Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Department of Thoracic and Vascular Surgery, University of Antwerp, Wilrijk, Belgium.
Division of Thoracic and Vascular Surgery, University Hospital Antwerp, Edegem, Belgium.
Transplantation. 2023 Feb 1;107(2):341-350. doi: 10.1097/TP.0000000000004270. Epub 2022 Aug 16.
Chronic lung allograft dysfunction (CLAD) remains a major hurdle impairing lung transplant outcome. Parallel to the better clinical identification and characterization of CLAD and CLAD phenotypes, there is an increasing urge to find adequate biomarkers that could assist in the earlier detection and differential diagnosis of CLAD phenotypes, as well as disease prognostication. The current status and state-of-the-art of biomarker research in CLAD will be discussed with a particular focus on radiological biomarkers or biomarkers found in peripheral tissue, bronchoalveolar lavage' and circulating blood' in which significant progress has been made over the last years. Ultimately, although a growing number of biomarkers are currently being embedded in the follow-up of lung transplant patients, it is clear that one size does not fit all. The future of biomarker research probably lies in the rigorous combination of clinical information with findings in tissue, bronchoalveolar lavage' or blood. Only by doing so, the ultimate goal of biomarker research can be achieved, which is the earlier identification of CLAD before its clinical manifestation. This is desperately needed to improve the prognosis of patients with CLAD after lung transplantation.
慢性肺移植功能障碍（CLAD）仍然是影响肺移植效果的主要障碍。随着对 CLAD 和 CLAD 表型更好的临床识别和特征描述，人们越来越迫切地需要找到合适的生物标志物，以帮助更早地发现 CLAD 表型并进行鉴别诊断，以及预测疾病预后。本文将讨论 CLAD 中生物标志物研究的现状和最新进展，特别关注放射学生物标志物或在外周组织、支气管肺泡灌洗液和循环血液中发现的生物标志物，这些标志物在过去几年中取得了显著进展。最终，尽管目前越来越多的生物标志物被纳入肺移植患者的随访中，但很明显，没有一种方法适用于所有情况。生物标志物研究的未来可能在于将临床信息与组织、支气管肺泡灌洗液或血液中的发现严格结合起来。只有这样，才能实现生物标志物研究的最终目标，即在其临床表现之前更早地识别 CLAD。这对于改善肺移植后 CLAD 患者的预后是非常必要的。
