The milky (path)way of proteinosis: has the time come

Abstract

After having read the paper by Borie et al. [1] in this issue of European Respiratory Review , I decided not to write a classic scientific editorial. It is often difficult to write an editorial comment for a review article, and in this case even more so since the paper by Borie et al. [1] is one of the most comprehensive and up-to-date reviews on pulmonary alveolar proteinosis (PAP) since the milestone article of Seymour and Presneill [2]. What could I add or how would I comment on the achievement that lung biopsy is now no longer required to diagnose typical forms of autoimmune PAP? Or that the passive transfer of human granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies (GMAbs) to monkeys reproduces features typical of PAP, thus, supporting the pathogenic role of GMAbs [3]? Or that several surfactant-associated genes and proteins may be involved not only in proteinosis, but also in other forms of interstitial lung diseases [4]? Beyond the intrinsic value of the scientific information, the review by Borie et al. [1] also has the …