The Journal of Heart and Lung Transplantation
Volume 29, Issue 11 , Pages 1259-1269 , November 2010

Bronchoalveolar lavage neutrophilia in acute lung allograft rejection and lymphocytic bronchiolitis

  • Robin Vos, MD, PhD

      Affiliations

    • Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Bart M. Vanaudenaerde, PhD

      Affiliations

    • Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Stijn E. Verleden

      Affiliations

    • Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Stéphanie I. De Vleeschauwer

      Affiliations

    • Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Anna Willems-Widyastuti

      Affiliations

    • Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Dirk E. Van Raemdonck, MD, PhD

      Affiliations

    • Laboratory of Experimental Thoracic Surgery, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • Lung Transplantation Unit, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Lieven J. Dupont, MD, PhD

      Affiliations

    • Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • Lung Transplantation Unit, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Tim S. Nawrot, PhD

      Affiliations

    • Centre for Environmental Sciences, University Hasselt, Diepenbeek, Belgium
    • Unit of Lung Toxicology, Occupational and Environmental Medicine, School of Public Health, Katholieke Universiteit Leuven, Leuven, Belgium
    • ,
  • Erik K. Verbeken, MD, PhD

      Affiliations

    • Department of Histology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • ,
  • Geert M. Verleden, MD, PhD

      Affiliations

    • Laboratory of Pneumology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • Lung Transplantation Unit, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium
    • Corresponding Author InformationReprint requests: Geert M. Verleden, MD, PhD, University Hospital Gasthuisberg, Lung Transplantation Unit, 49 Herestraat, B-3000 Leuven, Belgium. Telephone: +32-16-346800. Fax: +32-16-346803

