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- Title
Immunological diversity in phenotypes of chronic lung allograft dysfunction: a comprehensive immunohistochemical analysis.
- Authors
Vandermeulen, Elly; Lammertyn, Elise; Verleden, Stijn E.; Ruttens, David; Bellon, Hannelore; Ricciardi, Mario; Somers, Jana; Bracke, Ken R.; Van Den Eynde, Kathleen; Tousseyn, Thomas; Brusselle, Guy G.; Verbeken, Erik K.; Verschakelen, Johny; Emonds, Marie-Paule; Van Raemdonck, Dirk E.; Verleden, Geert M.; Vos, Robin; Vanaudenaerde, Bart M.
- Abstract
Chronic rejection after organ transplantation is defined as a humoral- and cell-mediated immune response directed against the allograft. In lung transplantation, chronic rejection is nowadays clinically defined as a cause of chronic lung allograft dysfunction ( CLAD), consisting of different clinical phenotypes including restrictive allograft syndrome ( RAS) and bronchiolitis obliterans syndrome ( BOS). However, the differential role of humoral and cellular immunity is not investigated up to now. Explant lungs of patients with end-stage BOS ( n = 19) and RAS ( n = 18) were assessed for the presence of lymphoid (B and T cells) and myeloid cells (dendritic cells, eosinophils, mast cells, neutrophils, and macrophages) and compared to nontransplant control lung biopsies ( n = 21). All myeloid cells, with exception of dendritic cells, were increased in RAS versus control (neutrophils, eosinophils, and mast cells: all P < 0.05, macrophages: P < 0.001). Regarding lymphoid cells, B cells and cytotoxic T cells were increased remarkably in RAS versus control ( P < 0.001) and in BOS versus control ( P < 0.01). Interestingly, lymphoid follicles were restricted to RAS ( P < 0.001 versus control and P < 0.05 versus BOS). Our data suggest an immunological diversity between BOS and RAS, with a more pronounced involvement of the B-cell response in RAS characterized by a structural organization of lymphoid follicles. This may impact future therapeutic approaches.
- Subjects
CRYPTOGENIC organizing pneumonia; LUNG transplantation; TRANSPLANTATION of organs, tissues, etc.; HOMOGRAFTS; LUNG biopsy; GENETICS; THERAPEUTICS
- Publication
Transplant International, 2017, Vol 30, Issue 2, p134
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.12882