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Title: | Heterogeneity of chronic lung allograft dysfunction: Insights from protein expression in broncho alveolar lavage | Authors: | Verleden, S.E. Vos, R. Mertens, V. Willems-Widyastuti, A. De Vleeschauwer, S.I. DUPONT, Tim Verleden, G.M. Van Raemdonck, D.E. Vanaudenaerde, B.M. |
Issue Date: | 2011 | Publisher: | ELSEVIER SCIENCE INC |
Source: | Journal of Heart and Lung Transplantation, Journal of Heart and Lung Transplantation, 30 (6) , p. 667-673 -673 | Abstract: | BACKGROUND: Chronic lung allograft dysfunction (CLAD) remains a major risk factor for death after lung transplantation. Previous data suggested that within CLAD at least 2 phenotypes are present: a neutrophilic type (nCLAD or neutrophilic reversible allograft dysfunction [NRAD]), reversible with azithromycin therapy, vs a low neutrophilic type, non-responsive to azithromycin (fibrotic bronchiolitis obliterans syndrome [fBOS]). We aimed to further characterize this dichotomy by measuring multiple proteins in the bronchoalveolar lavage (BAL) fluid of 28 lung recipients.METHODS: Patients were retrospectively subdivided by the absence or presence of CLAD and subsequently by their response to azithromycin, resulting in 3 groups: 10 stable, 9 responsive (nCLAD/NRAD), and 9 non-responsive (fBOS). Enzyme-linked immunosorbent assay was used to measure 32 different proteins.RESULTS: Protein variations were predominantly present in the nCLAD/NRAD group, whereas no differences were observed in the fBOS group compared with control. MCP-1 (p < 0.01), RANTES (p < 0.05), IL-beta (p < 0.01), IL-8 (p < 0.01), TIMP-1 (p < 0.01), MMP-8 (p < 0.01), MMP-9 (p < 0.01), HGF (p < 0.001), MPO (p < 0.01), and bile acid (p < 0.05) concentrations were upregulated in nCLAD/NRAD compared with fBOS, whereas PDGF-AA (p < 0.05) was downregulated.CONCLUSIONS: These data provide further evidence that within CLAD there is a heterogeneity of phenotypes with different mechanisms involved. Further investigation is warranted to unravel the pathophysiology of both phenotypes. J Heart Lung Transplant 2011;30:667-73 (C) 2011 International Society for Heart and Lung Transplantation. All rights reserved. | Keywords: | bronchiolitis obliterans syndrome;chronic lung allograft dysfunction;lung transplantation;neutrophilic reversible allograft dysfunction;bronchoalveolar lavage;lung rejection | Document URI: | http://hdl.handle.net/1942/30686 | Link to publication/dataset: | http://www.scopus.com/inward/record.url?eid=2-s2.0-79955877424&partnerID=MN8TOARS | DOI: | 10.1016/j.healun.2010.12.008 | ISI #: | WOS:000290834600009 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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