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Title
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Heterogeneity of chronic lung allograft dysfunction : insights from protein expression in broncho alveolar lavage
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Author
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Abstract
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| 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. |
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Language
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English
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Source (journal)
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Journal of heart and lung transplantation. - St-Louis, Mo.
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Publication
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St-Louis, Mo.
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2011
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ISSN
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1053-2498
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DOI
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10.1016/J.HEALUN.2010.12.008
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Volume/pages
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30
:6
(2011)
, p. 667-673
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ISI
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000290834600009
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Pubmed ID
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21276737
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Full text (Publisher's DOI)
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