血造干细胞移植 (HSCT) 相关的慢性肺部疾病:一个概述
Arianna Traunero1, Francesca Peri1, Laura Badina2
1Department of Medical, Surgical and Health Sciences, University of Trieste, 34126 Trieste, Italy.
Children (Basel, Switzerland)
|September 28, 2023
概括
造血干细胞移植 (HSCT) 接受者面临着晚发性非传染性肺部并发症 (LONIPC) 的风险. 移植与宿主疾病 (GvHD) 是一个关键的LONIPC,新兴的见解将其病变与肺移植排斥联系起来.
科学领域:
- 肺部医学 肺部医学
- 血液学 血液学 血液学
- 移植手术 移植手术
背景情况:
- 血造干细胞移植 (HSCT) 接受者容易患上肺部疾病,通常具有多个相互作用的病原体机制.
- 由于复杂性和异质性,区分个人对肺部参与的贡献和进行研究是具有挑战性的.
- 慢性肺部表现,称为晚发病的非传染性肺部并发症 (LONIPCs),包括药物毒性,过敏和慢性移植对宿主疾病 (GvHD).
研究的目的:
- 审查HSCT接受者的慢性肺表现,重点关注LONIPCs.
- 突出GvHD在LONIPC中的关键作用,并讨论最近的治疗进展.
- 探索肺GvHD和肺移植排斥之间的共享病原遗传机制的新兴观点.
主要方法:
- 这是一篇意见文章,综合了当前对LONIPC的知识和观点.
- 文献综述侧重于与药物相关的毒性,过敏,慢性肺GvHD和肺移植排斥.
- 讨论研究LONIPC等罕见和异质疾病的挑战.
主要成果:
- 移植与宿主疾病 (GvHD) 是最关键的LONIPC,显著影响发病率和死亡率.
- 移植患者的肺肺排斥与GvHD具有惊人的病原学相似之处.
- 患者稀缺和异质的临床特征使随机对照试验复杂化,导致有限的高质量证据.
结论:
- 劳动者,特别是GvHD,在HSCT接受者中构成重大挑战.
- 认可GvHD和肺移植排斥之间的共享病原体为血液学家和胸部外科医生提供了有前途的见解.
- 有限的证据需要仔细考虑免疫抑制治疗选择,特别是对于儿科患者群体.
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