{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:16:28Z","timestamp":1790957788248,"version":"4.1.0"},"reference-count":55,"publisher":"European Respiratory Society (ERS)","issue":"2","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2018,11,15]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease of unknown origin that is associated with high morbidity and mortality. In this perspective, we briefly review the current understanding of the pathophysiology of IPF and the importance of environmental triggers as a precipitant of disease. We discuss occult intrinsic and extrinsic environmental factors that affect the lung microenvironment and may contribute to the development and progression of disease. The clinical implications of this framework need to be further elucidated, because prompt identification and elimination of occult exposures may represent a novel treatment modality.<\/jats:p>","DOI":"10.1183\/13993003.01699-2018","type":"journal-article","created":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T05:25:26Z","timestamp":1543469126000},"page":"1801699","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":65,"title":["Idiopathic pulmonary fibrosis: unmasking cryptogenic environmental factors"],"prefix":"10.1183","volume":"53","author":[{"given":"Coralynn","family":"Sack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Raghu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2019,2,21]]},"reference":[{"key":"2024102100441614000_53.2.1801699.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201506-1063ST"},{"key":"2024102100441614000_53.2.1801699.2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2009-040GL"},{"key":"2024102100441614000_53.2.1801699.3","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1164\/rccm.201807-1255ST","article-title":"Diagnosis of idiopathic pulmonary fibrosis. An official ATS\/ERS\/JRS\/ALAT clinical practice guideline","volume":"198","author":"Raghu","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102100441614000_53.2.1801699.4","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/S2213-2600(18)30007-9","article-title":"Time for a change: is idiopathic pulmonary fibrosis still idiopathic and only fibrotic?","volume":"6","author":"Wolters","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2024102100441614000_53.2.1801699.5","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00692-2018"},{"key":"2024102100441614000_53.2.1801699.6","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.161.2.ats3-00"},{"key":"2024102100441614000_53.2.1801699.7","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1056\/NEJMra1705751","article-title":"Idiopathic pulmonary fibrosis","volume":"378","author":"Lederer","year":"2018","journal-title":"N Engl J Med"},{"key":"2024102100441614000_53.2.1801699.8","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/S2213-2600(17)30433-2","article-title":"Diagnostic criteria for idiopathic pulmonary fibrosis: a Fleischner Society white paper","volume":"6","author":"Lynch","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2024102100441614000_53.2.1801699.9","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1016\/j.rmed.2018.08.008","article-title":"Sarcoidosis and IPF in the same patient-a coincidence, an association or a phenotype?","volume":"144S","author":"Collins","year":"2018","journal-title":"Respir Med"},{"key":"2024102100441614000_53.2.1801699.10","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S2213-2600(13)70191-7","article-title":"Chronic hypersensitivity pneumonitis in patients diagnosed with idiopathic pulmonary fibrosis: a prospective case-cohort study","volume":"1","author":"Morell","year":"2013","journal-title":"Lancet Respir Med"},{"key":"2024102100441614000_53.2.1801699.11","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/S2213-2600(17)30216-3","article-title":"The MUC5B promoter polymorphism and telomere length in patients with chronic hypersensitivity pneumonitis: an observational cohort-control study","volume":"5","author":"Ley","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2024102100441614000_53.2.1801699.12","doi-asserted-by":"crossref","first-page":"118","DOI":"10.3389\/fmed.2017.00118","article-title":"Exploring animal models that resemble idiopathic pulmonary fibrosis","volume":"4","author":"Tashiro","year":"2017","journal-title":"Front Med"},{"key":"2024102100441614000_53.2.1801699.13","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01385-2017"},{"key":"2024102100441614000_53.2.1801699.14","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201403-0509PP"},{"key":"2024102100441614000_53.2.1801699.15","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1097\/JOM.0000000000000608","article-title":"Occupational interstitial lung diseases","volume":"57","author":"Litow","year":"2015","journal-title":"J Occup Environ Med"},{"key":"2024102100441614000_53.2.1801699.16","doi-asserted-by":"publisher","DOI":"10.1165\/rcmb.2013-0094TR"},{"key":"2024102100441614000_53.2.1801699.17","first-page":"9","article-title":"Elemental analysis of inorganic dusts in lung tissues of interstitial pneumonias","volume":"54","author":"Tsuchiya","year":"2007","journal-title":"J Med Dent Sci"},{"key":"2024102100441614000_53.2.1801699.18","first-page":"2061","article-title":"[Elemental analysis of hilar and mediastinal lymph nodes in idiopathic pulmonary fibrosis]","volume":"30","author":"Hashimoto","year":"1992","journal-title":"Nihon Kyobu Shikkan Gakkai Zasshi"},{"key":"2024102100441614000_53.2.1801699.19","first-page":"745","article-title":"[Quantitative and qualitative analyses of inorganic dusts in idiopathic interstitial pneumonia (IIP)]","volume":"61","author":"Inoue","year":"1986","journal-title":"Hokkaido Igaku Zasshi"},{"key":"2024102100441614000_53.2.1801699.20","first-page":"327","article-title":"Lung dust content in idiopathic pulmonary fibrosis: a study with scanning electron microscopy and energy dispersive X ray analysis","volume":"48","author":"Mons\u00f3","year":"1991","journal-title":"Br J Ind Med"},{"key":"2024102100441614000_53.2.1801699.