在阿齐思罗米预防时代,淋巴细胞支气管炎的严重程度下降
Jesse Santos1, Steven R Hays1, Jeffrey A Golden1
1San Francisco Department of Medicine, University of California, San Francisco, CA.
Transplantation direct
|August 14, 2023
概括
阿齐思罗米 (AZI) 预防没有减少大气道淋巴细胞炎症 (LB) 或改善肺移植后的存活率. 虽然LB在AZI后下降,但这并没有转化为肺移植接受者的更好的结果.
科学领域:
- 肺部医学 肺部医学
- 移植免疫学 移植免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 大气道淋巴细胞炎症 (LB) 与急性细胞排斥和慢性肺全移植功能障碍 (CLAD) 有关.
- 阿齐思罗米 (AZI) 预防用于减轻呼吸道炎症和预防CLAD,但其疗效不一致.
研究的目的:
- 为了研究AZI预防与下巴减少的关联,改变了支气管支气管洗 (BAL) 免疫细胞概况,并改善了无CLAD存活率.
- 评价AZI预防对肺移植受体体体内本病学LB和BAL白细胞群的影响.
主要方法:
- 在协议化AZI启动之前和之后,从内支气管活检中对LB频率的比较分析.
- 顺序混合模型回归用于LB等级比较和混合效应建模用于BAL白细胞分析.
- 考克斯的比例危险模型来评估AZI对CLAD无存活率的影响,经过对共变量进行调整.
主要成果:
- 与AZI时代相比,在AZI前的时代,较高的LB等级的几率增加了2倍 (P < 0.001).
- 在这两个时代,LB一直与BAL中性嗜好有关.
- 在AZI前和AZI时代之间没有观察到CLAD或死亡风险的显著差异 (HR1.3,P = 0.45).
结论:
- AZI预防与呼吸道炎症的减少有关,尽管这可能是由于直接AZI影响以外的其他因素.
- 在这个队列中,AZI预防没有证明与肺移植接受者中改善的CLAD无生存率的相关性.
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