Key result
Biomarkers in bronchial alveolar lavage and peripheral blood offer an appealing alternative to lung biopsy for early prediction and phenotyping of chronic lung allograft dysfunction.
Why the study?
Chronic lung allograft dysfunction (CLAD) limits long-term survival after lung transplantation, but diagnosis via pulmonary function tests requires significant lung injury, driving the need for early biomarker-based recognition.
Do biomarkers in BAL and peripheral blood aid in predicting and phenotyping chronic lung allograft dysfunction in lung transplant recipients?
Do biomarkers in BAL and peripheral blood aid in predicting and phenotyping chronic lung allograft dysfunction in lung transplant recipients?
Biomarkers in BAL and peripheral blood may enable early detection and phenotyping of chronic lung allograft dysfunction, potentially guiding preventive and early intervention strategies in lung transplant recipients.
May support noninvasive CLAD monitoring in lung transplant recipients; leaves open clinical utility pending prospective validation.
Introduction: Lung transplantation remains an important treatment for patients with end stage lung disease. Chronic lung allograft dysfunction (CLAD) remains the greatest limiting factor for long term survival. As the diagnosis of CLAD is based on pulmonary function tests, significant lung injury is required before a diagnosis is feasible, likely when irreversible damage has already occurred. Therefore, research is ongoing for early CLAD recognition, with biomarkers making up a substantial amount of this research.Areas covered: The purpose of this review is to describe available biomarkers, focusing on those which aid in predicting CLAD and distinguishing between different CLAD phenotypes. We describe biomarkers presenting in bronchial alveolar lavage (BAL) as well as circulating in peripheral blood, both of which offer an appealing alternative to lung biopsy.Expert opinion: Development of CLAD involves complex, multiple immune and nonimmune mechanisms. Therefore, evaluation of potential CLAD biomarkers serves a dual purpose: clinically, the goal remains early detection and identification of patients at increased risk. Simultaneously, biomarkers offer insight into the different mechanisms involved in the pathophysiology of CLAD, leading to the development of possible interventions. The ultimate goal is the development of both preventive and early intervention strategies for CLAD to improve the overall survival of our lung transplant recipients.
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Shtraichman et al. (2020) conducted a review in Chronic lung allograft dysfunction (CLAD). Biomarkers was evaluated. Biomarkers in bronchial alveolar lavage and peripheral blood offer an appealing alternative to lung biopsy for early prediction and phenotyping of chronic lung allograft dysfunction.
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