Soluble CD30 levels as a diagnostic marker for bronchiolitis obliterans syndrome following human lung transplantation

Abstract

The long term survival of human lung allograft is hampered by the occurrence of chronic rejection, Bronchiolitis Obliterans Syndrome (BOS). This end-stage disease is normally diagnosed clinically by using the pulmonary function tests. This results in delay of BOS diagnosis and consequently prevents early intervention. It is generally accepted that alloimmunity plays an important role in chronic rejection of the allograft. In this study we analyzed serial serum samples from BOS+ and BOS− patients for sCD30 levels to determine the role of sCD30 to predict the onset of BOS. In contrast to BOS negative patients and normal subjects, 6 out of 9 BOS+ patients (P<0.05) studied had an increase in the sCD30 levels. Significantly, the rise was noted 7.57 ±2.63 months before the clinical diagnosis was evident. Therefore, we propose that the rise in serum sCD30 levels can be used as a marker for the detection of patients who are at risk of development of BOS.

Soluble CD30 Measured After Lung Transplantation Does Not Predict Bronchiolitis Obliterans Syndrome in a Tacrolimus/Mycophenolate Mofetil–based Immunosuppressive Regimen

“…Pre-transplant sCD30 levels were associated with the development of BOS in a tacrolimus-based regimen but not in a cyclosporinebased regimen, and the association between post-transplant sCD30 levels and the development of BOS was observed only in a cyclosporine-based immunosuppressive regimen. 10,15,16 This study has evaluated the utility of sCD30 as a biomarker for the development of BOS in a tacrolimus-based regimen.…”

“…13,14 In addition, in lung transplantation, a similar observation was made: high posttransplant sCD30 concentrations correlated well with the development of BOS. 15,16 In those studies a cyclosporine-based immunosuppressive regimen was used. As sCD30 levels are known to be influenced by the type of immunosuppression employed, our objective was to test the utility of post-transplant sCD30 as a biomarker for BOS during a tacrolimus-based regimen.…”

Soluble CD30 Levels in Recipients Undergoing Heart Transplantation Do Not Predict Post-transplant Outcome

“…26 Similarly, in lung transplantation, post-transplant sCD30 has been proposed to predict the onset of bronchiolitis obliterans, a consequence of chronic lung allograft rejection, albeit with conflicting underpinning evidence. 27,28 In conclusion, the results of our study show that pre-transplant serum sCD30 is not a useful biomarker for predicting either acute rejection or recipient survival after heart transplantation. Further studies are needed to determine whether serial measurements of sCD30 after heart transplantation have predictive value for transplant outcome.…”

Elevated pretransplantation soluble CD30 is associated with decreased early allograft function after human lung transplantation

“…Before and after 2005, immunosurpression consisted of cyclosporine/imuran/steroids and tacrolimus/ cellcept/steroids, respectively. Patients groups were identified as those with low (Ͻ20) and high (Ͼ20) sCD30 levels based on previous studies [5][6][7]. A similar number of patients received cyclosporinebased immunosuppressive treatment in each cohort.…”

“…sCD30 is a part of the tumor necrosis factor (TNF) receptor super family and is secreted into serum by activated T cells. sCD30 has been associated with TH2 pathways and correlated with renal allograft dysfunction and pulmonary bronchiolitis obliterans syndrome (BOS) [3][4][5][6]. No study has examined associations between sCD30 and early pulmonary allograft function.…”