Update of the International Multidisciplinary Classification of Interstitial Pneumonias: European Respiratory Society/American Thoracic Society statement (overview of the new guidelines)

Abstract

The relevance of this work is determined by the need to implement the latest scientific advances in the problem of interstitial lung diseases (ILD) into medical practice. The aim of the work was to discuss the main updated guidelines for the classification of ILD by the European Respiratory Society (ERS)/American Thoracic Society (ATS). Results. The article presents the main clarifying changes to the international classification of ILD recommended by ERS/ATS experts. The new document proposes three main changes: expansion of the concept of “interstitial pneumonia” (IP) by including secondary cases; introduction of new subcategories of IP; identification of such subcategories as interstitial (fibrotic and non-fibrotic) disorders and disorders of alveolar accumulation. The article provides a detailed analysis of the essence of the proposed changes. Conclusion. A committee of multidisciplinary experts developed an updated structure for the classification of interstitial lung diseases. This structure expands the classification beyond idiopathic diseases, clarifies the terminology for bronchiolocentric interstitial pneumonia and alveolar-macrophage pneumonia, and further divides interstitial and alveolar filling disorders. Detailed information on various advances in molecular medicine is presented, and future research priorities are identified. These updates are expected not only to improve patient care but also to guide future research toward further understanding of these diseases, leading to further updates of this document by expanding the range of issues discussed and, ideally, providing a deeper biological basis for subgroups of the conditions.