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Semin Immunopathol. 2011 Mar;33(2):135-56. doi: 10.1007/s00281-011-0249-9. Epub 2011 Jan 27.

Lung transplantation: infection, inflammation, and the microbiome.

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Division of Pulmonary and Critical Medicine, Department of Medicine, University of California, La Jolla, CA 92093, USA.


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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