早期的血清生物标志物来表征肺移植后不同类型的原发性移植功能障碍:一个系统的范围审查
Vittorio Scaravilli1,2, Gloria Turconi3, Sebastiano Maria Colombo1
1Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
ERJ open research
|August 6, 2024
概括
这次审查确定了26个肺移植 (LUTX) 后初级移植功能障碍 (PGD) 的血清生物标志物. 很少有生物标志物显示出诊断潜力,突出显示了对PGD表型的进一步研究的需要.
科学领域:
- 生物标志物和移植免疫学
- 肺部医学和重症监护
- 在器官移植的翻译研究.
背景情况:
- 主要移植功能障碍 (PGD) 是肺移植 (LUTX) 后的一个主要并发症.
- 血清生物标志物为PGD表型化和指导向治疗提供了潜在的潜力.
- 本范围审查系统地评估了关于PGD血清生物标志物的现有文献.
研究的目的:
- 对LUTX后与PGD相关的血清生物标志物进行全面的范围审查.
- 为了确定PGD表型化候选生物标志物.
- 评估当前的研究状况,并识别知识缺口.
主要方法:
- 按照JBI和PRISMA指南进行系统审查.
- 搜索了MEDLINE,科学网,EMBASE和科克兰图书馆.
- 包括25项前性观察性研究,涉及1793名接受LUTX的成年患者.
主要成果:
- 确定了26个候选血清生物标志物,分为炎症,内皮,上皮,细胞损伤和凝血标志物.
- 只有五种生物标志物 (sRAGE,ICAM-1,PAI-1,SP-D,FSTL-1) 进行了ROC分析,其中位数AUC为0.58.
- 大多数研究 (21/25) 将PGD 3级与不太严重的PGD进行比较,但只有四项使用了更新的2016年PGD定义.
结论:
- 几种血清生物标志物对LUTX后的未来PGD表型研究显示出希望.
- 关于PGD生物标志物的实用性,存在重大知识差距.
- 以更新的标准和先进的方法进行进一步的国际前性研究对于推进PGD研究至关重要.
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