Early Changes in Basement Membrane Thickness in Airway Walls Post-Lung Transplantation

Law, Lucas Man-Chung; Zheng, Ling; Orsida, B; Levvey, Bronwyn; Oto, Takahiro; Kotsimbos, A. Thomas C.; Snell, Gregory I; Williams, Trevor

doi:10.1016/j.healun.2005.01.007

Cited by 15 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19 Finally, it remains unclear whether our findings can be related to early structural airway changes, such as epithelial basement membrane thickening. 36 Thus, although novel, our study is preliminary. Confirmation of the present findings and further elucidation of their exact role in the development of chronic allograft dysfunction/BOS after LTx will require additional studies preferably longitudinal, multi-centered and with larger patient populations.…”

Section: Discussionmentioning

confidence: 78%

Airway Colonization and Gastric Aspiration After Lung Transplantation: Do Birds of a Feather Flock Together?

Vos

Blondeau

Vanaudenaerde

et al. 2008

The Journal of Heart and Lung Transplantation

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 78%

Airway Colonization and Gastric Aspiration After Lung Transplantation: Do Birds of a Feather Flock Together?

Vos

Blondeau

Vanaudenaerde

et al. 2008

The Journal of Heart and Lung Transplantation

View full text Add to dashboard Cite

“…Work from the present laboratory showed differential expression of gene transcripts in patients with large-airway, but not small-airway, lymphocytic bronchitis (11). However, the ability of pathologic changes in large airways to predict future development of BOS has been less clear (12).…”

mentioning

confidence: 67%

Association of Large-Airway Lymphocytic Bronchitis with Bronchiolitis Obliterans Syndrome

Greenland

Jones²,

Hays³

et al. 2013

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Rationale: Lung transplantation offers great promise for otherwise terminal lung diseases, but the development of bronchiolitis obliterans syndrome (BOS) continues to limit survival. Although acute rejection and lymphocytic bronchiolitis have been identified as risk factors for the development of BOS, it is unclear whether largeairway lymphocytic inflammation conveys the same risk. Objectives: We evaluated lymphocytic bronchitis on endobronchial biopsies as a risk factor for BOS and mortality. Methods: Endobronchial biopsies were collected and graded during surveillance after lung transplantation. We assessed samples with negative cultures collected in the first 90 days from 298 subjects and compared large-airway lymphocytic bronchitis assessed by a 0-2 "E-score" and with standard A and BR pathology scores for acute rejection and small-airway lymphocytic bronchiolitis, respectively. Measurements and Main Results: We found surprisingly little association between large-and small-airway lymphocytic inflammation scores from a given bronchoscopy. Endobronchial lymphocytic bronchitis was more prevalent in subjects in BOS stage 0p and BOS stages 1-3 at the time of biopsy. Within 90 days after transplantation, increasing maximum E-score was associated with greater risk of BOS (adjusted hazard ratio, 1.76; 95% confidence interval, 1.11-2.78; P ¼ 0.02) and in this analysis 90-day maximum E-scores were the only score type predictive of BOS (P , 0.01). Conclusions: These results support a multicenter study to evaluate endoscopic biopsies for the identification of patients at increased risk for BOS. The association of endobronchial lymphocytic inflammation and BOS may have mechanistic implications.Keywords: bronchiolitis obliterans; graft rejection; bronchoscopy; lung transplantation Lung transplantation can offer improved quality of life and survival from otherwise terminal lung diseases. However, the development of chronic rejection, manifested as bronchiolitis obliterans syndrome (BOS), is a major barrier to long-term patient survival (1). BOS can cause death from graft failure and can occur despite potent immunosuppression (2, 3). One risk factor for BOS is symptomatic acute rejection (4). When confirmed by transbronchial biopsy, acute rejection generally is treated with additional immunosuppressive medications (5). Most lung transplantation centers also use surveillance bronchoscopy to identify otherwise silent episodes of acute rejection (6), presuming that untreated acute rejection increases the risk of BOS (7,8).Previous studies revealed that small-airways lymphocytic bronchiolitis in transbronchial biopsy specimens also is associated with increased risk of BOS (9). Endobronchial biopsies have been evaluated in lung transplant recipients, in whom acute rejection and current BOS were associated with largeairway lymphocytosis (10). This lymphocytosis is predominantly CD4 1 and CD45 1 (10). Work from the present laboratory showed differential expression of gene transcripts in patients with large-airway, but not small-ai...

show abstract

“…[57][58][59] It is worth noting that this change to the basal lamina occurs in only 1 other airway disease, bronchiolitis obliterans associated with a cytotoxic immunologic attack on small airway epithelial cells in lung transplant rejection. 60,61 Airway biopsies obtained from infants with severe intermittent wheezing reveal little difference in the basal lamina from that of normal airways, but after the age of about 3 years, the characteristic thickening associated with asthma is seen. 62 A detailed electron microscopic assessment of the basal lamina in adult and childhood asthma compared with normal epithelium has shown that the collagen fibrils were significantly thinner, and fewer of the fibrils were banded as found in the interstitial collagen of the adjacent submucosa, suggesting a different matrix structure.…”

Section: Changes To the Epithelial Basal Laminamentioning

confidence: 99%

Epithelium dysfunction in asthma

Holgate

2007

Journal of Allergy and Clinical Immunology

442

326

View full text Add to dashboard Cite

Early Changes in Basement Membrane Thickness in Airway Walls Post-Lung Transplantation

Cited by 15 publications

References 29 publications

Airway Colonization and Gastric Aspiration After Lung Transplantation: Do Birds of a Feather Flock Together?

Airway Colonization and Gastric Aspiration After Lung Transplantation: Do Birds of a Feather Flock Together?

Association of Large-Airway Lymphocytic Bronchitis with Bronchiolitis Obliterans Syndrome

Epithelium dysfunction in asthma

Contact Info

Product

Resources

About