The impact of the EVLP on the lung microbiome and its inflammatory reaction
The Role of the Pulmonary Microbiome in Respiratory Health and Diseases
The pulmonary microbiome has emerged as a significant factor in respiratory health and diseases. Despite the sterile conditions maintained during ex vivo lung perfusion (EVLP), the use of antibiotics in the perfuse liquid can lead to dynamic changes in the lung microbiome.
Study Design: Investigating EVLP’s Impact on the Lung Microbiome
Here, we present the design of a study that aims to investigate the hypothesis that EVLP alters the lung microbiome and induces tissue inflammation.
This pilot, prospective, controlled study will be conducted in two Spanish donor centers and will include seven organ donors after brain death or after controlled cardiac death. After standardized retrieval, the left lung will be preserved in cold storage and the right lung will be perfused with EVLP.
Samples from bronchoalveolar lavage, perfusion and preservation solutions, and lung biopsies will be collected from both lungs and changes in lung microbiome and inflammatory response will be compared.
Lung transplantation (LTx) is the ultimate treatment option for patients suffering from several end-stage pulmonary diseases
Despite efforts to optimize results, primary graft dysfunction (PGD) is one of the most serious and common complications of LTx. PGD is an inflammatory pulmonary response that occurs due to ischemic-reperfusion damage.
It is associated with both early mortality and long-term outcomes, including chronic lung allograft dysfunction and late mortality.
The lungs harbor a diverse community of microbes, collectively known as the pulmonary microbiome. This microbial ecosystem, intricately intertwined with the local immune landscape, exerts a profound influence on pulmonary homeostasis and inflammatory responses.
Alterations of the microbial composition and diversity of the pulmonary microbiome (dysbiosis) have been associated with aberrant immune activation and sustained inflammation, contributing to the pathogenesis of acute and chronic respiratory disorders.
Is EVLP a platform for pre-transplant organ assessment, optimization, and repair?
Ex vivo lung perfusion (EVLP) offers a platform for pre-transplant organ assessment, optimization, and repair. It provides the opportunity to evaluate marginal donor lungs, mitigate ischemia-reperfusion injury, and even rehabilitate injured or rejected lungs deemed unsuitable for transplantation under static conditions.
In summary
This will be the first study designed to analyze the impact of EVLP on the lung microbiome and the local inflammatory response. Understanding the composition, diversity, and functional interactions of the pulmonary microbiome in lung transplants holds promise for personalized respiratory medicine.
Authors
Grando L, Boada M, Faner R, Gómez-Ollés S, Ruiz V, Bohils M, Albiol J, Marrero R, Rosell L, Salinas I, Ruiz D, Ruiz Á, Rodríguez-Villar C, Ureña A, Paredes-Zapata D, Guirao Á, Sánchez-Etayo G, Molins L, Quiroga N, Gómez-Brey A, Michavila X, Sandiumenge A, Agustí À, Ramos R
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Fecha de publicación
11 November 2024
Categorías asociadas al artículo
- Bronchial infection-Infección bronquial, Chronic bronchitis, Chronic bronchitis-Bronquitis crónica, Estudios-Studies, Exacerbations-Exacerbaciones, Fibrosing interstitial lung diseases (f-ILDs) - Enfermedades pulmonares intersticiales fibrosantes (EPI-f), Fibrosis, Investigación, Lung function-Función pulmonar, Lung Transplantation and Organ Preservation, Pulmonary Arterial Hypertension (PAH), Systemic Inflammation, Tratamientos-Treatments
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