Review of Current and Emerging Antifibrotic Therapy for Asbestosis and Silicosis

Asbestosis and silicosis are progressive occupational lung diseases driven by asbestos fiber and respirable crystalline silica inhalation, resulting in chronic inflammation and irreversible pulmonary fibrosis. While prevention and early diagnosis remain paramount due to the lack of curative options, current supportive therapies offer limited efficacy. This review examines their pathogenesis, immune mechanisms, and management strategies, with emphasis on antifibrotic agents like pirfenidone and nintedanib, alongside emerging therapies such as PDE4B inhibitors (e.g., nerandomilast) and stem cell approaches. Recent clinical data suggest slowed fibrosis progression, but occupational-specific RCTs are needed to optimize safety, efficacy, and biomarkers in high-risk cohorts like construction workers.