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Molecular Basis of Pulmonary Disease - Insights from Rare Lung Disorders (Hardcover, Edition.)
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Molecular Basis of Pulmonary Disease - Insights from Rare Lung Disorders (Hardcover, Edition.)
Series: Respiratory Medicine
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Dr.
SharonRounds,theeditorforthisserieswhoinvitedustowriteabookonrare
lungdiseases,developedtheideaafterattendingthe2004Lymphangioleiomyomatosis
(LAM)Foundationannualresearchmeeting.
Shewasakeynotespeakeratthatevent
(duringhertenureasthepresidentoftheAmericanThoracicSociety)andwasw-
nesstothepowerofpatientadvocacyandthemission-basedscienti
ceffortthathad
broughtthisrarediseaseofwomenfromobscuritytoclinicaltrialswithtargetedmol-
ulartherapiesinunderadecade.
Theprogressinpulmonaryalveolarproteinosis(PAP),
pulmonaryalveolarmicrolithiasis(PAM),inheriteddisordersofsurfactantmetabolism,
and pulmonary arterial hypertension, to name a few, has been no
less astounding.
Advanceshavecomefromthemostsurprisingdirections;fruit
iesforLAM,gen- ically engineered mice made for other purposes for
PAP, and groundbreaking hi-
densitySNP(single-nucleotidepolymorphism)analysesdoneonahandfuloffamilies
forPAM.
Inmanycases,insightsintobiologygainedfromrarediseaseshaveinformed
researchapproachesandtreatmentstrategiesformorecommondiseases;forexample,
knowledgegainedfromthestudyofPAPabouttheroleofGM-CSFinthelunghas
sparkedinterestintheuseofantiGM-CSFapproachestocontrolbothpulmonaryand
extrapulmonaryin ammationinavarietyofdiseases. The
ndingthatinterstitiallung
diseasedevelopsinfamilieswithcytotoxicmutationsinsurfactantproteinC(SP-C),
agenewhichisexpressedonlyinalveolartypecells,hasunderscoredtheimportance
oftheintegrityofthealveolarepitheliuminthepathogenesisofparenchymal
brosis.
Opportunitiestoapproachlungdiseasepathogenesisfromthevantagepointofap-
marymoleculardefectaregiftsfromnaturethatareuniquelyabundantamongtherare
lungdisorders.
WesalutetheNIHandtheNationalCenterforResearchResourcesfortheirvisionin
facilitatingthetranslationofbasicresearchadvancesinrarelungdiseasesintoclinical
realitythroughtheRareLungDiseaseConsortium,anetworkof13USandinter-
tionalsitesthatiscurrentlyconductingclinicaltrialsandstudiesinLAM,alphaone
antitrypsin de ciency, pediatric interstitial lung disease, and
PAP. It has been a rare
privilegetoworkonsuchfascinatingdiseaseswithsuchcapableinvestigatorsfromall
overtheworldoverthepast6years. v vi Preface
Theformatforthisvolumeisunique. Mostchaptershavebeenauthoredbyacli-
cianandabasicscientistwhoareexpertinthediseasetopicandunderlyingmolecular
defect,respectively.
Theirchargewastofocusonthegeneticbasisandmolecularpat-
genesisofdisease,animalmodels,clinicalfeatures,diagnosticapproach,conventional
managementandtreatment,andfuturetherapeutictargetsanddirections.
Theintentwas
nottoprovideabroadoverview,butrathertoshedlightonthemolecularmechanisms
thatevoketheclinicalpresentationandengendertreatmentstrategiesforeachdisease.
Wehopethatthisapproachwillproveusefulforpulmonarycliniciansandscientists
alike.
Wethankourwives,Holly,Jean,andVicky,fortheirsupportandindulgencewith
latenightemailsandwork- lledweekends,Dr.
Roundsfortheinvitationtowritethe
book,andalloftheauthorswhocontributed. FrancisMcCormack,MD
RalphPanos,MD BruceTrapnell,MD Contents Preface...v
Contributors...ix 1 AClinicalApproachtoRareLungDiseases...1 RalphJ.
