{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:53:44Z","timestamp":1788980024418,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although transbronchial lung cryobiopsy (TBLC) is widely used in diagnostic algorithms for various interstitial lung diseases (ILDs), its real\u2010world utility in the therapeutic decision\u2010making strategy for ILD patients remains unclear, in particular, when judging the time to start antifibrotic agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed medical records of 40 consecutive patients with idiopathic or fibrotic hypersensitivity pneumonitis who underwent TBLC. A TBLC\u2010based usual interstitial pneumonia (UIP) score was used to assess three morphologic descriptors: patchy fibrosis, fibroblastic foci, and honeycombing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our 40 patients with ILD, the most frequent radiological feature was indeterminate for UIP (45.0%). Final diagnosis included idiopathic pulmonary fibrosis (22.5%), fibrotic nonspecific interstitial pneumonia (5.0%), fibrotic hypersensitivity pneumonitis (35.0%), and unclassifiable ILD (37.5%). Linear mixed\u2010effects analysis showed that declines in the slopes of %FVC and %DL<jats:sub>CO<\/jats:sub> in patients with TBLC\u2010based UIP \u201cScore \u2265\u20092\u201d were significantly steeper than those of patients with \u201cScore \u2264\u20091.\u201d During follow\u2010up of patients with Score \u2265\u20092 (<jats:italic>n<\/jats:italic>\u2009=\u200924), more than half of them (<jats:italic>n<\/jats:italic>\u2009=\u200917) received an antifibrotic agent, with most patients (<jats:italic>n<\/jats:italic>\u2009=\u200913) receiving early administration of the antifibrotic agent within 6\u2009months after the TBLC procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TBLC\u2010based UIP Score \u2265\u20092 indicated the increased possibility of a progressive fibrosis course that may prove helpful in predicting progressive pulmonary fibrosis\/progressive fibrosing ILD even if disease is temporarily stabilized due to anti\u2010inflammatory agents. Patients may benefit from early introduction of antifibrotic agents by treating clinicians.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13809","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T02:39:35Z","timestamp":1721183975000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Usefulness of Transbronchial Lung Cryobiopsy When Starting Antifibrotic Treatment and Predicting Progressive Fibrosing Interstitial Lung Disease: Descriptive Research"],"prefix":"10.1111","volume":"18","author":[{"given":"Makiko","family":"Takatsuka","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine Saitama Red Cross Hospital  Saitama Japan"},{"name":"Department of Respiratory Medicine Tokyo Jikei University Hospital  Tokyo 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