心脏移植和生物标志物:关于它们在临床实践中的有用性的综述
L Martini1, G E Mandoli1, M C Pastore1
1Department of Medical Biotechnology, University of Siena, Siena, Italy.
Frontiers in cardiovascular medicine
|February 8, 2024
概括
生物标志物对于检测心脏移植并发症,如RVD和PGD至关重要. 这项研究审查了既有和新的生物标志物,评估它们在治疗心脏移植接受者的临床实用性.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 生物标志物发现发现
背景情况:
- 晚期心力衰竭 (AdvHF) 需要心脏移植 (HTx) 进行最终治疗.
- 诸如右心室功能障碍 (RVD),排斥,心脏全移植血管病变 (CAV) 和初级移植功能障碍 (PGD) 等并发症显著影响HTx预后.
- 早期识别和预防这些并发症对于改善患者的治疗结果至关重要.
研究的目的:
- 审查既有和新生物标志物的潜力,以检测和管理HTx并发症.
- 在日常实践中评估各种生物标志物的临床适用性.
- 突出特定生物标志物与HTx相关问题之间的关联.
主要方法:
- 对心脏移植中使用的生物标志物的综合文献综述.
- 对已确定的生物标志物的分析,包括NT-proBNP,hs-troponins和促炎细胞因子.
- 评估较新的生物标志物,如细胞外囊泡 (EV),捐赠者特异性抗体 (DSA),基因表达特征 (GEP),捐赠者衍生的无细胞DNA (dd-cfDNA),microRNA (miRNA) 和可溶性抑制瘤性2 (sST2).
主要成果:
- 像NT-proBNP和hs-troponins这样的已知生物标志物通常被使用,但有局限性.
- 新兴的生物标志物 (EVs,DSA,GEP,dd-cfDNA,miRNA,sST2) 在识别特定的HTx并发症方面显示出希望.
- 每个生物标志物都与不同的移植后并发症有不同程度的关联.
结论:
- 生物标志物研究对于改善晚期心力衰竭和心脏移植接受者的管理至关重要.
- 一系列生物标志物,从既定到新,可以帮助早期检测和监测HTx并发症.
- 需要进一步验证,以便将这些生物标志物有效地纳入常规临床实践,以改善患者护理.
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