期刊
FRONTIERS IN IMMUNOLOGY
卷 10, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2019.01681
关键词
lung transplantation; chronic lung allograft dysfunction; BOS; RAS; biomarker; blood; bronchoalveolar lavage fluid
类别
资金
- Vaincre La Mucoviscidose, l'Association Gregory Lemarchal, la Fondation du Souffle
- French Research Ministry, University Hospital Institute (IHU)-European Center for Transplantation and Immunotherapy Services (CESTI)
- DHU Oncogreffe
- French government [ANR-10-IBHU-005, ANR-11-LABX-0016-01]
- Nantes Metropole
- Region Pays de la Loire
- ANR project PRELUD [ANR-18-CE17-0019]
- Marie Sklodowska-Curie fellowship (IF-EF) from the European Union's Horizon 2020 Research and Innovation Programme [706296]
- Fondation du souffle
- Fonds Agir pour les maladies chroniques
- LabEX IGO
- Marie Curie Actions (MSCA) [706296] Funding Source: Marie Curie Actions (MSCA)
A growing number of patients with end-stage lung disease have benefited from lung transplantation (LT). Improvements in organ procurement, surgical techniques and intensive care management have greatly increased short-term graft survival. However, long-term outcomes remain limited, mainly due to the onset of chronic lung allograft dysfunction (CLAD), whose diagnosis is based on permanent loss of lung function after the development of irreversible lung lesions. CLAD is associated with high mortality and morbidity, and its exact physiopathology is still only partially understood. Many researchers and clinicians have searched for CLAD biomarkers to improve diagnosis, to refine the phenotypes associated with differential prognosis and to identify early biological processes that lead to CLAD to enable an early intervention that could modify the inevitable degradation of respiratory function. Donor-specific antibodies are currently the only biomarkers used in routine clinical practice, and their significance for accurately predicting CLAD is still debated. We describe here significant studies that have highlighted potential candidates for reliable and non-invasive biomarkers of CLAD in the fields of imaging and functional monitoring, humoral immunity, cell-mediated immunity, allograft injury, airway remodeling and gene expression. Such biomarkers would improve CLAD prediction and allow differential LT management regarding CLAD risk.
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