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Updated: Jun 23, 2025
Author Spotlight: Enhancing Transplantation Research Through MicroCT Angiography in Murine Models
Published on: September 22, 2023
Lung transplantation: Current insights and outcomes
Claudio Napoli1, Giuditta Benincasa2, Alfonso Fiorelli3
1Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", 80138 Naples, Italy; U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Clinical Department of Internal Medicine and Specialistics, University of Campania "L. Vanvitelli,", Naples, Italy.
Predicting lung transplant rejection remains challenging due to limited biomarkers. Donor-derived cell-free DNA and transcriptomics show promise for early diagnosis of acute rejection and chronic lung allograft dysfunction (CLAD).
Area of Science:
- Immunology
- Transplantation Medicine
- Biomarker Discovery
Background:
- Immune-mediated rejection complicates lung transplantation outcomes.
- Chronic lung allograft dysfunction (CLAD) is a leading cause of mortality, necessitating early diagnostic tools.
Purpose of the Study:
- To review novel and existing technologies for identifying immune-mediated rejection mechanisms in lung transplantation.
- To highlight emerging biomarkers for improved precision medicine in lung allograft recipients.
Main Methods:
- Review of omics technologies (genomics, epigenomics, transcriptomics) and bioinformatic platforms.
- Analysis of clinical trial data for biomarker performance.
- Discussion of emerging biomarkers like exosomes, telomere length, DNA methylation, and neutrophil extracellular traps (NETs).
Main Results:
- Genomic biomarkers, particularly donor-derived cell-free DNA in plasma and bronchoalveolar lavage fluid, show diagnostic potential for acute rejection and CLAD phenotypes.
- Transcriptomic analysis led to the Molecular Microscope® Diagnostic System (MMDx) for interpreting molecular signatures in lung biopsies.
- Several other potential biomarkers are under investigation but have not yet entered clinical trials.
Conclusions:
- Omics technologies are crucial for understanding lung allograft rejection pathways and discovering specific biomarkers.
- Donor-derived cell-free DNA and transcriptomic signatures represent promising avenues for early detection and management of lung transplant rejection.
- Further research into novel biomarkers is essential for advancing precision medicine in lung transplantation.
