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Application of artificial intelligence and machine learning in lung transplantation: a comprehensive review

Front Digit Health. 2025 May 1;7:1583490. doi: 10.3389/fdgth.2025.1583490. eCollection 2025.

ABSTRACT

Lung transplantation (LTx) is an effective method for treating end-stage lung disease. The management of lung transplant recipients is a complex, multi-stage process that involves preoperative, intraoperative, and postoperative phases, integrating multidimensional data such as demographics, clinical data, pathology, imaging, and omics. Artificial intelligence (AI) and machine learning (ML) excel in handling such complex data and contribute to preoperative assessment and postoperative management of LTx, including the optimization of organ allocation, assessment of donor suitability, prediction of patient and graft survival, evaluation of quality of life, and early identification of complications, thereby enhancing the personalization of clinical decision-making. However, these technologies face numerous challenges in real-world clinical applications, such as the quality and reliability of datasets, model interpretability, physicians' trust in the technology, and legal and ethical issues. These problems require further research and resolution so that AI and ML can more effectively enhance the success rate of LTx and improve patients' quality of life.

PMID:40376618 | PMC:PMC12078212 | DOI:10.3389/fdgth.2025.1583490

Tumor-derived exosomal CCT6A serves as a matchmaker introducing chemokines to tumor-associated macrophages in pancreatic ductal adenocarcinoma

Cell Death Dis. 2025 May 15;16(1):382. doi: 10.1038/s41419-025-07720-y.

ABSTRACT

M2-polarized tumor-associated macrophages (TAMs) are a key factor contributing to the poor prognosis of pancreatic ductal adenocarcinoma (PDAC). While various factors within the tumor microenvironment (TME) drive their formation, the role of PDAC-derived exosomes in this process remains unclear. We aim to clarify the regulatory impacts of tumor-derived exosomes to TAMs. After the intratumoral injection to subcutaneous tumor of C57BL/6 mice, we demonstrated PDAC-derived exosomes exacerbate PDAC progression, accompanied with upregulated M2 phenotype of TAMs and unaffected proliferation signatures. Through intratumoral injection model and multi-Omics analyses, we identified CCT6A as a novel tumor-derived exosomal protein, bridging TAMs M2 polarization and PDAC prognosis. Co-culture with exosomes derived from CCT6Ahigh PDAC leads to greater M2 phenotype of TAMs via PI3K-AKT signaling. According to proteomics data, chemokines' abundance reduces over tenfold once exosomal CCT6A absence, including CXCL1, CXCL3, CCL20 and CCL5, whose interaction with CCT6A in PDAC cells was confirmed by interactomics data. Moreover, we found silencing CCT6A abrogated the antagonism effects of CD47 antibody immunotherapy. Our findings implied that the subunit of the T-complex protein Ring Complex (TRiC) CCT6A serves as a matchmaker during exosome-mediated chemokines transfer from PDAC to TAMs. Silencing CCT6A effectively sensitized PDAC to CD47 antibody immunotherapy in vivo.

PMID:40374617 | PMC:PMC12081750 | DOI:10.1038/s41419-025-07720-y

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