Early Identification of Chronic Lung Allograft Dysfunction: The Need of Biomarkers

Frontiers in Immunology

Sophie Brouard²  Richard Danger²  Johanna Claustre³  Adrien Tissot⁴  Antoine Magnan⁵ 

[1] Centre de Recherche en Transplantation et Immunologie (CRTI), INSERM, Université de Nantes, Nantes, France;Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France;Service Hospitalo-Universitaire de Pneumologie – Physiologie, CHU Grenoble Alpes, Grenoble, France;Service de Pneumologie, Institut du Thorax, CHU Nantes, Nantes, France;UMR S 1087 CNRS UMR 6291, Institut du Thorax, CHU Nantes, Université de Nantes, Nantes, France;

关键词: lung transplantation;    chronic lung allograft dysfunction;    BOS;    RAS;    biomarker;    blood;   

DOI  :  10.3389/fimmu.2019.01681

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown