通过冷活检检测到的急性细胞排斥和在肺移植受体中增加的捐赠者衍生的无细胞DNA之间的相关性
Carolin Steinack1,2, Macé M Schuurmans1,2, Silvan M Vesenbeckh1,2
1Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
JHLT open
|January 16, 2026
概括
捐赠者衍生的无细胞DNA (dd-cfDNA) 与肺移植受体的急性细胞排斥 (ACR) 有有限的关联. 需要进一步的研究来确认dd-cfDNA.
科学领域:
- 移植免疫学 移植免疫学
- 发现生物标志物的发现.
- 分子诊断学 分子诊断学
背景情况:
- 急性细胞排斥 (ACR) 是肺移植接受者 (LTR) 的一个主要并发症.
- 目前的诊断方法,如横支气管活检,是侵入性的.
- 作为ACR检测的非侵入性生物标志物,正在研究来自捐赠者的无细胞DNA (dd-cfDNA).
研究的目的:
- 为验证临床血dd-cfDNA测定用于检测LTR中的ACR.
- 评估与冷活检相比,dd-cfDNA的临床实用性.
- 评估dd-cfDNA水平与ACR发生率之间的关联.
主要方法:
- 对接受监视支气管镜检查的LTR进行前性队列研究.
- 使用基于单核酸多态的测定方法测量血dd-cfDNA分数.
- 基于对冷活检 (≥A1) 的病理评估进行的ACR诊断.
主要成果:
- 在39个LTR中的43个样本中,ACR (≥A1) 的发生率为14%.
- 稳定和ACR队列 (0.41%与0.56%,p=0.630) 之间的中位数dd-cfDNA分数没有显著差异.
- 使用≥1%的dd-cfDNA值,ACR的积极预测值为20.0%.
结论:
- dd-cfDNA的分量没有显示出与通过冷活检检测到的ACR发生率的强烈关联.
- dd-cfDNA测定表明ACR的阳性预测值很低.
- 需要进行更大规模的长期随访研究,以进一步评估dd-cfDNA在监测LTR中的作用.
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