16S rRNA analysis of bronchoalveolar microbiome after lung transplantation.. The role of the lung microbiome in the development of CLAD after lung transplanation

Lung transplantation is the ultimate treatment option for patients with end-stage respiratory diseases but bears the highest mortality rate among all solid organ transplantations due to chronic lung allograft dysfunction (CLAD). The mechanisms leading to CLAD remain elusive due to insufficient understanding of the complex post-transplant adaptation processes.To better understand lung adaptation processes after transplanation and preceding CLAD, and investigate their association with future changes in allograft function.Methods: We performed an exploratory cohort study in 78 patients, including broncho-alveolar lavage samples from lung donors and recipients (after transplantation). We analyzed the alveolar microbiome using 16S rRNA sequencing, the cellular composition using flow-cytometry, and conducted metabolome and lipidome profiling.

肺移植是终末期呼吸系统疾病患者的最终治疗选择，但因慢性肺移植物功能障碍（chronic lung allograft dysfunction, CLAD），其死亡率在所有实体器官移植中高居首位。由于对移植后复杂的适应过程缺乏足够认知，慢性肺移植物功能障碍的具体发病机制仍未明确。为更深入阐明移植后及慢性肺移植物功能障碍发生前的肺适应过程，并探究其与移植物功能后续变化的关联，本研究开展相关探索。
方法：本研究纳入78例患者开展探索性队列研究，采集了肺移植供者及受者（移植后）的支气管肺泡灌洗液样本。研究采用16S rRNA测序技术分析肺泡微生物组，通过流式细胞术检测细胞组成，并开展代谢组学与脂质组学谱分析。