Update on the immunological mechanisms of primary graft dysfunction and chronic lung allograft dysfunction.

IF 1.8 4区 医学 Q3 TRANSPLANTATION Current Opinion in Organ Transplantation Pub Date : 2024-12-01 Epub Date: 2024-10-16 DOI:10.1097/MOT.0000000000001175
Jong Cheol Jeong, Andrew E Gelman, Anita S Chong
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Abstract

Purpose of review: Primary graft dysfunction (PGD) and chronic lung allograft dysfunction (CLAD) are the leading causes of graft loss in lung transplant recipients. The development of mouse lung transplant models has allowed for the genetic dissection of cellular and molecular pathways that prevent graft survival. This review provides an overview into recent mechanistic insights into PGD and CLAD.

Recent findings: Mouse orthotopic lung transplant models and investigations of human lung transplant recipeints have revealed new molecular and cellular targets that promote PGD and CLAD. Donor and recipient-derived innate immune cells promote PGD and CLAD. PGD is driven by communication between classical monocytes and tissue-resident nonclassical monocytes activating alveolar macrophages to release chemokines that recruit neutrophils. Products of cell damage trigger neutrophil NET release, which together with NK cells, antibodies and complement, that further promote PGD. The development of CLAD involves circuits that activate B cells, CD8 + T cells, classical monocytes, and eosinophils.

Summary: Effective targeted management of PGD and CLAD in lung transplant recipient to improve their long-term outcome remains a critical unmet need. Current mechanistic studies and therapeutic studies in mouse models and humans identify new possibilities for prevention and treatment.

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原发性移植物功能障碍和慢性肺异体移植功能障碍的最新免疫学机制。
审查目的:原发性移植物功能障碍(PGD)和慢性肺移植功能障碍(CLAD)是肺移植受者移植物丧失的主要原因。小鼠肺移植模型的开发使人们能够从遗传学角度剖析阻碍移植物存活的细胞和分子途径。本综述概述了最近对PGD和CLAD的机理认识:小鼠正位肺移植模型和人类肺移植配方的研究揭示了促进 PGD 和 CLAD 的新分子和细胞靶点。供体和受体衍生的先天性免疫细胞促进了PGD和CLAD。PGD是由经典单核细胞和组织驻留的非经典单核细胞之间的交流驱动的,这些单核细胞激活肺泡巨噬细胞释放趋化因子,从而招募中性粒细胞。细胞损伤产物触发中性粒细胞 NET 释放,NET 与 NK 细胞、抗体和补体一起进一步促进 PGD。CLAD的发展涉及激活B细胞、CD8+ T细胞、经典单核细胞和嗜酸性粒细胞的回路。摘要:对肺移植受者的PGD和CLAD进行有效的靶向治疗,以改善其长期预后,仍是一项尚未满足的关键需求。目前在小鼠模型和人体中进行的机理研究和治疗研究为预防和治疗提供了新的可能性。
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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
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