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儿科肺移植的最新进展:探索儿童慢性肺移植功能障碍的机制。

Update on pediatric lung transplantation: mir-ando into the mechanisms of chronic lung allograft dysfunction in children.

机构信息

Stanford Children's Health, Palo Alto, California, USA.

出版信息

Curr Opin Organ Transplant. 2020 Jun;25(3):293-298. doi: 10.1097/MOT.0000000000000763.

Abstract

PURPOSE OF REVIEW

Lung transplantation (LTx) is a worthwhile treatment for children with end-stage lung diseases who have no practicable medical or surgical solutions. But the long-term survival remains the lowest in all solid-organ transplant, with a median survival of 5.7 years, limited by the onset of chronic lung allograft dysfunction (CLAD). This reviews a recent publication in pediatric patients that focuses on translational regulation by microRNA.

RECENT FINDINGS

The mechanisms that cause transplanted lung allografts have been difficult to identify. This review discusses pertinent findings in the first and largest observational prospective study of pediatric lung transplant recipients. The review discusses the relevance of microRNA that distinguish stable patients from those who can be predicted to display graft dysfunction on a molecular panel.

SUMMARY

The article under review detected highly specific and sensitive markers of both acute rejection and CLAD in pediatric LTx recipients. With the use of next-generation sequencing techniques, biomarkers may soon provide the basis for earlier detection of graft function and stimulate development of therapeutic interventions to impact outcomes and survival. The review touches on the relevance of these findings and how future research can build on them.

摘要

目的综述

肺移植(LTx)是治疗终末期肺部疾病患儿的一种有价值的方法,这些患儿没有可行的医疗或手术解决方案。但长期存活率仍然是所有实体器官移植中最低的,中位存活率为 5.7 年,这受到慢性肺移植物功能障碍(CLAD)的限制。这篇综述关注了儿科患者中最近发表的一篇关于 microRNA 翻译调控的文章。

最近的发现

导致移植肺同种异体移植物的机制难以确定。本综述讨论了第一项也是最大规模的儿科肺移植受者前瞻性观察研究中的相关发现。综述讨论了 microRNA 的相关性,这些 microRNA 可以区分稳定患者和那些可以预测在分子面板上显示移植物功能障碍的患者。

总结

综述中提到的文章在儿科 LTx 受者中检测到了急性排斥反应和 CLAD 的高度特异性和敏感性标志物。随着下一代测序技术的应用,生物标志物可能很快为更早地发现移植物功能提供基础,并刺激治疗干预措施的发展,从而影响结果和生存率。该综述还涉及到这些发现的相关性,以及未来的研究如何在此基础上进一步发展。

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