Division of Pulmonary and Critical Medicine, Department of Medicine, University of California, La Jolla, CA 92093, USA.
Semin Immunopathol. 2011 Mar;33(2):135-56. doi: 10.1007/s00281-011-0249-9. Epub 2011 Jan 27.
Lung transplantation is the only therapeutic option for patients with end-stage pulmonary disorders. Despite the improvements in surgical techniques and immunosuppressive therapy, allograft function and long-term survival are limited by the development of chronic lung transplant rejection. In this review, we focus on bronchiolitis obliterans syndrome (BOS) which is the major manifestation of chronic lung allograft rejection. We specifically review the effect of infection, a risk factor for BOS, cytokines/chemokines in the pathogenesis of BOS, and the potential link between the allograft microbiome and immune responses that may mediate the development of BOS. Understanding the allograft microbiome and how it relates to the pathologic mechanisms of BOS may suggest targeted therapies to improve long-term survival post-lung transplantation.
肺移植是终末期肺部疾病患者的唯一治疗选择。尽管手术技术和免疫抑制治疗有所改善，但同种异体移植物功能和长期存活率仍受到慢性肺移植排斥反应的发展限制。在这篇综述中，我们重点关注闭塞性细支气管炎综合征（BOS），它是慢性肺同种异体移植排斥的主要表现。我们特别回顾了感染的作用，感染是 BOS 的一个危险因素，BOS 发病机制中的细胞因子/趋化因子，以及同种异体微生物组与可能介导 BOS 发展的免疫反应之间的潜在联系。了解同种异体微生物组及其与 BOS 病理机制的关系，可能提示靶向治疗以改善肺移植后的长期存活率。
