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LAM is another small airway disease: lessons from microCT

Among interstitial lung diseases, the presence of cysts is a characteristic of lymphangioleiomyotosis (LAM). Insight was gained thanks to genetic studies which unravelled the involvement of the tuberous sclerosis complex (TSC)-mTOR pathway. Accordingly, both sirolimus (an mTOR inhibitor) and everolimus (an inducer of autophagic flux) gained approval in the treatment of LAM [1]. Now the question is how and when these drugs should be best initiated. In a way very similar to what currently stands in COPD, the earliest looks the best. Intuitively, the main issue is then to justify what would be the most appropriate outcome to improve and/or to prevent. Understanding the natural history of the disease would then allow for early interventions based on early events. MicroCT should become routine part of pathology when assessing lung samples https://bit.ly/2XYTYoq