دورية أكاديمية
أعرض في EDS

BAL Fluid Eosinophilia Associates With Chronic Lung Allograft Dysfunction Risk: A Multicenter Study.

التفاصيل البيبلوغرافية
العنوان: BAL Fluid Eosinophilia Associates With Chronic Lung Allograft Dysfunction Risk: A Multicenter Study.
المؤلفون: Todd JL; Department of Medicine, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC. Electronic address: jamie.todd@duke.edu., Weber JM; Duke Clinical Research Institute, Durham, NC., Kelly FL; Department of Medicine, Duke University Medical Center, Durham, NC., Neely ML; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC., Mulder H; Duke Clinical Research Institute, Durham, NC., Frankel CW; Department of Medicine, Duke University Medical Center, Durham, NC., Nagler A; Department of Medicine, Duke University Medical Center, Durham, NC., McCrae C; Translational Science & Experimental Medicine, Early Respiratory & Immunology, AstraZeneca, Gaithersburg, MD., Newbold P; AstraZeneca, Wilmington, DE., Kreindler J; AstraZeneca, Wilmington, DE., Palmer SM; Department of Medicine, Duke University Medical Center, Durham, NC; Duke Clinical Research Institute, Durham, NC.
المصدر: Chest [Chest] 2023 Sep; Vol. 164 (3), pp. 670-681. Date of Electronic Publication: 2023 Mar 30.
نوع المنشور: Multicenter Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 0231335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1931-3543 (Electronic) Linking ISSN: 00123692 NLM ISO Abbreviation: Chest Subsets: MEDLINE
أسماء مطبوعة: Publication: 2016- : New York : Elsevier
Original Publication: Chicago : American College of Chest Physicians
مواضيع طبية MeSH: Lung Transplantation*/adverse effects , Eosinophilia*/etiology, Humans ; Bronchoalveolar Lavage Fluid ; Lung ; Transplantation, Homologous ; Allografts ; Retrospective Studies ; Graft Rejection
مستخلص: Background: Chronic lung allograft dysfunction (CLAD) is the leading cause of death among lung transplant recipients. Eosinophils, effector cells of type 2 immunity, are implicated in the pathobiology of many lung diseases, and prior studies suggest their presence associates with acute rejection or CLAD after lung transplantation.
Research Question: Does histologic allograft injury or respiratory microbiology correlate with the presence of eosinophils in BAL fluid (BALF)? Does early posttransplant BALF eosinophilia associate with future CLAD development, including after adjustment for other known risk factors?
Study Design and Methods: We analyzed BALF cell count, microbiology, and biopsy data from a multicenter cohort of 531 lung recipients with 2,592 bronchoscopies over the first posttransplant year. Generalized estimating equation models were used to examine the correlation of allograft histology or BALF microbiology with the presence of BALF eosinophils. Multivariable Cox regression was used to determine the association between ≥ 1% BALF eosinophils in the first posttransplant year and definite CLAD. Expression of eosinophil-relevant genes was quantified in CLAD and transplant control tissues.
Results: The odds of BALF eosinophils being present was significantly higher at the time of acute rejection and nonrejection lung injury histologies and during pulmonary fungal detection. Early posttransplant ≥ 1% BALF eosinophils significantly and independently increased the risk for definite CLAD development (adjusted hazard ratio, 2.04; P = .009). Tissue expression of eotaxins, IL-13-related genes, and the epithelial-derived cytokines IL-33 and thymic stromal lymphoprotein were significantly increased in CLAD.
Interpretation: BALF eosinophilia was an independent predictor of future CLAD risk across a multicenter lung recipient cohort. Additionally, type 2 inflammatory signals were induced in established CLAD. These data underscore the need for mechanistic and clinical studies to clarify the role of type 2 pathway-specific interventions in CLAD prevention or treatment.