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1404786"},{"key":"2024102100441614000_53.2.1801699.22","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.6.9804105"},{"key":"2024102100441614000_53.2.1801699.23","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00037005"},{"key":"2024102100441614000_53.2.1801699.24","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00211311"},{"key":"2024102100441614000_53.2.1801699.25","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201512-2316PP"},{"key":"2024102100441614000_53.2.1801699.26","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/S2213-2600(17)30219-9","article-title":"Antacid therapy in idiopathic pulmonary fibrosis: more questions than answers?","volume":"5","author":"Johannson","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2024102100441614000_53.2.1801699.27","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S2213-2600(13)70105-X","article-title":"Anti-acid treatment and disease progression in idiopathic pulmonary fibrosis: an analysis of data from three randomised controlled trials","volume":"1","author":"Lee","year":"2013","journal-title":"Lancet Respir Med"},{"key":"2024102100441614000_53.2.1801699.28","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201101-0138OC"},{"key":"2024102100441614000_53.2.1801699.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2005.10.014"},{"key":"2024102100441614000_53.2.1801699.30","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00488-2016"},{"key":"2024102100441614000_53.2.1801699.31","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/S2213-2600(18)30301-1","article-title":"Laparoscopic anti-reflux surgery for the treatment of idiopathic pulmonary fibrosis (WRAP-IPF): a multicentre, randomised, controlled phase 2 trial","volume":"6","author":"Raghu","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2024102100441614000_53.2.1801699.32","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.3390\/ijms18122735","article-title":"The lung microbiome in idiopathic pulmonary fibrosis: a promising approach for targeted therapies","volume":"18","author":"Fastr\u00e8s","year":"2017","journal-title":"Int J Mol Sci"},{"issue":"Suppl. 2","key":"2024102100441614000_53.2.1801699.33","doi-asserted-by":"crossref","first-page":"S186","DOI":"10.1513\/AnnalsATS.201502-088AW","article-title":"Viruses in idiopathic pulmonary fibrosis. Etiology and exacerbation","volume":"12","author":"Moore","year":"2015","journal-title":"Ann Am Thorac Soc"},{"key":"2024102100441614000_53.2.1801699.34","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00000713"},{"key":"2024102100441614000_53.2.1801699.35","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/S2213-2600(14)70069-4","article-title":"Lung microbiome and disease progression in idiopathic pulmonary fibrosis: an analysis of the COMET study","volume":"2","author":"Han","year":"2014","journal-title":"Lancet Respir Med"},{"key":"2024102100441614000_53.2.1801699.36","unstructured":"CleanUP IPF for the Pulmonary Trials Cooperative. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02759120 Date last accessed: September 3, 2018."},{"key":"2024102100441614000_53.2.1801699.37","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200408-1104OC"},{"key":"2024102100441614000_53.2.1801699.38","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200612-1759OC"},{"key":"2024102100441614000_53.2.1801699.39","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.6.2001056"},{"key":"2024102100441614000_53.2.1801699.40","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1101277"},{"key":"2024102100441614000_53.2.1801699.41","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.301.6759.1015"},{"key":"2024102100441614000_53.2.1801699.42","first-page":"107","article-title":"Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Egypt: a multicenter case-control study","volume":"3","author":"Awadalla","year":"2012","journal-title":"Int J Occup Environ Med"},{"key":"2024102100441614000_53.2.1801699.43","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/152.4.307"},{"key":"2024102100441614000_53.2.1801699.44","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.150.3.8087336"},{"key":"2024102100441614000_53.2.1801699.45","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/152.1.32"},{"key":"2024102100441614000_53.2.1801699.46","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004018"},{"key":"2024102100441614000_53.2.1801699.47","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1111\/resp.13342","article-title":"Clinical behaviour of patients exposed to organic dust and diagnosed with idiopathic pulmonary fibrosis","volume":"23","author":"De Sadeleer","year":"2018","journal-title":"Respirology"},{"key":"2024102100441614000_53.2.1801699.48","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1016\/j.chest.2017.07.034","article-title":"Exposure to ambient particulate matter is associated with accelerated functional decline in idiopathic pulmonary fibrosis","volume":"153","author":"Winterbottom","year":"2017","journal-title":"Chest"},{"key":"2024102100441614000_53.2.1801699.49","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2017-209967"},{"key":"2024102100441614000_53.2.1801699.50","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00122213"},{"key":"2024102100441614000_53.2.1801699.51","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.chest.2018.01.015","article-title":"Air pollution exposure is associated with lower lung function, but not changes in lung function, in patients with idiopathic pulmonary fibrosis","volume":"154","author":"Johannson","year":"2018","journal-title":"Chest"},{"key":"2024102100441614000_53.2.1801699.52","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00559-2017"},{"key":"2024102100441614000_53.2.1801699.53","doi-asserted-by":"crossref","unstructured":"Singh S , Collins BF , Bairwa M , et al. Hypersensitivity pneumonitis and its correlation with ambient air pollution in urban India. Eur Respir J 2019; 53: 1801563.","DOI":"10.1183\/13993003.01563-2018"},{"key":"2024102100441614000_53.2.1801699.54","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1164\/rccm.201607-1484OC","article-title":"Interstitial lung disease in India. Results of a prospective registry","volume":"195","author":"Singh","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2024102100441614000_53.2.1801699.55","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jaip.2016.07.011","article-title":"Home environmental interventions for the prevention or control of allergic and respiratory diseases: what really works","volume":"5","author":"Le Cann","year":"2017","journal-title":"J Allergy Clin Immunol Pract"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.01699-2018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T07:31:11Z","timestamp":1740382271000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.01699-2018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":55,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,21]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1183\/13993003.01699-2018"],"URL":"https:\/\/doi.org\/10.1183\/13993003.01699-2018","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}