References 

  1. Burton CM, Iversen M, Carlsen J, et al. Acute cellular rejection is a risk factor for bronchiolitis obliterans syndrome independent of post-transplant baseline FEV1. J Heart Lung Transplant. 2009;28:888–893
  2. Glanville AR, Aboyoun CL, Havryk A, Plit M, Rainer S, Malouf MA. Severity of lymphocytic bronchiolitis predicts long-term outcome after lung transplantation. Am J Respir Crit Care Med. 2008;177:1033–1040
  3. Stewart S, Fishbein MC, Snell GI, et al. Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection. J Heart Lung Transplant. 2007;26:1229–1242
  4. Yousem SA. Lymphocytic bronchitis/bronchiolitis in lung allograft recipients. Am J Surg Pathol. 1993;17:491–496
  5. Burton CM, Iversen M, Scheike T, Carlsen J, Andersen CB. Is lymphocytic bronchiolitis a marker of acute rejection? (An analysis of 2,697 transbronchial biopsies after lung transplantation). J Heart Lung Transplant. 2008;27:1128–1134
  6. Kesten S, Maidenberg A, Winton T, Maurer J. Treatment of presumed and proven acute rejection following six months of lung transplant survival. Am J Respir Crit Care Med. 1995;152:1321–1324
  7. Ross DJ, Marchevsky A, Kramer M, Kass RM. “Refractoriness” of airflow obstruction associated with isolated lymphocytic bronchiolitis/bronchitis in pulmonary allografts. J Heart Lung Transplant. 1997;16:832–838
  8. De Soyza A, Fisher AJ, Small T, Corris PA. Inhaled corticosteroids and the treatment of lymphocytic bronchiolitis following lung transplantation. Am J Respir Crit Care Med. 2001;164:1209–1212
  9. Slebos DJ, Postma DS, Koëter GH, Van Der Bij W, Boezen M, Kauffman HF. Bronchoalveolar lavage fluid characteristics in acute and chronic lung transplant rejection. J Heart Lung Transplant. 2004;23:532–540
  10. Zheng L, Orsida B, Whitford H, et al. Longitudinal comparisons of lymphocytes and subtypes between airway wall and bronchoalveolar lavage after human lung transplantation. Transplantation. 2005;80:185–192
  11. Gregson AL, Hoji A, Saggar R, et al. Bronchoalveolar immunologic profile of acute human lung transplant allograft rejection. Transplantation. 2008;85:1056–1059
  12. Verleden GM, Vanaudenaerde BM, Dupont LJ, Van Raemdonck DE. Azithromycin reduces airway neutrophilia and interleukin-8 in patients with bronchiolitis obliterans syndrome. Am J Respir Crit Care Med1. 2006;174:566–570
  13. Yousem SA, Berry GJ, Cagle PT, et al. Revision of the 1990 working formulation for the classification of pulmonary allograft rejection: Lung Rejection Study Group. J Heart Lung Transplant. 1996;15:1–15
  14. Vanaudenaerde BM, De Vleeschauwer SI, Vos R, et al. The role of the IL23/IL17 axis in bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant. 2008;8:1911–1920
  15. Anon Standardization of spirometry, 1994 update: American Thoracic Society. Am J Respir Crit Care Med. 1995;152:1107–1136
  16. Vos R, Vanaudenaerde BM, Geudens N, Dupont LJ, Van Raemdonck DE, Verleden GM. Pseudomonal airway colonisation: risk factor for bronchiolitis obliterans syndrome after lung transplantation?. Eur Respir J. 2008;31:1037–1045
  17. Chakinala MM, Ritter J, Gage BF, et al. Yield of surveillance bronchoscopy for acute rejection and lymphocytic bronchitis/bronchiolitis after lung transplantation. J Heart Lung Transplant. 2004;23:1396–1404
  18. Tikkanen J, Lemström K, Halme M, Pakkala S, Taskinen E, Koskinen P. Cytological monitoring of peripheral blood, bronchoalveolar lavage fluid, and transbronchial biopsy specimens during acute rejection and cytomegalovirus infection in lung and heart-lung allograft recipients. Clin Transplant1. 2001;15:77–88
  19. Patil J, Lande JD, Li N, Berryman TR, King RA, Hertz MI. Bronchoalveolar lavage cell gene expression in acute lung rejection: development of a diagnostic classifier. Transplantation. 2008;85:224–231
  20. Sarwal M, Chua MS, Kambham N, et al. Molecular heterogeneity in acute renal allograft rejection identified by DNA microarray profiling. N Engl J Med. 2003;349:125–138
  21. Aboyoun CL, Tamm M, Chhajed PN, et al. Diagnostic value of follow-up transbronchial lung biopsy after lung rejection. Am J Respir Crit Care Med. 2001;164:460–463
  22. Vanaudenaerde BM, Meyts I, Vos R, et al. A dichotomy in bronchiolitis obliterans syndrome after lung transplantation revealed by azithromycin therapy. Eur Respir J. 2008;32:832–843
  23. Hasegawa T, Iacono AT, Yousem SA. The anatomic distribution of acute cellular rejection in the allograft lung. Ann Thorac Surg1. 2000;69:1529–1531
  24. Slebos DJ, Kauffman HF, Koëter GH, Verschuuren EA, Bij W, Postma DS. Airway cellular response to two different immunosuppressive regimens in lung transplant recipients. Clin Transplant. 2005;19:243–249
  25. D'Ovidio F, Mura M, Tsang M, et al. Bile acid aspiration and the development of bronchiolitis obliterans after lung transplantation. J Thorac Cardiovasc Surg. 2005;129:1144–1152
  26. Burton CM, Iversen M, Carlsen J, Andersen CB. Interstitial inflammatory lesions of the pulmonary allograft: a retrospective analysis of 2697 transbronchial biopsies. Transplantation. 2008;86:811–819
  27. Snell GI, Levvey BJ, Zheng L, et al. Interleukin-17 and airway inflammation: a longitudinal airway biopsy study after lung transplantation. J Heart Lung Transplant. 2007;26:669–674

PII: S1053-2498(10)00343-8

doi: 10.1016/j.healun.2010.05.019

The Journal of Heart and Lung Transplantation
Volume 29, Issue 11 , Pages 1259-1269 , November 2010

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