Panos 2 ClinicalTrialsforRareLungDiseases...31 JeffreyKrischer 3
IdiopathicandFamilialPulmonaryArterialHypertension ...39 JeanM.
Elwing,GailH. Deutsch,WilliamC. Nichols, andTimothyD. LeCras 4
Lymphangioleiomyomatosis...85 ElizabethP. HenskeandFrancisX.
McCormack 5 AutoimmunePulmonaryAlveolarProteinosis...111 BruceC.
Trapnell,KohNakata,andYoshikazuInoue 6
MutationsinSurfactantProteinCandInterstitialLungDisease ...133
RalphJ. PanosandJamesP. Bridges 7
HereditaryHaemorrhagicTelangiectasia ...167 ClaireShovlinandS.
PaulOh 8 Hermansky-Dr.
SharonRounds,theeditorforthisserieswhoinvitedustowriteabookonrare
lungdiseases,developedtheideaafterattendingthe2004Lymphangioleiomyomatosis
(LAM)Foundationannualresearchmeeting.
Shewasakeynotespeakeratthatevent
(duringhertenureasthepresidentoftheAmericanThoracicSociety)andwasw-
nesstothepowerofpatientadvocacyandthemission-basedscienti
ceffortthathad
broughtthisrarediseaseofwomenfromobscuritytoclinicaltrialswithtargetedmol-
ulartherapiesinunderadecade.
Theprogressinpulmonaryalveolarproteinosis(PAP),
pulmonaryalveolarmicrolithiasis(PAM),inheriteddisordersofsurfactantmetabolism,
and pulmonary arterial hypertension, to name a few, has been no
less astounding.
Advanceshavecomefromthemostsurprisingdirections;fruit
iesforLAM,gen- ically engineered mice made for other purposes for
PAP, and groundbreaking hi-
densitySNP(single-nucleotidepolymorphism)analysesdoneonahandfuloffamilies
forPAM.
Inmanycases,insightsintobiologygainedfromrarediseaseshaveinformed
researchapproachesandtreatmentstrategiesformorecommondiseases;forexample,
knowledgegainedfromthestudyofPAPabouttheroleofGM-CSFinthelunghas
sparkedinterestintheuseofantiGM-CSFapproachestocontrolbothpulmonaryand
extrapulmonaryin ammationinavarietyofdiseases. The
ndingthatinterstitiallung
diseasedevelopsinfamilieswithcytotoxicmutationsinsurfactantproteinC(SP-C),
agenewhichisexpressedonlyinalveolartypecells,hasunderscoredtheimportance
oftheintegrityofthealveolarepitheliuminthepathogenesisofparenchymal
brosis.
Opportunitiestoapproachlungdiseasepathogenesisfromthevantagepointofap-
marymoleculardefectaregiftsfromnaturethatareuniquelyabundantamongtherare
lungdisorders.
WesalutetheNIHandtheNationalCenterforResearchResourcesfortheirvisionin
facilitatingthetranslationofbasicresearchadvancesinrarelungdiseasesintoclinical
realitythroughtheRareLungDiseaseConsortium,anetworkof13USandinter-
tionalsitesthatiscurrentlyconductingclinicaltrialsandstudiesinLAM,alphaone
antitrypsin de ciency, pediatric interstitial lung disease, and
PAP. It has been a rare
privilegetoworkonsuchfascinatingdiseaseswithsuchcapableinvestigatorsfromall
overtheworldoverthepast6years. v vi Preface
Theformatforthisvolumeisunique. Mostchaptershavebeenauthoredbyacli-
cianandabasicscientistwhoareexpertinthediseasetopicandunderlyingmolecular
defect,respectively.
Theirchargewastofocusonthegeneticbasisandmolecularpat-
genesisofdisease,animalmodels,clinicalfeatures,diagnosticapproach,conventional
managementandtreatment,andfuturetherapeutictargetsanddirections.
