[Environmental exposome and interstitial lung diseases].

Interstitial lung diseases (ILDs) encompass a heterogeneous group of pulmonary disorders whose prevalence is increasing, partly driven by the environmental exposome. Fine particulate matter (PM2.5), air pollutants, bioaerosols, and occupational exposures (such as silica, asbestos, and organic dust) play a major role in the initiation, progression, and exacerbations of ILDs. These agents induce oxidative stress, inflammation, and fibrotic activation. Conditions such as asbestosis, anthracosilicosis, idiopathic pulmonary fibrosis, sarcoidosis, and hypersensitivity pneumonitis illustrate the interaction between individual susceptibility and environmental factors. Infections and the lung microbiome also contribute to pathophysiology and may act as disease triggers in at-risk populations. The exposome concept provides an integrative framework to understand these complex interactions. Despite recent advances, uncertainties remain, particularly regarding the long-term effects of inhaled ultrafine particles.