Hamilton B C S, Kukreja J, Ware L B, Matthay M A
Department of Surgery, University of California San Francisco, San Francisco, California;
Department of Surgery, University of California San Francisco, San Francisco, California.
Am J Physiol Lung Cell Mol Physiol. 2017 Apr 1;312(4):L531-L541. doi: 10.1152/ajplung.00454.2016. Epub 2017 Jan 27.
Severe primary graft dysfunction affects 15-20% of lung transplant recipients and carries a high mortality risk. In addition to known donor, recipient, and perioperative clinical risk factors, numerous biologic factors are thought to contribute to primary graft dysfunction. Our current understanding of the pathogenesis of lung injury and primary graft dysfunction emphasizes multiple pathways leading to lung endothelial and epithelial injury. Protein biomarkers specific to these pathways can be measured in the plasma, bronchoalveolar lavage fluid, and lung tissue. Clarification of the pathophysiology and timing of primary graft dysfunction could illuminate predictors of dysfunction, allowing for better risk stratification, earlier identification of susceptible recipients, and development of targeted therapies. Here, we review much of what has been learned about the association of protein biomarkers with primary graft dysfunction and evaluate this association at different measurement time points.
严重原发性移植肺功能障碍影响15%至20%的肺移植受者，且具有很高的死亡风险。除了已知的供体、受体及围手术期临床风险因素外，众多生物学因素也被认为与原发性移植肺功能障碍有关。我们目前对肺损伤及原发性移植肺功能障碍发病机制的理解强调了导致肺内皮和上皮损伤的多种途径。这些途径特有的蛋白质生物标志物可在血浆、支气管肺泡灌洗液及肺组织中检测到。阐明原发性移植肺功能障碍的病理生理学及发生时间，可能会揭示功能障碍的预测指标，从而实现更好的风险分层、更早识别易感受者以及开发靶向治疗方法。在此，我们回顾了关于蛋白质生物标志物与原发性移植肺功能障碍之间关联的诸多研究，并在不同测量时间点评估这种关联。