Theintentwas
nottoprovideabroadoverview,butrathertoshedlightonthemolecularmechanisms
thatevoketheclinicalpresentationandengendertreatmentstrategiesforeachdisease.
Wehopethatthisapproachwillproveusefulforpulmonarycliniciansandscientists
alike.
Wethankourwives,Holly,Jean,andVicky,fortheirsupportandindulgencewith
latenightemailsandwork- lledweekends,Dr.
Roundsfortheinvitationtowritethe
book,andalloftheauthorswhocontributed. FrancisMcCormack,MD
RalphPanos,MD BruceTrapnell,MD Contents Preface...v
Contributors...ix 1 AClinicalApproachtoRareLungDiseases...1 RalphJ.
Panos 2 ClinicalTrialsforRareLungDiseases...31 JeffreyKrischer 3
IdiopathicandFamilialPulmonaryArterialHypertension ...39 JeanM.
Elwing,GailH. Deutsch,WilliamC. Nichols, andTimothyD. LeCras 4
Lymphangioleiomyomatosis...85 ElizabethP. HenskeandFrancisX.
McCormack 5 AutoimmunePulmonaryAlveolarProteinosis...111 BruceC.
Trapnell,KohNakata,andYoshikazuInoue 6
MutationsinSurfactantProteinCandInterstitialLungDisease ...133
RalphJ. PanosandJamesP. Bridges 7
HereditaryHaemorrhagicTelangiectasia ...167 ClaireShovlinandS.
PaulOh 8 Hermansky-Dr.
SharonRounds,theeditorforthisserieswhoinvitedustowriteabookonrare
lungdiseases,developedtheideaafterattendingthe2004Lymphangioleiomyomatosis
(LAM)Foundationannualresearchmeeting.
Shewasakeynotespeakeratthatevent
(duringhertenureasthepresidentoftheAmericanThoracicSociety)andwasw-
nesstothepowerofpatientadvocacyandthemission-basedscienti
ceffortthathad
broughtthisrarediseaseofwomenfromobscuritytoclinicaltrialswithtargetedmol-
ulartherapiesinunderadecade.
Theprogressinpulmonaryalveolarproteinosis(PAP),
pulmonaryalveolarmicrolithiasis(PAM),inheriteddisordersofsurfactantmetabolism,
and pulmonary arterial hypertension, to name a few, has been no
less astounding.
Advanceshavecomefromthemostsurprisingdirections;fruit
iesforLAM,gen- ically engineered mice made for other purposes for
PAP, and groundbreaking hi-
densitySNP(single-nucleotidepolymorphism)analysesdoneonahandfuloffamilies
forPAM.
Inmanycases,insightsintobiologygainedfromrarediseaseshaveinformed
researchapproachesandtreatmentstrategiesformorecommondiseases;forexample,
knowledgegainedfromthestudyofPAPabouttheroleofGM-CSFinthelunghas
sparkedinterestintheuseofantiGM-CSFapproachestocontrolbothpulmonaryand
extrapulmonaryin ammationinavarietyofdiseases. The
ndingthatinterstitiallung
diseasedevelopsinfamilieswithcytotoxicmutationsinsurfactantproteinC(SP-C),
agenewhichisexpressedonlyinalveolartypecells,hasunderscoredtheimportance
oftheintegrityofthealveolarepitheliuminthepathogenesisofparenchymal
brosis.
Opportunitiestoapproachlungdiseasepathogenesisfromthevantagepointofap-
marymoleculardefectaregiftsfromnaturethatareuniquelyabundantamongtherare
lungdisorders.
WesalutetheNIHandtheNationalCenterforResearchResourcesfortheirvisionin
facilitatingthetranslationofbasicresearchadvancesinrarelungdiseasesintoclinical
realitythroughtheRareLungDiseaseConsortium,anetworkof13USandinter-
tionalsitesthatiscurrentlyconductingclinicaltrialsandstudiesinLAM,alphaone
antitrypsin de ciency, pediatric interstitial lung disease, and
PAP. It has been a rare
privilegetoworkonsuchfascinatingdiseaseswithsuchcapableinvestigatorsfromall
overtheworldoverthepast6years. v vi Preface
Theformatforthisvolumeisunique. Mostchaptershavebeenauthoredbyacli-
cianandabasicscientistwhoareexpertinthediseasetopicandunderlyingmolecular
defect,respectively.
