Transcripts associated with chronic lung allograft dysfunction in transbronchial biopsies of lung transplants

2021 ◽  
Author(s):  
Michael D Parkes ◽  
Kieran M Halloran ◽  
Alim Hirji ◽  
Shane Pon ◽  
Justin Weinkauf ◽  
...  
Keyword(s):  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction ◽  
Lung Transplants

scholarly journals Lung Transplantation: The State of the Airways

2016 ◽  
Vol 140 (3) ◽  
pp. 241-244 ◽  
Author(s):  
Aliya N. Husain ◽  
Edward R. Garrity
Keyword(s):  
Lung Transplantation ◽  
Bronchiolitis Obliterans ◽  
Review Literature ◽  
Definitive Treatment ◽  
Term Survival ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction ◽  
Restrictive Allograft Syndrome ◽  
Lung Transplants ◽  
End Stage

Context Lung transplantation has become a viable option for definitive treatment of several end-stage lung diseases for which there are no other options available. However, long-term survival continues to be limited by chronic lung allograft dysfunction, which primarily affects the airways. Objective —To highlight the complications occurring mainly in the airways of the lung transplant recipient from the early to late posttransplant periods. Data Sources Review literature focusing on the airways in patients with lung transplants and clinical experience of the authors. Conclusions Postsurgical complications and infections of the airways have decreased because of better techniques and management. Acute cellular rejection of the airways can be distinguished from infection pathologically and on cultures. Separating small from large airways need not be an issue because both are risk factors for bronchiolitis obliterans. Grading of airway rejection needs to be standardized. Chronic lung allograft dysfunction consists of both bronchiolitis obliterans and restrictive allograft syndrome, neither of which can be treated very effectively at present.

Lung volumes predict survival in patients with chronic lung allograft dysfunction

Pneumologie ◽  
2017 ◽  
Vol 71 (S 01) ◽  
pp. S1-S125
Author(s):  
N Kneidinger ◽  
K Milger ◽  
S Janitza ◽  
F Ceelen ◽  
G Leuschner ◽  
...  
Keyword(s):  
Lung Volumes ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction

scholarly journals Regulatory and Effector Cell Disequilibrium in Patients with Acute Cellular Rejection and Chronic Lung Allograft Dysfunction after Lung Transplantation: Comparison of Peripheral and Alveolar Distribution

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 780 ◽  
Author(s):  
Laura Bergantini ◽  
Miriana d’Alessandro ◽  
Elda De Vita ◽  
Felice Perillo ◽  
Antonella Fossi ◽  
...  
Keyword(s):  
Mononuclear Cells ◽  
Bronchiolitis Obliterans Syndrome ◽  
Regulatory Cells ◽  
Peripheral Blood Mononuclear ◽  
Effector Cells ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction ◽  
Through Flow ◽  
B Regulatory Cells ◽  
Cellular Rejection

Background: The immune mechanisms occurring during acute rejection (AR) and chronic lung allograft dysfunction are a challenge for research and the balance between effector and regulatory cells has not been defined completely. In this study, we aimed to elucidate the interaction of effector cells, mainly Th17, Th1 and Th2, and regulatory cells including (CD4+CD25+CD127low/−) T reg cells and phenotypes of B regs, CD19+CD24hiCD38hi, CD19+CD24hiCD27hi and CD19+CD5+CD1d+. Methods: Bronchoalveolar lavage cells (BAL) and peripheral blood mononuclear cells (PBMCs) from stable lung transplanted (LTx )subjects (n = 4), AR patients (n = 6) and bronchiolitis obliterans syndrome (BOS) (n = 6) were collected at the same time. Cellular subsets were detected through flow cytometry. Results: A predominance of Th17 cells subtypes in the PBMCs and BAL and a depletion of Tregs, that resulted in decrease Treg/Th17 ratio, was observed in the AR group. CD19+CD24hiCD38hi Bregs resulted increased in BAL of AR patients. Th1 cells predominance and a reduction of Tregs cells was observed in BAL from AR patients. Moreover, multivariate analysis showed interdependences within studied variables revealing that effector cells and regulatory cells can effectively discriminate patients’ immunological status. Conclusions: In AR, BOS and stable lung transplant, regulatory and effector cells clearly demonstrated different pathways of activation. Understanding of the balance of T cells and T and B regulatory cells can offers insights into rejection.

scholarly journals Twelve-month effects of everolimus on renal and lung function in lung transplantation: differences in chronic lung allograft dysfunction phenotypes

2021 ◽  
Vol 12 ◽  
pp. 204062232199344
Author(s):  
Filippo Patrucco ◽  
Elias Allara ◽  
Massimo Boffini ◽  
Mauro Rinaldi ◽  
Cristina Costa ◽  
...  
Keyword(s):  
Renal Function ◽  
Lung Function ◽  
Lung Transplant ◽  
Bronchiolitis Obliterans Syndrome ◽  
Forced Expiratory Volume ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction ◽  
Transplant Patients ◽  
Restrictive Allograft Syndrome ◽  
Trend Data

Background: Chronic lung allograft dysfunction (CLAD), a complication affecting the survival of lung transplanted patients, includes two clinical phenotypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). Everolimus is used in CLAD because of its antiproliferative mechanism. In lung transplant patients treated with everolimus, the clinical course of renal and lung function has not yet been assessed systematically in CLAD, BOS and RAS patients for more than 6 months. Methods: We retrospectively evaluated the 12-month follow-up of renal and lung function of lung-transplanted patients switched to everolimus and evaluated the reduction in immunosuppressant dosage (ISD) and mortality. Subgroups were based on indication for everolimus treatment: CLAD and non-CLAD patients, BOS and RAS among CLAD patients. Results: We included 26 patients, 17 with CLAD (10 BOS, seven RAS). After 1 year from the everolimus switch, we observed renal function improvement (serum creatinine −17%, estimated glomerular filtration rate +24%) and stable pulmonary function [forced expiratory volume in the first second (FEV1) −0.5%, forced vital capacity (FVC) +0.05%]. RAS patients had progressive functional loss, whereas BOS patients had FEV1 improvement and FVC stability. All-cause mortality was higher in the CLAD versus non-CLAD group (41% versus 11%), without differences between BOS and RAS patients ( p > 0.05). All patients had significant and persistent ISD reduction. Conclusion: Lung transplant patients treated with everolimus had improvements in renal function and reduced ISD. We observed sustained improvements in lung function for CLAD related to BOS subgroup results, whereas RAS confirmed the 1-year worsening functional trend. Data seem to suggest one more piece of the puzzle in CLAD phenotyping.

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