Diagnosis, Pathophysiology and Experimental Models of Chronic Lung Allograft Rejection.
Diagnosis, Pathophysiology and Experimental Models of Chronic Lung Allograft Rejection.
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DOI：
10.1097/tp.0000000000002250
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发表时间：
2018-09
期刊：
影响因子：
6.2
通讯作者：
Kreisel D
中科院分区：
文献类型：
--
作者：
Gauthier JM;Ruiz-Pérez D;Li W;Hachem RR;Puri V;Gelman AE;Kreisel D
慢性排斥反应是现代肺移植的致命弱点，其特征是同种异体移植功能缓慢、渐进性下降。临床上，这表现为梗阻性疾病、限制性疾病或两者的混合体，取决于潜在的病理。慢性排斥反应的两种主要表型包括闭塞性毛细支气管炎综合征和限制性同种异体移植综合征。过去十年的研究表明，这些表型中的每一种都有独特的潜在病理生理机制，这可能需要一种不同的治疗方案来实现最佳控制。从大小动物模型中都获得了对导致慢性排斥反应的错综复杂的同种异体免疫途径的见解，为未来的研究提供了方向。在这篇综述中，我们探讨了慢性排斥的病理特征，从临床和基础科学研究中获得的最新见解，以及慢性肺排斥动物模型的现状。
Chronic rejection is the Achilles’ heel of modern lung transplantation, characterized by a slow, progressive decline in allograft function. Clinically, this manifests as obstructive disease, restrictive disease, or a mixture of the 2 depending on the underlying pathology. The 2 major phenotypes of chronic rejection include bronchiolitis obliterans syndrome and restrictive allograft syndrome. The last decade of research has revealed that each of these phenotypes has a unique underlying pathophysiology which may require a distinct treatment regimen for optimal control. Insights into the intricate alloimmune pathways contributing to chronic rejection have been gained from both large and small animal models, suggesting directions for future research. In this review, we explore the pathological hallmarks of chronic rejection, recent insights gained from both clinical and basic science research, and the current state of animal models of chronic lung rejection.