描述肺移植后原发性移植物功能障碍不同表型的早期血清生物标志物:系统性范围界定综述

V. Scaravilli, Gloria Turconi, S. Colombo, Amedeo Guzzardella, Marco Bosone, A. Zanella, Lieuwe Bos, Giacomo Grasselli
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摘要

肺移植(LUTX)常常因原发性移植物功能障碍(PGD)而变得复杂。血浆生物标志物具有进行 PGD 表型分析和靶向治疗的潜力。根据 JBI 和 PRISMA 指南,我们按照 ISHLT 指南对 MEDLINE、Web of Science、EMBASE 和 Cochrane 图书馆中报告再灌注 72 小时内测量的血清生物标志物与 PGD 之间关系的论文进行了系统性检索。我们提取了研究细节、患者人口统计学特征、PGD 定义和时间、生物标志物浓度以及它们在鉴别 PGD 病例方面的表现。在筛选出的 1050 篇论文中,共纳入了 25 项前瞻性观察研究,其中只有 9 项研究是在过去十年中进行的。这些论文共纳入了 1793 例成年患者(1195 例双 LUTX,研究规模中位数为 100(IQR 44-119))。大多数研究(21 篇)比较了 3 级 PGD 和较轻的 PGD,但只有 4 篇符合 2016 年的 PGD 定义。分别有23篇和2篇论文采用了酶联免疫吸附测定法和多重微珠阵列技术。总共确定了 26 个候选生物标记物,包括 13 个炎症标记物、3 个内皮激活标记物、3 个上皮损伤标记物、3 个细胞损伤标记物和 2 个凝血失调标记物。只有 5 个生物标记物(sRAGE、ICAM-1、PAI-1、SP-D、FSTL-1)进行了 AUROCC 分析,在 406 例患者(276 例双 LUTX)中得出的中值为 0.58(0.51,0.78)。为了填补现有的知识空白,有必要进一步开展国际前瞻性研究,纳入最新的诊断标准、现代化平台和先进的统计方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early serum biomarkers to characterise different phenotypes of primary graft dysfunction after lung transplantation: a systematic scoping review
Lung transplantation (LUTX) often is complicated by primary graft dysfunction (PGD). Plasma biomarkers hold potential for PGD phenotyping and targeted therapy. This scoping review aims to collect the available literature in search of serum biomarkers for PGD phenotyping.Following JBI and PRISMA guidelines, we conducted a systematic review searching MEDLINE, Web of Science, EMBASE, and The Cochrane Library for papers reporting the association between serum biomarkers measured within 72 h of reperfusion and PGD, following ISHLT guidelines. We extracted study details, patient demographics, PGD definition and timing, biomarker concentration, and their performance in identifying PGD cases.Among the 1050 papers screened, 25 prospective observational studies were included, with only 9 conducted in the last decade. These papers included 1793 unique adult patients (1195 double LUTX, median study size 100 (IQR 44–119). Most (n=21) compared PGD grade 3 to less severe PGD, but only 4 adhered to 2016 PGD definitions. Enzyme-linked immunosorbent assays and the multiplex bead array technique were utilised in 23 and 2 papers, respectively. In total, 26 candidate biomarkers were identified, comprising 13 inflammatory, 3 endothelial activation, 3 epithelial injury, 3 cellular damage, 2 coagulation dysregulation markers. Only 5 biomarkers (sRAGE, ICAM-1, PAI-1, SP-D, FSTL-1) underwent AUROCC analysis, yielding a median value of 0.58 (0.51, 0.78) in 406 patients (276 double LUTX).Several biomarkers exhibit promise for future studies aimed at PGD phenotyping after LUTX. To uncover the significant existing knowledge gaps, further international prospective studies incorporating updated diagnostic criteria, modern platforms, and advanced statistical approaches are essential.
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