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中华移植杂志(电子版) ›› 2025, Vol. 19 ›› Issue (06) : 462 -469. doi: 10.3877/cma.j.issn.1674-3903.2025.06.014

综述

肺移植手术前后呼吸道菌群变化的研究进展
段祎璨1,2,3, 黄曼1,2,()   
  1. 1310009 杭州,浙江大学医学院附属第二医院综合ICU
    2310000 杭州,多脏器衰竭预警与干预(浙江大学)教育部重点实验室
    3310058 杭州,浙江大学医学院
  • 收稿日期:2025-05-14 出版日期:2025-12-25
  • 通信作者: 黄曼
  • 基金资助:
    国家科技重大项目(2023ZD0505900)

Research advances in respiratory microbiota changes before and after lung transplantation

Yican Duan1,2,3, Man Huang1,2,()   

  1. 1Department of General ICU, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
    2Key Laboratory of Multiple Organ Failure (Zhejiang University), Ministry of Education, Hangzhou 310000, China
    3School of Medicine, Zhejiang University, Hangzhou 310058, China
  • Received:2025-05-14 Published:2025-12-25
  • Corresponding author: Man Huang
引用本文:

段祎璨, 黄曼. 肺移植手术前后呼吸道菌群变化的研究进展[J/OL]. 中华移植杂志(电子版), 2025, 19(06): 462-469.

Yican Duan, Man Huang. Research advances in respiratory microbiota changes before and after lung transplantation[J/OL]. Chinese Journal of Transplantation(Electronic Edition), 2025, 19(06): 462-469.

肺移植是终末期肺病的关键治疗方式,然而术后并发症会严重影响患者远期生存,呼吸道菌群在肺移植预后中的作用日益受到关注,为理解和干预肺移植后并发症提供思路。本文综述肺移植受者围手术期至长期恢复过程中呼吸道菌群的动态变化特征:围手术期阶段,各类终末期肺病本身已呈现出α-多样性降低及特定菌种富集等菌群紊乱迹象;术后菌群变化则存在着时间和空间异质性,其多样性和负荷量变化与多种并发症相关。其潜在机制可能涉及菌群失衡通过代谢物-免疫轴加剧移植物局部炎症及纤维化,因此,针对微生物群的干预策略有一定的临床转化潜力。但对于呼吸道菌群的长期动态监测体系、机制验证和个体化调控策略仍需进一步探索,未来应着力整合多组学技术,推动呼吸道菌群研究从描述性分析向机制阐释与临床转化转变。

Lung transplantation is a key treatment for end-stage lung diseases, yet postoperative complications often significantly affect long-term survival of recipients. In recent years, the role of the respiratory microbiota in lung transplantation outcomes has gained increasing attention, offering new perspectives for understanding and intervening in post-transplant complications. This article systematically reviews the dynamic changes in the respiratory microbiota of lung transplant recipients from the perioperative period through long-term recovery. Findings indicate that during the perioperative phase, various end-stage lung diseases already exhibit microbiota dysbiosis, characterized by reduced alpha-diversity and enrichment of specific bacterial species. Postoperatively, the microbiota demonstrates temporal and spatial heterogeneity, with changes in its diversity and microbial load correlating with multiple complications. Evidence suggests that microbiota imbalance may exacerbate local inflammation and fibrosis in the lung graft through metabolite-immune interactions, highlighting the potential clinical value of microbiota-targeted interventions. However, establishing long-term dynamic monitoring systems for the microbiota, validating underlying mechanisms, and developing individualized regulatory strategies remain important challenges. Moving forward, integrating multiomics technologies will be essential to advance the field from descriptive observations toward mechanistic insight and clinical translation.

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