Immune endotypes and disease trajectories in autoimmune disease-associated interstitial lung disease

Interstitial lung disease (ILD) represents one of the most severe and clinically impactful manifestations of systemic autoimmune diseases, contributing significantly to morbidity and mortality. Despite being classified within shared diagnostic frameworks, autoimmune disease-associated ILD (AISD-ILD) encompasses a wide spectrum of pulmonary phenotypes, ranging from predominantly inflammatory patterns to progressive fibrosing disease. Current approaches largely rely on disease classification, imaging patterns, and functional impairment; however, these frameworks often fail to explain the marked inter-individual variability in clinical behaviour and outcomes. Increasing evidence suggests that immune dysregulation at both systemic and tissue levels plays a central role in shaping lung involvement, yet the mechanisms underlying this heterogeneity remain incompletely understood.This Research Topic aims to bridge the gap between descriptive phenotyping and a more mechanistic understanding of disease evolution in AISD-ILD. In particular, it will focus on identifying immune endotypes and patterns of disease evolution that may underlie divergent clinical courses, including stable disease, fluctuating inflammatory activity, and progressive fibrosing phenotypes.Recent advances in immunophenotyping, imaging, and clinical cohort studies have highlighted the importance of integrating systemic immune features with organ-specific processes, including tissue-resident immune responses and immune–stromal interactions. However, these insights have not yet been fully translated into clinically meaningful frameworks for patient stratification and outcome prediction.By prioritizing studies that explore disease evolution, heterogeneity, and progression, this Research Topic seeks to provide a more dynamic understanding of AISD-ILD. Ultimately, the goal is to support the development of more precise, mechanism-informed approaches to risk stratification and therapeutic decision-making in immune-mediated lung disease.We welcome the submission of Original Research, Review, Mini Review, and Perspective articles on themes including, but not limited to:• Immune endotypes associated with distinct clinical and radiological patterns in AISD-ILD • Mechanisms underlying progression from inflammation to fibrosis in autoimmune lung disease • Biomarkers associated with disease evolution, progression, and long-term outcomes • Imaging approaches as surrogates of immune activity and fibrotic progression • Integration of immunological, radiological, and clinical data • Organ-specific immune responses and immune–stromal interactions in lung involvement • Comparative approaches across autoimmune diseases to identify shared and distinct pathways of lung damage Particular emphasis will be given to studies that integrate immunological insights with clinical, imaging, or outcome data, and that contribute to a dynamic understanding of disease evolution. Topic editors: Gaetano La Rocca, Marco Sebastiani, Elisabetta Zanatta, Belén Atienza-Mateo Source: https://www.frontiersin.org/research-topics/79941/immune-endotypes-and-disease-trajectories-in-autoimmune-disease-associated-interstitial-lung-disease