在肺移植中探索急性细胞排斥:来自供体的无细胞DNA分析的见解
Andrea Zajacova1, Majd Alkhouri1, Miray Guney2
1Prague Lung Transplant Program, Department of Pneumology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czechia.
概括
来自捐赠者的无细胞DNA (dd-cfDNA) 显示出对肺移植接受者的监测有前途. 较高的dd-cfDNA水平可能表明急性细胞排斥 (ACR),这表明它有可能作为选工具用于全移植健康.
科学领域:
- 移植免疫学 移植免疫学
- 分子诊断学 分子诊断学
- 发现生物标志物的发现.
背景情况:
- 急性细胞排斥 (ACR) 是肺移植后的常见并发症,缺乏标准化查指南.
- 跨支气管活检的组织学评估是ACR评估的当前标准.
- 源自捐赠者的无细胞DNA (dd-cfDNA) 是用于全移植监测的新型生物标志物.
研究的目的:
- 将组织学评估与dd-cfDNA进行比较,以检测ACR.
- 评估总无细胞DNA (cfDNA),绝对dd-cfDNA和dd-cfDNA百分比在评估全移植健康中的有用性.
主要方法:
- 包括2021年5月至2024年3月的双边肺移植接受者.
- 根据组织学等级≥A2或症状性A1排斥来定义ACR+病例.
- 对照样本来自稳定,未经治疗的A0或A1排斥患者.
主要成果:
- 中位 dd-cfDNA 度在 ACR+ 组 (61.2 cp/mL) 与对照组 (25.8 cp/mL;P=0.04) 中显著更高.
- 两组之间在dd-cfDNA百分比或cfDNA总水平方面没有发现显著差异.
结论:
- 绝对dd-cfDNA度显示,在接受肺移植患者中,有可能排除ACR.
- dd-cfDNA作为查全移植健康的查工具表现有前途.
- 需要进一步的研究来验证临床效用和优化实施.
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