Parkland Memorial Hospital, Dallas, TX, USA.
Division of Cardiology, University of Texas Southwestern Medical Center, 5959 Harry Hines Jr. Blvd, Dallas, TX, 75235, USA.
Curr Heart Fail Rep. 2022 Aug;19(4):236-246. doi: 10.1007/s11897-022-00556-z. Epub 2022 May 21.
Survival outcomes for heart transplant recipients have improved in recent decades, but infection remains a significant cause of morbidity and mortality. In this review, we discuss several biological markers, or biomarkers, that may be used to monitor immunologic status in this patient population.
While modest, data on the utility of immune biomarkers in heart transplant recipients suggest correlation between low level of immune response and increased infection risk. More novel assays, such as the detection of circulating levels of pathogen cell-free DNA in plasma and the use of Torque teno virus load as a surrogate for net state of immunosuppression, have potential to be additional important biomarkers. Biomarker approaches to individualize immunosuppression therapy among heart transplant recipients is a promising area of medicine. However, additional studies are needed to inform the optimal protocol in which to incorporate these biomarkers into clinical practice.
近几十年来,心脏移植受者的生存率有所提高,但感染仍是发病率和死亡率的重要原因。在这篇综述中,我们讨论了一些可能用于监测该患者人群免疫状态的生物标志物。
虽然数据有限,但免疫生物标志物在心脏移植受者中的应用数据表明,免疫反应水平低与感染风险增加之间存在相关性。更新型的检测方法,如检测血浆中循环病原体无细胞 DNA 的水平以及使用扭结瘤病毒载量作为免疫抑制状态的替代指标,有可能成为其他重要的生物标志物。采用生物标志物方法对心脏移植受者进行个体化免疫抑制治疗是一个很有前途的医学领域。然而,需要进一步的研究来确定将这些生物标志物纳入临床实践的最佳方案。