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Inflammation-associated remodelling and fibrosis in the lung – a process and an end point
William A.H. Wallace*, Paul M. Fitch*, A. John Simpson* and Sarah E.M. Howie*
  *MRC Centre for Inflammation Research, Queen's Medical Research Institute, Edinburgh University, Edinburgh, UK ; and  Departments of Pathology and   Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
Correspondence to Dr William A.H. Wallace
Department of Pathology
Royal Infirmary of Edinburgh
51 Little France Crescent
Edinburgh EH16 4SA
Tel.: 0131 242 7134
Fax: 0131 242 7146
E-mail: william.wallace@luht.scot.nhs.uk
Copyright 2007 Blackwell Publishing Ltd
KEYWORDS
fibrosis • inflammation • injury • lung • remodelling

Summary

AbstractIntroductionAcute inflammation and alveolar injuryChronic inflammation and alveolar injuryRemodelling in interstitial lung diseaseReferences

Fibrosis by common usage in the pathological and clinical literature is the end result of a healing process and synonymous with scarring. We would argue that its use to describe a dynamic series of events which may be reversible is unhelpful and that the term 'lung remodelling' is a better description for this process as it reflects changes in tissue organization that may or may not progress to 'fibrosis' as a final fixed point. Resolution, through reversal of active lung remodelling, by therapeutic intervention is possible providing the alveolar architecture remains intact. If the lung architecture is lost then healing by permanent fibrosis with loss of organ function is inevitable.


Received for publication: 16 October 2006 Accepted for publication: 16 October 2006

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1365-2613.2006.00515.x About DOI

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