Persistent high BAL fluid granulocyte activation marker levels as early indicators of bronchiolitis obliterans after lung transplant

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Riise, Gerdt C.,1956Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för lungmedicin och allergologi,Institute of Internal Medicine, Dept of Respiratory Medicine/Allergology (author)

Persistent high BAL fluid granulocyte activation marker levels as early indicators of bronchiolitis obliterans after lung transplant

Article/chapterEnglish1999

Publisher, publication year, extent ...

1999

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LIBRIS-ID:oai:gup.ub.gu.se/45454
https://gup.ub.gu.se/publication/45454URI

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Language:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

The major cause of mortality in the long-term in lung transplant recipients is chronic rejection. This is a fibroproliferative process in the small airways leading to obliterative bronchiolitis and progressive loss of lung function, both constituting the clinical entity bronchiolitis obliterans syndrome (BOS). Granulocyte activation has been implicated as one factor behind BOS. Granulocyte markers in bronchoalveolar lavage (BAL) fluid were prospectively and longitudinally studied in order to identify possible association with BOS. BAL fluid from 266 bronchoscopy procedures performed in twelve single lung, eight bilateral lung and five heart/lung transplant recipients were analysed. The majority (19 of 25) were studied for a period of 2 yrs after surgery. Myeloperoxidase (MPO), eosinophil cationic protein (ECP) and interleukin-8 (IL-8) levels were used as indirect markers of activation and attraction of granulocytes. Five patients developed BOS. Ninety-eight episodes of acute rejection, nine of bacterial infection, 19 of cytomegalovirus pneumonitis, nine of Pneumocystis carinii infection, two of aspergillus infection and two of respiratory syncytial virus infection were diagnosed. BOS patients had significantly higher mean levels of MPO, ECP and IL-8 compared to patients without BOS, irrespective of acute rejection status. Over time, the five patients with BOS had significantly elevated BAL fluid levels of MPO and ECP as well as neutrophil percentages, and in four patients this increase preceded the clinical diagnosis of BOS by several months. Elevated bronchoalveolar lavage fluid neutrophil percentage as well as levels of the granulocyte activation markers myeloperoxidase and eosinophil cationic protein appear to be early signs of development of BOS in lung transplant recipients.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Dermatologi och venereologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Dermatology and Venereal Diseases hsv//eng
Adult
Biological Markers/analysis
Blood Proteins/metabolism
Bronchiolitis Obliterans/*diagnosis/etiology
Bronchoalveolar Lavage Fluid/chemistry
Eosinophil Granule Proteins
Female
Follow-Up Studies
Graft Rejection/diagnosis
Granulocytes/*metabolism
Humans
Inflammation Mediators/metabolism
Interleukin-8/metabolism
*Lung Transplantation
Male
Middle Aged
Peroxidase/metabolism
Postoperative Complications/*diagnosis
Prospective Studies
*Ribonucleases
Time Factors

Added entries (persons, corporate bodies, meetings, titles ...)

Andersson, Bengt A.,1952Gothenburg University,Göteborgs universitet,Institutionen för medicinsk mikrobiologi och immunologi,Institute of Medical Microbiology/Immunology(Swepub:gu)xabeng (author)
Kjellström, Christer,1955Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin,Institute of Internal Medicine (author)
Mårtensson, Gunnar,1949Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin,Institute of Internal Medicine(Swepub:gu)xmargu (author)
Nilsson, Folke,1950Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute(Swepub:gu)xnilfo (author)
Ryd, Walter,1945Gothenburg University,Göteborgs universitet,Institutionen för laboratoriemedicin,Institute of Laboratory Medicine (author)
Scherstén, Henrik,1956Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute (author)
Göteborgs universitetInstitutionen för invärtesmedicin, Avdelningen för lungmedicin och allergologi (creator_code:org_t)

Related titles

In:Eur Respir J14:5, s. 1123-300903-1936

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https://gup.ub.gu.se/publication/45454

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Dermatology and ...

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