肺部微生物组与慢性移植肺功能障碍关联的研究进展

Research progress on the association between lung microbiome and chronic lung allograft dysfunction

摘要

慢性移植肺功能障碍（CLAD）是肺移植术后常见并发症，严重影响患者的长期存活，且目前仍缺乏有效的治疗手段。肺部微生物组的紊乱是多种肺部疾病的发病因素，多项研究表明肺移植术后肺部微生物组的构成特征与 CLAD 存在关联。因此，本文就 CLAD的定义、肺部微生物组特征、肺部微生物组对 CLAD 发生发展的影响、肺部微生物组在 CLAD 发生中的潜在机制以及基于肺部微生物组的 CLAD 干预策略等方面进行综述，以期为肺移植术后 CLAD 的预防和治疗提供新思路，从而改善肺移植受者预后。

Abstract

Chronic lung allograft dysfunction (CLAD) is a common complication after lung transplantation, which severely impairs the long-term survival of patients. At present, effective therapeutic approaches remain lacking. Dysregulation of the lung microbiome acts as a pathogenic factor for a variety of pulmonary diseases. Accumulating studies have demonstrated that the compositional characteristics of the lung microbiome after lung transplantation are closely associated with CLAD. Therefore, this article reviews the definition of CLAD, characteristics of the lung microbiome, the influence of the lung microbiome on the occurrence and progression of CLAD, the potential mechanisms underlying the lung microbiome in the pathogenesis of CLAD, and microbiome-based intervention strategies for CLAD. It aims to provide novel insights for the prevention and treatment of CLAD following lung transplantation and further improve the prognosis of lung transplant recipients.

关键词

肺移植 / 慢性移植肺功能障碍 / 微生物组 / 细菌负荷 / 闭塞性细支气管炎综合征 / 限制性同种异体移植综合征 / 上皮-间充质转化

Key words

Lung transplantation / Chronic lung allograft dysfunction / Microbiome / Bacterial burden / Bronchiolitis obliterans syndrome / Restrictive allograft syndrome / Epithelial-mesenchymal transition

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基金资助

国家重点研发计划“常见多发病防治研究”重点专项(2023YFC2507105)

江苏省科技计划重点研究项目(BE2022697)