title: Role of innate immunity in primary graft dysfunction after lung transplantation.
abstract: OBJECTIVE
  Primary graft dysfunction (PGD), a form of acute lung injury after lung transplantation, has a significant impact on clinical outcomes after lung transplantation. This potentially reversible graft impairment occurs after ischemia-reperfusion injury. This review describes the expanding body of literature evaluating the central role of innate immune activation, nonadaptive responses and dysregulation in the development of PGD after lung transplant.
  
  
  RESULTS
  The innate immune system, highlighted by Toll-like receptor pathways and neutrophil migration and influx, plays an important role in the initiation and propagation of ischemia-reperfusion injury. Recent plasma biomarker and gene association studies have identified several genes and proteins composing innate immune pathways to be associated with PGDs. Long pentraxin-3 and Toll-like receptors, as well as inflammasomes and Toll-interacting protein, are associated with the development of PGD after lung transplantation.
  
  
  CONCLUSIONS
  Innate immune pathways are involved in the development of PGD and may provide attractive targets for therapies. It may be possible to prevent or treat PGD, as well as to allow pre-transplant PGD risk stratification. To improve understanding of the mechanisms behind clinical risk factors for PGD will require further in-depth correlation of donor-specific and recipient-related triggers of nonadaptive immune responses.
authors.affiliation: aPulmonary, Allergy, and Critical Care Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania bSection of Cardiothoracic Surgery, University of Chicago, Chicago, Illinois, USA.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Diamond
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Wigfield
mesh_terms: D000818:Animals; D015415:Biomarkers; D006801:Humans; D007113:Immunity, Innate; D016040:Lung Transplantation / Q000009:adverse effects*; D055031:Primary Graft Dysfunction / Q000276:immunology*; D012307:Risk Factors; D014019:Tissue Donors
chemical_list: D015415:Biomarkers