(Copyright © 2023 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
References: Am J Respir Crit Care Med. 2018 Sep 15;198(6):805-807. (PMID: 29733677)
N Engl J Med. 2017 Jun 22;376(25):2448-2458. (PMID: 28530840)
J Heart Lung Transplant. 2007 Dec;26(12):1229-42. (PMID: 18096473)
Cells. 2020 Nov 20;9(11):. (PMID: 33233857)
J Immunol. 2014 Aug 15;193(4):1549-59. (PMID: 25015831)
Am J Respir Crit Care Med. 2009 Sep 1;180(5):388-95. (PMID: 19483109)
J Heart Lung Transplant. 2021 Oct;40(10):1060-1072. (PMID: 34446355)
J Heart Lung Transplant. 2019 May;38(5):493-503. (PMID: 30962148)
J Immunol. 2007 Jan 1;178(1):511-9. (PMID: 17182591)
J Immunol. 2008 Aug 15;181(4):2790-8. (PMID: 18684970)
J Allergy Clin Immunol. 2003 Feb;111(2):227-42; quiz 243. (PMID: 12589338)
Am J Respir Crit Care Med. 2013 Nov 1;188(9):1117-25. (PMID: 24063316)
Am J Respir Crit Care Med. 2004 Jul 15;170(2):181-7. (PMID: 15130908)
JCI Insight. 2017 Dec 21;2(24):. (PMID: 29263310)
Am J Transplant. 2005 Aug;5(8):2022-30. (PMID: 15996255)
Proc Natl Acad Sci U S A. 2007 Oct 2;104(40):15858-63. (PMID: 17898169)
Transplantation. 2014 Jan 15;97(1):83-9. (PMID: 24157472)
Transplantation. 2009 May 27;87(10):1530-7. (PMID: 19461490)
Am J Respir Crit Care Med. 2004 Nov 1;170(9):1022-6. (PMID: 15297270)
Am J Transplant. 2020 Jun;20(6):1489-1494. (PMID: 32342596)
JCI Insight. 2019 Jun 6;4(11):. (PMID: 31167966)
Clin Exp Immunol. 2016 Jan;183(1):57-64. (PMID: 26291602)
N Engl J Med. 2021 May 13;384(19):1800-1809. (PMID: 33979488)
Transpl Int. 2021 Jan;34(1):62-75. (PMID: 33025592)
N Engl J Med. 2014 Sep 25;371(13):1189-97. (PMID: 25199060)
Front Immunol. 2019 Apr 16;10:692. (PMID: 31057533)
J Immunol. 2014 Apr 15;192(8):3548-58. (PMID: 24616476)
Transplant Direct. 2018 Jul 11;4(8):e370. (PMID: 30255130)
J Heart Lung Transplant. 2022 Apr;41(4):501-507. (PMID: 35031205)
J Exp Med. 2008 Mar 17;205(3):699-710. (PMID: 18316417)
Hum Pathol. 1996 Mar;27(3):269-73. (PMID: 8600042)
Am J Transplant. 2020 Apr;20(4):924-930. (PMID: 31647606)
J Heart Lung Transplant. 2012 Apr;31(4):354-63. (PMID: 22330935)
Am J Transplant. 2022 Dec;22(12):3002-3011. (PMID: 36031951)
J Heart Lung Transplant. 1998 Oct;17(10):1038. (PMID: 9811417)
N Engl J Med. 2021 Oct 28;385(18):1656-1668. (PMID: 34706171)
معلومات مُعتمدة: U01 AI113315 United States AI NIAID NIH HHS
فهرسة مساهمة: Keywords: BAL fluid; acute rejection; chronic lung allograft dysfunction; eosinophils; lung transplantation
تواريخ الأحداث: Date Created: 20230401 Date Completed: 20230911 Latest Revision: 20240904
رمز التحديث: 20240904
مُعرف محوري في PubMed: PMC10548454
DOI: 10.1016/j.chest.2023.03.033
PMID: 37003354
قاعدة البيانات: MEDLINE
الوصف
تدمد:1931-3543
DOI:10.1016/j.chest.2023.03.033