Bronchoalveolar lavage in lung transplantation

Shennib, Hani; Nguyen, Dao M.

doi:10.1016/0003-4975(91)90824-a

Cited by 19 publications

(4 citation statements)

References 28 publications

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“…Corresponding to these results, the BAL of lung transplant patients shows an increase of neutrophils up to 50% of the total cell count (71,76,80). This neutrophilic alveolitis normalizes after the 1st wk, reflecting an improvement in the clinical course (81).…”

Section: Uncomplicated Course After Lung Transplantationmentioning

confidence: 85%

Bronchoalveolar lavage in lung transplantation

Tiroke

Bewig

Haverich

1999

Clinical Transplantation

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Fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) has become a crucial tool in the management of lung transplant recipients. Detection of pulmonary infectious pathogens by culture, cytology, and histology of BAL, protected brush specimens, and transbronchial biopsies (TBB) is highly effective. Morphologic and phenotypological analyses of BAL cells may be suggestive for certain complications after lung transplantation. For interpretation of BAL findings, the natural course of BAL cell morphology and phenotypology after lung transplantation must be considered. During the first 3 months after pulmonary transplantation, elevated total cell count in BAL and neutrophilic alveolitis are common, representing the cellular response to graft injury and interaction of immunocompetent cells of donor and recipient origin. With increasing time after transplantation the CD4/CD8 ratio decreases due to lowered percentages of CD4 cells in BAL. During bacterial pneumonias, the cellular profile of BAL is characterized by a marked granulocytic alveolitis. Lymphocytic alveolitis with a decreased CD4/CD8 ratio is suggestive of acute rejection, but is also found in viral pneumonias and obliterative bronchiolitis. In the case of a combined lymphocytosis and neutrophilia without any evidence of infection, obliterative bronchiolitis should be considered. Functional analyses of BAL cells can give additional information about the immunologic status of the graft, even before histologic changes become evident but have not been established in routine transplant monitoring. However, functional studies suggest an important role of activated, alloreactive and donor-specific T lymphocytes in the pathogenesis of acute and chronic lung rejection. Investigations of soluble components in BAL have given further insight into the immunologic processes after lung transplantation. In this overview, the characteristics of BAL after lung transplantation will be summarized, and its relevance for the detection of pulmonary complications will be discussed.

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Section: Uncomplicated Course After Lung Transplantationmentioning

confidence: 85%

Bronchoalveolar lavage in lung transplantation

Tiroke

Bewig

Haverich

1999

Clinical Transplantation

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“…For adequate sensitivity, large numbers of TBB specimens need to be taken, with one study advocating 18 samples [10]. Currently, it is recommended that a minimum of five TBBs, are taken [7]; however, a significantly decreased sensitivity has been reported where fewer than nine specimens have been taken [11]. The need for adequate numbers of specimens must be balanced against morbidity in a clinical risk/benefit estimation.…”

mentioning

confidence: 99%

Airway versus transbronchial biopsy and BAL in lung transplant recipients: different but complementary

et al. 1997

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A Ai ir rw wa ay y v ve er rs su us s t tr ra an ns sb br ro on nc ch hi ia al l b bi io op ps sy y a an nd d B BA AL L i in n l lu un ng g t tr ra an ns sp pl la an nt t r re ec ci ip pi ie en nt ts s: : d di if ff fe er re en nt t b bu ut t c co om mp pl le em me en nt ta ar ry y We found that all the EBB had inflammatory cells present but that only five TBB specimens had evidence of inflammation, with airway material being present in 78% of the TBB. Paired BAL and EBB yielded different results, with no correlations between total macrophages, lymphocytes, CD4+ cells or CD8+ cells.We conclude that endobronchial biopsies are potentially useful as an additional sample for the monitoring of inflammation in lung allografts, since they yield different, and potentially complimentary, information to bronchoalveolar lavage and transbronchial biopsy.

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“…Age is a crucial factor in carcinogenesis ( 31 ). Numerous studies have reported that aging is associated with highly reproducible changes in DNA methylation at specific sites in the genome ( 32 , 33 ). Age-associated hypermethylation is enriched close to CpG islands, whereas hypomethylation occurs outside of CpG islands ( 34 , 35 ).…”

Section: Discussionmentioning

confidence: 99%

Hypermethylation of MDFI promoter with NSCLC is specific for females, non‑smokers and people younger than 65

Chen

et al. 2018

Oncol Lett

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Non-small cell lung carcinoma (NSCLC) is a major subtype of lung cancer. Aberrant DNA methylation has been frequently observed in NSCLC. The aim of the present study was to investigate the role of MyoD family inhibitor (MDFI) methylation in NSCLC. Formalin-fixed paraffin-embedded tumor tissues and adjacent non-cancerous tissues were collected from a total of 111 patients with NSCLC. A methylation assay was performed using the quantitative methylation-specific polymerase chain reaction method. The percentage of methylated reference was used to represent the methylation level of the MDFI promoter. Data mining of a dataset from The Cancer Genome Atlas (TCGA) demonstrated that MDFI promoter methylation levels were significantly increased in 830 tumor tissues compared with 75 non-tumor tissues (P=0.012). However, the results on tissues obtained in the present study indicated that the MDFI promoter methylation levels in tumor tissues were not significantly different compared with those in the adjacent non-tumor tissues (P=0.159). Subsequent breakdown analysis identified that higher MDFI promoter methylation levels were significantly associated with NSCLC in females (P=0.031), but not in males (P=0.832). Age-based subgroup analysis demonstrated that higher MDFI promoter methylation levels were significantly associated with NSCLC in younger patients (≤65 years; P=0.003), but not in older patients (P=0.327). In addition, the association of MDFI methylation with NSCLC was significant in non-smokers (P=0.014), but not in smokers (P=0.832). Similar results also have been determined from subgroup analysis of the TCGA datasets. The Gene Expression Omnibus database indicated MDFI expression restoration in partial lung cancer cell lines (H1299 and Hotz) following demethylation treatment. However, it was identified that MDFI promoter hypermethylation was not significantly associated with prognosis of NSCLC (P>0.05). In conclusion, the present study indicated that the association of higher methylation of the MDFI promoter with NSCLC may be specific to females, non-smokers and people aged ≤65.

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Bronchoalveolar lavage in lung transplantation

Cited by 19 publications

References 28 publications

Bronchoalveolar lavage in lung transplantation

Bronchoalveolar lavage in lung transplantation

Airway versus transbronchial biopsy and BAL in lung transplant recipients: different but complementary

Hypermethylation of MDFI promoter with NSCLC is specific for females, non‑smokers and people younger than 65

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