Ghép phổi: nhiễm trùng, viêm và vi sinh vật học

Takeshi Nakajima1, Vyachesav Palchevsky2, David L. Perkins3, John A. Belperio2, Patricia W. Finn1
1Division of Pulmonary and Critical Medicine, Department of Medicine, University of California, La Jolla, USA
2Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, USA
3Division of Nephrology, Department of Medicine, University of California, San Diego, La Jolla, USA

Tóm tắt

Ghép phổi là lựa chọn điều trị duy nhất cho bệnh nhân mắc các rối loạn phổi ở giai đoạn cuối. Mặc dù có những cải tiến trong kỹ thuật phẫu thuật và liệu pháp ức chế miễn dịch, chức năng của mảnh ghép và khả năng sống sót lâu dài vẫn bị hạn chế bởi sự phát triển của tình trạng thải ghép phổi mạn tính. Trong bài đánh giá này, chúng tôi tập trung vào hội chứng viêm phế quản nhỏ tắc nghẽn (BOS), đó là biểu hiện chính của tình trạng thải ghép phổi mạn tính. Chúng tôi đặc biệt xem xét tác động của nhiễm trùng, một yếu tố nguy cơ cho BOS, cũng như các cytokine/chemokine trong bệnh sinh của BOS, và mối liên hệ tiềm năng giữa vi sinh vật học mảnh ghép và phản ứng miễn dịch có thể trung gian sự phát triển của BOS. Hiểu biết về vi sinh vật học mảnh ghép cùng cách nó liên quan đến các cơ chế bệnh lý của BOS có thể gợi ý những liệu pháp nhắm mục tiêu để cải thiện khả năng sống sót lâu dài sau khi ghép phổi.

Từ khóa

#ghép phổi #thải ghép mạn tính #hội chứng viêm phế quản nhỏ tắc nghẽn #nhiễm trùng #cytokine #vi sinh vật học mảnh ghép

Tài liệu tham khảo

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