Key result
Review details the complex immune mechanisms and crosstalk driving chronic lung allograft dysfunction.
Why the study?
Chronic lung allograft dysfunction remains the primary obstacle to long-term outcomes after lung transplantation, involving complex multifactorial immune processes that require clarification.
This review highlights the complex, multifactorial immune mechanisms, including innate, adaptive, and autoimmune responses, driving chronic lung allograft dysfunction.
Answers are grounded in this paper and cite their sources.
May inform immune-targeted CLAD strategies in lung recipients; leaves open prospective validation of crosstalk mechanisms.
Lung transplantation is the optimal treatment for selected patients with end-stage chronic lung diseases. However, chronic lung allograft dysfunction remains the leading obstacle to improved long-term outcomes. Traditionally, lung allograft rejection has been considered primarily as a manifestation of cellular immune responses. However, in reality, an array of complex, interacting and multifactorial mechanisms contribute to its emergence. Alloimmune-dependent mechanisms, including T-cell-mediated rejection and antibody-mediated rejection, as well as non-alloimmune injuries, have been implicated. Moreover, a role has emerged for autoimmune responses to lung self-antigens in the development of chronic graft injury. The aim of this review is to summarise the immune processes involved in the pathogenesis of chronic lung allograft dysfunction, with advanced insights into the role of innate immune pathways and crosstalk between innate and adaptive immunity, and to identify gaps in current knowledge.
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Bos et al. (2022) conducted a review in Chronic lung allograft dysfunction. Review of immune processes was evaluated. This review summarizes the complex alloimmune, non-alloimmune, and autoimmune mechanisms contributing to chronic lung allograft dysfunction, highlighting innate and adaptive immunity crosstalk.
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