Markers of Bronchiolitis Obliterans Syndrome after Lung Transplant: Between Old Knowledge and Future Perspective
Dalila Cavallaro,
Marco Guerrieri,
Stefano Cattelan,
Gaia Fabbri,
Sara Croce,
Martina Armati,
David Bennett,
Antonella Fossi,
Luca Voltolini,
Luca Luzzi,
Alberto Salvicchi,
Piero Paladini,
Adriano Peris,
Miriana d’Alessandro,
Paolo Cameli,
Elena Bargagli,
Tuscany Transplant Group,
Laura Bergantini
Affiliations
Dalila Cavallaro
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Marco Guerrieri
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Stefano Cattelan
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Gaia Fabbri
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Sara Croce
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Martina Armati
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
David Bennett
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Antonella Fossi
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Luca Voltolini
Thoracic Surgery Unit, Department of Experimental and Clinical Medicine, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy
Luca Luzzi
Lung Transplant Unit, Department of Medical, Surgical and Neuro Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Alberto Salvicchi
Thoracic Surgery Unit, Department of Experimental and Clinical Medicine, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy
Piero Paladini
Lung Transplant Unit, Department of Medical, Surgical and Neuro Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100 Siena, Italy
Adriano Peris
Organizzazione Toscana Trapianti, Regione Toscana, 50134 Firenze, Italy
Miriana d’Alessandro
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Paolo Cameli
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Elena Bargagli
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Tuscany Transplant Group
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Laura Bergantini
Respiratory Disease and Lung Transplant Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
Bronchiolitis obliterans syndrome (BOS) is the most common form of CLAD and is characterized by airflow limitation and an obstructive spirometric pattern without high-resolution computed tomography (HRCT) evidence of parenchymal opacities. Computed tomography and microCT analysis show abundant small airway obstruction, starting from the fifth generation of airway branching and affecting up to 40–70% of airways. The pathogenesis of BOS remains unclear. It is a multifactorial syndrome that leads to pathological tissue changes and clinical manifestations. Because BOS is associated with the worst long-term survival in LTx patients, many studies are focused on the early identification of BOS. Markers may be useful for diagnosis and for understanding the molecular and immunological mechanisms involved in the onset of BOS. Diagnostic and predictive markers of BOS have also been investigated in various biological materials, such as blood, BAL, lung tissue and extracellular vesicles. The aim of this review was to evaluate the scientific literature on markers of BOS after lung transplant. We performed a systematic review to find all available data on potential prognostic and diagnostic markers of BOS.
