肺移植后的急性排斥 肺移植后的急性排斥
Justin Hanks1, Christine Girard, Sameep Sehgal
1Department of Pulmonary Medicine, Integrated Hospital Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Current opinion in pulmonary medicine
|April 24, 2024
概括
肺移植中的急性排斥 (AR) 影响了移植功能和慢性排斥风险. 虽然基因病理学是关键的,但新的分子方法显示了早期AR检测和诊断的前景.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
- 肺部病理学 肺部病理学
背景情况:
- 急性排斥 (AR) 是早期肺移植功能障碍的主要原因.
- AR增加了发展慢性肺异位移植功能障碍的风险.
- AR呈现为急性细胞排斥 (ACR) 或抗体介导排斥 (AMR),或两者兼而有之.
研究的目的:
- 审查目前关于肺移植急性排斥 (AR) 的知识.
- 涵盖AR的发病,诊断,治疗和预防.
- 为突出AR的新兴诊断工具.
主要方法:
- 关于肺移植和AR的当前文献的综述.
- 对ACR和AMR的诊断标准的分析.
- 对ACR和AMR的治疗策略的检查.
主要成果:
- 胰腺病理学仍然是AR诊断的黄金标准.
- 对于早期AR检测,正在出现表观基因组和转录基因组方法.
- ACR诊断依赖于横支气管活检;AMR需要对供体特异性抗体 (DSA) 进行测量.
- ACR治疗涉及加强免疫抑制;AMR治疗侧重于消除DSA.
结论:
- 早期发现和准确诊断AR对于肺移植结果至关重要.
- 非侵入性分子诊断正在调查中,以补充组织病理学.
- 针对ACR和AMR的量身定制的治疗策略对于管理肺异位移植排斥至关重要.
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