Airway neutrophilia in stable and bronchiolitis obliterans syndrome patients following lung transplantation

Abstract

Results-Compared with controls, airway wall neutrophilia was increased in both stable lung transplant recipients and those with BOS (p<0.05). BAL neutrophils and IL-8 levels were also increased in both groups of transplant recipients compared with controls (p<0.01), the levels being significantly higher in the BOS group (p<0.01). Neutrophil numbers in the lung parenchyma were not significantly diVerent between the two groups of lung transplant recipients. Conclusion-Increased levels of neutrophils are present in the airway wall and BAL fluid of lung transplant recipients with and without BOS. BAL fluid levels of IL-8 are also increased, raising the possibility that neutrophils and/or IL-8 may play a part in the pathogenesis of BOS following lung transplantation. (Thorax 2000;55:53-59)

Inflammation Patterns in Allogeneic and Autologous Airway Tissue of Lung Transplant Recipients

“…This view is supported by findings in several animal (4,5) and clinical studies (6)(7)(8)(9)(10)(11)(12)(13). During lung transplant surgery, donor and recipient airways are anastomosed at the site of the left and right main bronchi.…”

“…In contrast to Zheng et al (6), who reported an increased neutrophilia in donor airway walls of both patients suffering from BOS and stable patients compared to normal controls, we did not find a significant difference in airway neutrophilia between allogeneic and autologous airways in BOS patients. However, in stable patients we also found more neutrophils in allogeneic compared to autologous airways ( Figure 3).…”

“…However, while allogeneic parts of central airways have been investigated in a few studies (6)(7)(8)(9)(10)(11)(12)(13)(14)(15), data relating to autologous parts of central airways of lung transplant recipients are almost completely lacking. One could argue that inflammatory reactions in autologous parts must be of alloimmune-independent origin (e.g.…”

Acute lung injury after allogeneic stem cell transplantation: is the lung a target of acute graft-versus-host disease?

“…61,93,101 Neutrophilia is also prominent finding in several forms of immune-mediated lung injury including acute respiratory distress syndrome (ARDS) and in bronchiolitis obliterans syndrome (BOS), characteristic of lung allograft rejection. [102][103][104][105][106][107] PMN products such as elastase, myeloperoxidase, metalloproteinases and oxidants are abundant in the BAL fluid of patients with ARDS and are believed to contribute to the endothelial and epithelial damage that occurs in this setting. 102,107 Furthermore, increases in PMN activation markers may also be early indicators of BOS after lung transplant.…”

Gene Expression Profiling of Bronchoalveolar Lavage Cells during Aspergillus Colonization of the Lung Allograft

“…36,37 However, in this study, Aspergillus colonized cases who developed CLAD did not have a greater proportion of BAL neutrophils than those who remained CLAD free. 40 Collectively, this suggests further exploration of the role for CHIT1 and CHI3L1 in pathogenesis of CLAD is warranted.…”