Innovations in Respiratory Therapy: Addressing Pulmonary Fibrosis with Inhalation Techniques

Abstract

Pulmonary fibrosis (PF) is a debilitating condition with increasing incidence worldwide. Idiopathic pulmonary fibrosis (IPF) is the most common form of PF, characterized by progressive lung scarring and declining lung function. Current oral treatments, such as pirfenidone and nintedanib, have limitations in efficacy, cost, and adverse effects. Inhalation therapy offers a promising alternative by delivering drugs directly to the lungs, reducing systemic side effects and enhancing therapeutic efficiency. This review explores the advantages, challenges, and novel formulations of inhalation therapy for PF. Inhalation devices, including nebulizers, pressurized metered-dose inhalers, and dry powder inhalers, enable targeted drug delivery. However, optimizing particle size, overcoming biological barriers, and mitigating immune responses remain challenges. Novel inhalation formulations, such as agonists/inhibitors of key pathways, nano-sized drug systems, and nanocarrier delivery systems, have shown promising results in preclinical studies. Polymeric nanoparticles, lipid-based nanocarriers, and gene therapy approaches demonstrate enhanced lung deposition, prolonged retention, and improved therapeutic outcomes. Other innovative interventions, such as inhaled gases and extracellular vesicles, also exhibit potential. While further research is needed to translate these findings into clinical practice, inhalation therapy represents a promising frontier in the management of PF, offering hope for improved patient outcomes and quality of life.