, 95% CI 1.3–5.8, p = 0.004). f-HP patients with a UIP-like pattern exhibit worse clinical outcomes and higher mortality. In cases of low BAL lymphocytosis with a high pre-test clinical suspicion of f-HP, lung biopsy may not be necessary as it increases the likelihood of identifying a UIP-like pattern.http://dx.doi.org/10.1080/25310429.2024.2425503hypersensitivity pneumonitisinterstitial lung diseasetransbronchial lung cryobiopsybaluip |
| spellingShingle | Simone Petrarulo Claudia Ravaglia Sissel Kronborg White Line Bille Madsen Frederik Lex Alessandra Dubini Elisabetta Fabbri Elisabeth Bendstrup Paolo Spagnolo Sara Piciucchi Venerino Poletti The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective study Pulmonology hypersensitivity pneumonitis interstitial lung disease transbronchial lung cryobiopsy bal uip |
| title | The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective study |
| title_full | The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective study |
| title_fullStr | The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective study |
| title_full_unstemmed | The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective study |
| title_short | The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective study |
| title_sort | clinical meaning of the uip pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy a multicentre retrospective study |
| topic | hypersensitivity pneumonitis interstitial lung disease transbronchial lung cryobiopsy bal uip |
| url | http://dx.doi.org/10.1080/25310429.2024.2425503 |
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