Theirchargewastofocusonthegeneticbasisandmolecularpat-
genesisofdisease,animalmodels,clinicalfeatures,diagnosticapproach,conventional
managementandtreatment,andfuturetherapeutictargetsanddirections.
Theintentwas
nottoprovideabroadoverview,butrathertoshedlightonthemolecularmechanisms
thatevoketheclinicalpresentationandengendertreatmentstrategiesforeachdisease.
Wehopethatthisapproachwillproveusefulforpulmonarycliniciansandscientists
alike.
Wethankourwives,Holly,Jean,andVicky,fortheirsupportandindulgencewith
latenightemailsandwork- lledweekends,Dr.
Roundsfortheinvitationtowritethe
book,andalloftheauthorswhocontributed. FrancisMcCormack,MD
RalphPanos,MD BruceTrapnell,MD Contents Preface...v
Contributors...ix 1 AClinicalApproachtoRareLungDiseases...1 RalphJ.
Panos 2 ClinicalTrialsforRareLungDiseases...31 JeffreyKrischer 3
IdiopathicandFamilialPulmonaryArterialHypertension ...39 JeanM.
Elwing,GailH. Deutsch,WilliamC. Nichols, andTimothyD. LeCras 4
Lymphangioleiomyomatosis...85 ElizabethP. HenskeandFrancisX.
McCormack 5 AutoimmunePulmonaryAlveolarProteinosis...111 BruceC.
Trapnell,KohNakata,andYoshikazuInoue 6
MutationsinSurfactantProteinCandInterstitialLungDisease ...133
RalphJ. PanosandJamesP. Bridges 7
HereditaryHaemorrhagicTelangiectasia ...167 ClaireShovlinandS.
PaulOh 8 Hermansky-PudlakSyndrome...189 LisaR. YoungandWilliamA.
Gahl 9 Alpha-1AntitrypsinDe ciency ...209
CharlieStrangeandSabinaJanciauskiene vii viii Contents 10
TheMarfanSyndrome ...225 AmareshNathandEnidR. Neptune 11
SurfactantDe ciencyDisorders:SP-BandABCA3...247 LawrenceM. Nogee 12
PulmonaryCapillaryHemangiomatosis ...267 EdwardD.
Chan,KathrynChmura,andAndrewSullivan 13
Anti-glomerularBasementDisease:Goodpasture'sSyndrome...275
GangadharTaduri,RaghuKalluri,andRalphJ. Panos 14
PrimaryCiliaryDyskinesia...293 MichaelR.
Knowles,HildaMetjian,MargaretW. Leigh, andMaimoonaA. Zariwala 15
PulmonaryAlveolarMicrolithiasis...325
KoichiHagiwara,TakeshiJohkoh,andTeruoTachibana 16
CysticFibrosis...339 AndreM. Cantin 17
PulmonaryLangerhans'CellHistiocytosis-Advances
intheUnderstandingofaTrueDendriticCellLungDisease...369
RobertVassallo 18 Sarcoidosis...389 RalphJ. PanosandAndrewP.
Fontenot 19 SclerodermaLungDisease...409 BrentW. Kinder
SubjectIndex...421 Contributors JamesP. Bridges,PhD,
DepartmentofNeonatologyinPulmonaryBiology,Children's
HospitalMedicalCenter,Cincinnati,OH AndreM. Cantin,MD, Department
of Medicine, University of Sherbrooke, Sherbrooke,QC,Canada
EdwardD. Chan,MD,
DepartmentofInternalMedicine,NationalJewishMedicaland
ResearchCenter,Denver,CO KathrynChmura,BA, Department of Medicine,
University of Colorado School of Medicine,Denver,CO GailH.
General
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