Silicosis future or investigational therapies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aparna Vuppala, M.B.B.S. [2]

Overview

Silicosis is an irreversible condition. Treatment options currently focus on alleviating the symptoms and preventing complications.

Experimental treatments include

In chronic silicosis with COPD flare up, prednisolone has been used and this resulted in statistically (although not clinically) significant improvements in lung volumes, carbon monoxide diffusing capacity, and partial pressure of arterial oxygen^[1]

Tamoxifen citrate, a selective estrogen receptor modulator used for the treatment of breast cancer , inhibits the production of transforming growth factor-beta (TGF-β). TGF-β has important roles in the formation of fibrosis such as the modulation of inflammation, wound repair, and immunity by decreasing lymphocyte proliferation and encouraging growth of fibroblasts. Studies about the possible effects of tamoxifen on progression, prevention, and treatment of the fibrotic pulmonary silicosis disease considering the anti-fibrotic effect shown in aforementioned studies^[2]

Whole-lung lavage can be done based on the similarity of acute silicosis and pulmonary alveolar proteinosis, although clinical utility is not very clear^[3]

↑ Sharma SK, Pande JN, Verma K (1991). “Effect of prednisolone treatment in chronic silicosis”. Am Rev Respir Dis. 143 (4 Pt 1): 814–21. doi:10.1164/ajrccm/143.4_Pt_1.814. PMID 2008993.
↑ Yoldas O, Karaca T, Bilgin BC, Yilmaz OH, Simsek GG, Alici IO; et al. (2015). “Tamoxifen citrate: a glimmer of hope for silicosis”. J Surg Res. 193 (1): 429–34. doi:10.1016/j.jss.2014.08.013. PMID 25218282.
↑ Stafford M, Cappa A, Weyant M, Lara A, Ellis J, Weitzel NS; et al. (2013). “Treatment of acute silicoproteinosis by whole-lung lavage”. Semin Cardiothorac Vasc Anesth. 17 (2): 152–9. doi:10.1177/1089253213486524. PMID 23632425.