Lymphocytic Airway Inflammation in Lung Allografts.
NK cell
T cell
inflammation
lung allograft
lung allograft immunity
lung allograft inflammation
lymphocyte
Journal
Frontiers in immunology
ISSN: 1664-3224
Titre abrégé: Front Immunol
Pays: Switzerland
ID NLM: 101560960
Informations de publication
Date de publication:
2022
2022
Historique:
received:
30
03
2022
accepted:
16
06
2022
entrez:
1
8
2022
pubmed:
2
8
2022
medline:
3
8
2022
Statut:
epublish
Résumé
Lung transplant remains a key therapeutic option for patients with end stage lung disease but short- and long-term survival lag other solid organ transplants. Early ischemia-reperfusion injury in the form of primary graft dysfunction (PGD) and acute cellular rejection are risk factors for chronic lung allograft dysfunction (CLAD), a syndrome of airway and parenchymal fibrosis that is the major barrier to long term survival. An increasing body of research suggests lymphocytic airway inflammation plays a significant role in these important clinical syndromes. Cytotoxic T cells are observed in airway rejection, and transcriptional analysis of airways reveal common cytotoxic gene patterns across solid organ transplant rejection. Natural killer (NK) cells have also been implicated in the early allograft damage response to PGD, acute rejection, cytomegalovirus, and CLAD. This review will examine the roles of lymphocytic airway inflammation across the lifespan of the allograft, including: 1) The contribution of innate lymphocytes to PGD and the impact of PGD on the adaptive immune response. 2) Acute cellular rejection pathologies and the limitations in identifying airway inflammation by transbronchial biopsy. 3) Potentiators of airway inflammation and heterologous immunity, such as respiratory infections, aspiration, and the airway microbiome. 4) Airway contributions to CLAD pathogenesis, including epithelial to mesenchymal transition (EMT), club cell loss, and the evolution from constrictive bronchiolitis to parenchymal fibrosis. 5) Protective mechanisms of fibrosis involving regulatory T cells. In summary, this review will examine our current understanding of the complex interplay between the transplanted airway epithelium, lymphocytic airway infiltration, and rejection pathologies.
Identifiants
pubmed: 35911676
doi: 10.3389/fimmu.2022.908693
pmc: PMC9335886
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
908693Subventions
Organisme : CSRD VA
ID : IK2 CX001034
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI125222
Pays : United States
Organisme : CSRD VA
ID : I01 CX002011
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL151552
Pays : United States
Organisme : BLRD VA
ID : IK2 BX005301
Pays : United States
Informations de copyright
Copyright © 2022 Santos, Calabrese and Greenland.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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