History of Lung Diseases: Inflammation & Immune
| Disease Category & Link | Progress, Diagnosis, Treatment, & Notable People |
| Acute Respiratory Distress Syndrome (ARDS) | Progress: This is an acute, severe inflammatory reaction of the entire lung, not a specific disease. It was first described in 1967 by Dr. David Ashbaugh and Dr. Thomas Petty. They identified 12 patients with severe, unexplained breathing failure (hypoxemia), stiff lungs, and fluid-filled lungs.
Diagnosis & Imaging: Imaging is central to the diagnosis. X-ray: The 1967 paper relied on chest X-rays, which showed diffuse, bilateral, “fluffy” infiltrates that looked like pulmonary edema (fluid) but without the enlarged heart seen in heart failure. This “whiteout” lung became the classic sign. CT Scan: The major leap in understanding came with CT in the 1980s. Dr. Luciano Gattinoni showed that the ARDS lung is not uniformly sick. He described the “baby lung” concept—a small, relatively healthy (aerated) portion of the lung, with the majority of the lung being collapsed and fluid-filled (dependent). This discovery, made possible by CT, revolutionized mechanical ventilation, leading to the low tidal volume strategy (ARDSNet) that protects the “baby lung” and saves lives. Treatment: Supportive care with mechanical ventilation, treating the underlying cause, and prone-positioning (lying the patient on their stomach). |
| Pneumoconiosis (Silicosis, CWP) | Progress: An occupational ILD caused by inhaling inorganic dust (silica, coal). Pliny the Elder (1st cent. AD) and Bernardino Ramazzini (1700) described diseases of miners. The link became undeniable during the Industrial Revolution.
Diagnosis & Imaging: Diagnosis is based on exposure history and imaging.
Treatment: None exists. Management is purely preventative (dust control). |
| Asbestosis (and Pleural Disease) | Progress: An ILD caused by inhaling asbestos fibers. The link was established in the 1920s (Nellie Kershaw case). Dr. Irving Selikoff‘s work in the 1960s on insulation workers proved the definitive link between asbestos, asbestosis, lung cancer, and mesothelioma.
Diagnosis & Imaging: Imaging is key to distinguishing it from other lung diseases.
Treatment: None. Supportive care and oxygen. |
| Idiopathic Pulmonary Fibrosis (IPF) / ILD | Progress: A devastating chronic, progressive lung-scarring disease of unknown cause. First described as a specific entity (“Hamman-Rich Syndrome”) in 1935 by Louis Hamman and Arnold Rich. The term ILD (Interstitial Lung Disease) now covers over 200 related conditions, including those caused by autoimmune diseases (like Rheumatoid Arthritis, Scleroderma).
Diagnosis & Imaging: This is a field defined by imaging.
Treatment: For decades, there was no treatment. The 2010s saw the first-ever effective drugs (Pirfenidone, Nintedanib), which are anti-fibrotics that slow the scarring process. |
| Sarcoidosis | Progress: An immune-mediated disease where the body forms tiny clusters of inflammatory cells (granulomas) in various organs, most commonly the lungs and lymph nodes. Caesar Boeck (1899) described the skin lesions. Its nature as a systemic lung disease was understood by the mid-20th century.
Diagnosis & Imaging: The diagnosis is almost entirely driven by imaging.
Treatment: Often resolves on its own. For symptomatic disease, the mainstay has been corticosteroids (like Prednisone) for decades. |
1. Notables Who Advanced Diagnosis & Management of Inflammation & Immune Diseases of the Lung
| Name & Wikipedia Link | Comment on Contribution |
| David Ashbaugh & Thomas Petty | In 1967, these two physicians co-authored the first description of what we now call ARDS (Acute Respiratory Distress Syndrome). They identified 12 patients with severe, unexplained respiratory failure, establishing its key diagnostic criteria. |
| Luciano Gattinoni | An Italian intensivist whose CT scan research in the 1980s revolutionized ARDS management. He developed the “baby lung” concept, showing that only a small part of the lung is functional, which led directly to the life-saving low tidal volume ventilation strategy. |
| Irving J. Selikoff | (1914–1992) A pioneer in occupational medicine. His research on insulation workers in the 1960s provided the definitive, undeniable link between asbestos exposure and the development of asbestosis, lung cancer, and mesothelioma. |
| Bernardino Ramazzini | (1633–1714) Considered the “father of occupational medicine.” In his 1700 book De Morbis Artificum Diatriba (Diseases of Workers), he described the lung diseases of miners, linking their “scanty breathing” to the inhalation of dust (pneumoconiosis). |
| Louis Hamman & Arnold Rich | (1877–1946) & (1893–1968) In 1935, these two Johns Hopkins physicians described “Hamman-Rich Syndrome,” a rapidly fatal, acute interstitial pneumonia. This was the first description of what we now classify as AIP and helped define the category of IPF/ILD. |
2. Notables Who Suffered From Pulmonary Inflammation & Immune Disease
| Name & Wikipedia Link | Comment on Disease |
| Steve McQueen | (1930–1980) The iconic “King of Cool” actor died from malignant mesothelioma. He believed his cancer was caused by exposure to asbestos in the U.S. Marines (removing lagging from pipes) and from his racing suit insulation. |
| Bernie Mac | (1957–2008) The comedian and actor suffered from sarcoidosis, an inflammatory granulomatous disease that primarily affected his lungs. His death was ultimately caused by complications from pneumonia, but his long-standing, immunosuppressed sarcoidosis was a critical factor. |
| Evel Knievel | (1938–2007) The legendary stunt performer suffered from idiopathic pulmonary fibrosis (IPF) for many years, a disease he believed was caused by his numerous high-impact crashes. He required continuous oxygen therapy and received a lung transplant in 1999. |
| Marlon Brando | (1924–2004) The Academy Award-winning actor died from respiratory failure due to pulmonary fibrosis. He also suffered from congestive heart failure, and the lung disease was a major contributor to his death. |
| Peter Benchley | (1940–2006) The author of the novel Jaws died from pulmonary fibrosis. He became a dedicated ocean conservationist later in life, ironically working to protect the sharks he had once demonized. |
| Bernie Banton | (1946–2007) An Australian social justice advocate who became the public face of the legal battle against asbestos manufacturer James Hardie. He suffered from and died of mesothelioma, having previously been diagnosed with asbestosis. |