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Lung transplantation: infection, inflammation, and the microbiome

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Abstract

Lung transplantation is the only therapeutic option for patients with end-stage pulmonary disorders. Despite the improvements in surgical techniques and immunosuppressive therapy, allograft function and long-term survival are limited by the development of chronic lung transplant rejection. In this review, we focus on bronchiolitis obliterans syndrome (BOS) which is the major manifestation of chronic lung allograft rejection. We specifically review the effect of infection, a risk factor for BOS, cytokines/chemokines in the pathogenesis of BOS, and the potential link between the allograft microbiome and immune responses that may mediate the development of BOS. Understanding the allograft microbiome and how it relates to the pathologic mechanisms of BOS may suggest targeted therapies to improve long-term survival post-lung transplantation.

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Acknowledgments

We thank Ko-Wei Lin PhD for a critical review of the manuscript. This work was supported by R01-HL077900 and R01-AI075317.

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Authors and Affiliations

  1. Division of Pulmonary and Critical Medicine, Department of Medicine, University of California, 9500 Gilman Drive 0643, La Jolla, CA, 92093, USA

    Takeshi Nakajima & Patricia W. Finn

  2. Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Internal Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Vyachesav Palchevsky & John A. Belperio

  3. Division of Nephrology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA

    David L. Perkins

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  1. Takeshi Nakajima
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  2. Vyachesav Palchevsky
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Correspondence to Patricia W. Finn.

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This article is published as part of the Special Issue on Transplantation and Tolerance.

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Nakajima, T., Palchevsky, V., Perkins, D.L. et al. Lung transplantation: infection, inflammation, and the microbiome. Semin Immunopathol 33, 135–156 (2011). https://doi.org/10.1007/s00281-011-0249-9

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