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Update on the pathophysiology of transfusion-related acute lung injury

Eveline A N Zeeuw van der Laan1, Saskia van der Velden1, Leendert Porcelijn2

  • 1Sanquin Research, Department of Experimental Immunohematology, Amsterdam and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam.

Current Opinion in Hematology
|September 2, 2020
PubMed
Abstract

Insights

Macrophages play a key role in transfusion-related acute lung injury (TRALI) pathogenesis. Targeting macrophage functions offers a promising therapeutic strategy for TRALI, a leading cause of transfusion fatalities.

Area of Science:

  • Immunology
  • Hematology
  • Pulmonary Medicine

Background:

  • Transfusion-related acute lung injury (TRALI) is a significant cause of transfusion-related fatalities.
  • While neutrophils are known contributors, recent research emphasizes the role of macrophages in TRALI pathogenesis.
  • Current therapeutic strategies for TRALI are limited, necessitating exploration of novel treatment targets.

Purpose of the Study:

  • To review recent advances in understanding TRALI pathogenesis.
  • To highlight the critical role of macrophages in TRALI development.
  • To discuss potential therapeutic strategies targeting macrophage functions.

Main Methods:

  • Review of recent scientific literature on TRALI pathogenesis.
  • Analysis of studies investigating the role of macrophages in experimental TRALI models.
  • Examination of findings related to osteopontin (OPN) and M1-polarized macrophages in TRALI.

Main Results:

  • Macrophages contribute to TRALI by releasing osteopontin (OPN), which promotes neutrophil recruitment.
  • Targeting OPN has been shown to prevent TRALI in mouse models.
  • M1-polarized alveolar macrophages are crucial for TRALI induction, and α1-antitrypsin (AAT) can mitigate TRALI by reducing this polarization.

Conclusions:

  • Macrophages, in addition to neutrophils, are key players in TRALI pathogenesis.
  • Targeting the pathogenic functions of macrophages presents a promising therapeutic avenue for TRALI.
  • Further research into macrophage-centric therapies could lead to effective treatments for TRALI.

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