Abstract
PURPOSE OF REVIEW: Interstitial lung disease (ILD) presents significant diagnostic and therapeutic challenges due to underlying biological heterogeneity and variable clinical course. Traditional diagnostic and prognostic tools are limited in their ability to capture this heterogeneity or guide personalized treatment. Advances in biological phenotyping have set the stage for precision medicine in ILD, improving diagnosis, prognosis, and therapeutic decision-making in ILD. This review highlights recent advances in biological phenotyping technologies and their potential to reshape ILD care. RECENT FINDINGS: Emerging evidence supports the use of genomic, transcriptomic, and proteomic, and metabolomic biomarkers to identify distinct ILD subgroups with prognostic or therapeutic relevance. Several biomarkers are being evaluated prospectively, including TOLLIP genotype and eNose technology. Machine learning enables the integration of high-dimensional multiomics data, offering insights beyond what single biomarkers can provide. SUMMARY: Precision medicine in ILD is advancing rapidly and holds promise for more individualized care. Future efforts should prioritize multimodal integration, prospective validation across diverse ILD subtypes, and translating research into clinical practice. Continued innovation and collaboration will be essential to fully realize the potential of precision medicine in transforming ILD care and research.