Early lung leukocyte infiltration, HLA and adhesion molecule expression predict chronic rejection

Transplant Immunology
G DevouassouxE Brambilla

Abstract

Obliterative bronchiolitis remains the main cause of graft dysfunction and death after 1 year. Defined by an irreversible airway obstruction, bronchiolitis obliterans syndrome is usually recognized in the advanced stage of the disease, with histological evidence of fibrotic damage. Fibrosis represents the end-stage of an inflammatory process, leading to the postulate that chronic lung graft dysfunction is preceded by cellular and molecular events. This study was performed during the first year following lung transplantation, in the absence of histological or functional criteria of chronic rejection. Transbronchial biopsies from eight lung allografts were examined. Four developed a bronchiolitis obliterans syndrome (Group I), and 4 had good outcomes (Group II) at 2 years. Using immunohistochemistry, the aim of the study was to correlate early immunological events with graft outcomes at 2 years. An up-regulation of HLA class I antigen (P = 0.0001), an overexpression of Ki-67 (P = 0.006) on bronchial epithelium, and graft infiltration by CD45+, CD25+ cells (P = 0.003) were significantly associated with the development of chronic rejection. An overexpression of numerous adhesion molecules was observed. However, only very late antig...Continue Reading

References

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Citations

May 27, 2006·American Journal of Respiratory and Critical Care Medicine·Cassandra L MikolsMichael J Walter
Oct 18, 2015·The American Journal of Pathology·Danny JonigkFlorian Laenger
Jan 7, 2005·Pediatric Pulmonology·Geoffrey Kurland, Peter Michelson
Jun 4, 2016·Transplantation·Pierre-Joseph RoyerUNKNOWN SysCLAD consortium

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