University of Groningen, University Medical Centre Groningen, Department of Pulmonary Medicine, PO Box 30. 001, 9700, RB, Groningen, the Netherlands.
University of Groningen, Department of Molecular Pharmacology, Groningen Research Institute of Pharmacy, PO box 196, 9700, AD, Groningen, the Netherlands; University of Groningen, University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, the Netherlands.
Transplant Rev (Orlando). 2021 Jul;35(3):100626. doi: 10.1016/j.trre.2021.100626. Epub 2021 May 4.
Chronic lung allograft dysfunction (CLAD) is the major long-term cause of morbidity and mortality after lung transplantation. Both bronchiolitis obliterans syndrome and restrictive lung allograft syndrome, two main types of CLAD, lead to fibrosis in either the small airways or alveoli and pleura. Pathological pathways in CLAD and other types of fibrosis, for example idiopathic pulmonary fibrosis, are assumed to overlap and therefore fibrosis biomarkers could aid in the early detection of CLAD. These biomarkers could help to differentiate between different phenotypes of CLAD and could, in comparison to biomarkers of inflammation, possibly distinguish an infectious event from CLAD when a decline in lung function is present. This review gives an overview of known CLAD specific biomarkers, describes new promising fibrosis biomarkers currently investigated in other types of fibrosis, and discusses the possible use of these fibrosis biomarkers for CLAD.
慢性肺移植物功能障碍（CLAD）是肺移植后发病率和死亡率的主要长期原因。两种主要类型的 CLAD，闭塞性细支气管炎综合征和限制性肺移植物综合征，导致小气道或肺泡和胸膜中的纤维化。CLAD 和其他类型的纤维化（例如特发性肺纤维化）的病理途径被认为是重叠的，因此纤维化生物标志物可以帮助早期发现 CLAD。这些生物标志物可以帮助区分 CLAD 的不同表型，并且与炎症标志物相比，当肺功能下降时，它们可能可以将感染事件与 CLAD 区分开来。本综述概述了已知的 CLAD 特异性生物标志物，描述了目前在其他类型的纤维化中研究的新的有前途的纤维化生物标志物，并讨论了这些纤维化生物标志物在 CLAD 中的可能用途。
