Reply: The rationale for distinguishing RB-ILD and AMP

<title>Extract</title> The 2025 European Respiratory Society/American Thoracic Society update on the classification of the interstitial pneumonias provides a comprehensive framework for the subcategorisation of these disorders, with particular focus on the corresponding histological and radiological patterns [1]. This classification includes continued separation of alveolar macrophage pneumonia (AMP), which was formerly termed desquamative interstitial pneumonia (DIP), and respiratory bronchiolitis–interstitial lung disease (RB-ILD). S. Mukhopadhyay and I. Sansano agree with the proposed change in terminology but have questioned the ongoing distinction between AMP and RB-ILD, arguing that these should be considered part of a single “smoking-related ILD” entity, along with inclusion of smoking-related interstitial fibrosis. Their primary rationale is based on the characteristic accumulation of macrophages within the alveolar spaces in all three of these entities and the frequent association of these findings with cigarette smoking [1]. Although S. Mukhopadhyay and I. Sansano raise important points for discussion, the committee was convinced by multiple arguments that RB-ILD and AMP should be kept as two distinct multidisciplinary diagnoses.

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Publication Details

Journal
European Respiratory Journal
Published
2025-12-01
DOI
https://doi.org/10.1183/13993003.02029-2025
Citations
2
Primary Topic
Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
Type
article
Field-Weighted Citation Impact
3.04
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article

Reply: The rationale for distinguishing RB-ILD and AMP

Yoshikazu Inoue, Elisabetta Renzoni, Claudia Ravaglia, Letícia Kawano-Dourado et al.
2 citations
European Respiratory Journal
Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
3.04
article

Reply: The rationale for distinguishing RB-ILD and AMP

Yoshikazu Inoue, Elisabetta Renzoni, Claudia Ravaglia, Letícia Kawano-Dourado, Takeshi Johkoh, Simon Walsh, Lida P. Hariri, Sara Piciucchi, Christopher J. Ryerson, Paul J. Wolters, Nicola Sverzellati, Marlies Wijsenbeek, Kerri A. Johannson, Aurélie Fabre, Ryoko Saito, Yet Hong Khor, Toby M. Maher, Amita Sharma, Katerina M. Antoniou, Philip L. Molyneaux, Ayodeji Adegunsoye, Soo‐Ryum Yang, Wendy A. Cooper, Raphaël Borie, Ella A. Kazerooni, Andrew G. Nicholson, Athol U. Wells, William D. Travis, Raymond Protti
article en
2 citations

Abstract

<title>Extract</title> The 2025 European Respiratory Society/American Thoracic Society update on the classification of the interstitial pneumonias provides a comprehensive framework for the subcategorisation of these disorders, with particular focus on the corresponding histological and radiological patterns [1]. This classification includes continued separation of alveolar macrophage pneumonia (AMP), which was formerly termed desquamative interstitial pneumonia (DIP), and respiratory bronchiolitis–interstitial lung disease (RB-ILD). S. Mukhopadhyay and I. Sansano agree with the proposed change in terminology but have questioned the ongoing distinction between AMP and RB-ILD, arguing that these should be considered part of a single “smoking-related ILD” entity, along with inclusion of smoking-related interstitial fibrosis. Their primary rationale is based on the characteristic accumulation of macrophages within the alveolar spaces in all three of these entities and the frequent association of these findings with cigarette smoking [1]. Although S. Mukhopadhyay and I. Sansano raise important points for discussion, the committee was convinced by multiple arguments that RB-ILD and AMP should be kept as two distinct multidisciplinary diagnoses.

European Respiratory JournalVol. 66(6)
University College Dublin (IE), Délégation Paris 5 (FR), University of Southern California (US), University of Parma (IT), Memorial Sloan Kettering Cancer Center (US), Harvard University (US), University of British Columbia (CA), University of Crete (GR), Inserm (FR), The University of Melbourne (AU), University of Calgary (CA), Universidade de São Paulo (BR), University of California, San Francisco (US), Guy's and St Thomas' NHS Foundation Trust (GB), Université Paris Cité (FR), University of Michigan (US), Royal Prince Alfred Hospital (AU), Royal Brompton & Harefield NHS Foundation Trust (GB), House of Representatives (NL), Harefield Hospital (GB), University of California System (US), University of Chicago (US), Massachusetts General Hospital (US), Monash Alfred Psychiatry Research centre (AU), Royal Brompton Hospital (GB), Assistance Publique – Hôpitaux de Paris (FR), Institute for Breathing and Sleep (AU), Hospital TotalCor (BR), Lung Institute (US), Kansai Rosai Hospital (JP), Michigan Medicine (US), St. Vincent's University Hospital (IE), Sendai Medical Center (JP), Ospedale G.B. Morgagni - L.Pierantoni (IT), Canadian Patient Safety Institute (CA), Eight19 (United Kingdom) (GB), The London College (GB), Hôpital Bichat-Claude-Bernard (FR), Fukujuji Hospital (JP), NHO Kinki Chuo Chest Medical Center (JP), Hospital São Paulo (BR), Austin Health (AU), Imperial College London (GB), Monash University (AU), Erasmus University Rotterdam (NL), University of Bologna (IT)
Openalex Percentile: Top 7%
Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
3.04
DOISourceOpenAlex
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