Novel treatment insights for pneumoconiosis: A Narrative Review

Resumen

Pneumoconiosis is a group of diseases provoked by mineral dust inhalation. Inhaled particles are phagocyted by alveolar macrophages, leading to an intracellular toxicity cycle caused by reactive oxygen species, inflammation, severe pulmonary fibrosis. Due to the limited reach of current interventions that are incapable of ceasing the disease or destroying lesions, this pathology keeps representing a critic challenge for the global public health. The objective of this investigation is to describe the variants of pneumoconiosis, current and potential approaches, as well as to contrast the efficacy of these approaches (both current and emerging). To achieve this, an exhaustive review in several databases, analysing literature from the last five years focused on pathophysiology and novel therapeutic proposals. Findings indicate that currently accepted therapies, like the Whole Lung Lavage and antifibrotic drugs, are limited to stopping the progression of the disease and their symptoms; whilst the lung transplant is the only method to cure pneumoconiosis completely, but portrays very high risks. In contrast, testing on animal models puts in evidence that directed drugs, like Nerandomilast and Galunisertib, efficiently stop fibroblastic proliferation and migration. Herbal compounds such as Sodium Tanshinone IIA Sulfonate and Kaempferol exhibit antioxidant effects capable of removing silicotic nodules. Additionally, an approach that really stands out is nanonechnology by the use of engineered conjugated nanoparticles to penetrate through several barriers of the respiratory tract and deliver genetic or pharmacological therapies in a precise and less invasive way. In conclusion, approaches in the present ate insufficient to revert damage caused by pneumoconiosis, hence these alternatives represent genuine faith to cease the disease from its roots, making the development of randomized controlled clinical trials an imperative to evaluate their viability and security to be used for humans.