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Bronchiolitis obliterans syndrome

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https://www.readbyqxmd.com/read/28716387/respiratory-virus-prior-to-hematopoietic-cell-transplantation-is-associated-with-allo-immune-mediated-lung-syndromes
#1
Birgitta Versluys, Marc Bierings, Jean Luc Murk, Tom Wolfs, Caroline Lindemans, Kors Vd Ent, Jaap Jan Boelens
BACKGROUND: Allo-immune mediated lung syndromes (allo-LS) are life-threatening complications after hematopoietic cell transplantation (HCT). Respiratory virus (RV) has been suggested to play a role in the pathogenesis. OBJECTIVE: We studied the relation between RV-DNA/RNA detection in upper/lower airway before HCT and the occurrence of allo-LS. METHODS: We retrospectively analyzed all HCT recipients between 2004 and 2014, in whom Real-Time PCR for RV was done from Nasal-Pharyngeal-Aspirates (NPA) and Broncho-Alveolar- Lavage (BAL) before HCT...
July 14, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28712587/clinical-implications-of-donor-age-a-single-institution-analysis-spanning-3%C3%A2-decades
#2
Christopher T Holley, Rosemary F Kelly, Sara J Shumway, Roland Z Brown, Marshall I Hertz, Kyle D Rudser, Coco W Quinlan, Irena Cich, Gabriel Loor
BACKGROUND: We sought to clarify the effect of donor age as a continuous variable on morbidity and mortality in a single-institution experience. METHODS: From 1986 to 2016, 882 adult lung transplants were performed, including 396 in the lung allocation score era. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate the association of donor age with overall survival and bronchiolitis obliterans syndrome (BOS) score ≥1-free survival. Logistic regression was used to evaluate the association with primary graft dysfunction grade 3...
June 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28662986/therapy-options-for-chronic-lung-allograft-dysfunction-bronchiolitis-obliterans-syndrome-following-first-line-immunosuppressive-strategies-a-systematic-review
#3
Christian Benden, Maria Haughton, Saoirse Leonard, Lars C Huber
BACKGROUND: Long-term success of lung transplantation is limited by the development of chronic lung allograft dysfunction (CLAD), of which bronchiolitis obliterans syndrome (BOS) is the most common form. This systematic review sought to identify the current evidence base for CLAD-BOS therapies after initial immunosuppressive treatment strategies. METHODS: The MEDLINE, Embase, and Cochrane Library databases from inception to May 3, 2016, were searched using keywords relating to CLAD-BOS, study designs, and treatments of interest, including extracorporeal photopheresis (ECP), aerosolized cyclosporine, total lymphoid irradiation (TLI), alemtuzumab, and montelukast...
May 29, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28658530/the-role-of-biomechanical-anatomical-modeling-via-computed-tomography-for-identification-of-restrictive-allograft-syndrome
#4
Miho Horie, Tomohito Saito, Joanne Moseley, Luigia D'Errico, Pascal Salazar, Daisuke Nakajima, Kristy Brock, Kazuhiro Yasufuku, Matthew Binnie, Shaf Keshavjee, Narinder Paul
Chronic lung allograft dysfunction (CLAD) reduces long term graft survival. It is important to distinguish CLAD subtypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS) as RAS has a worse prognosis and accurate subtyping could facilitate targeted treatments. However, the current diagnosis of CLAD subtypes is based on pulmonary function test results that reflect global estimates of lung function; anatomical modeling based on computed tomography (CT) has the potential to provide detailed analysis of global and regional lung function...
June 28, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28653398/lung-transplant-recipients-on-long-term-extracorporeal-photopheresis
#5
Bruno Isenring, Cécile Robinson, Urs Buergi, Macé M Schuurmans, Malcolm Kohler, Lars C Huber, Christian Benden
Extracorporeal photophoresis (ECP) is an increasingly used therapy to address chronic lung allograft dysfunction (CLAD) following lung transplantation. In 2008, we reported the first single-center experience showing that ECP not only reduces lung function decline in patients with bronchiolitis obliterans syndrome (BOS) but results in stabilization of patients with recurrent acute cellular rejection (ACR). In the current study, the original cohort was followed up further 5 years. In addition, patients with CLAD were retrospectively classified according to recently published phenotypes...
June 27, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28646553/epithelial-mesenchymal-transition-emt-a-spectrum-of-states-role-in-lung-development-homeostasis-and-disease
#6
REVIEW
Mohit Kumar Jolly, Chris Ward, Mathew Suji Eapen, Stephen Myers, Oskar Hallgren, Herbert Levine, Sukhwinder Singh Sohal
Epithelial Mesenchymal Transition (EMT) plays key roles during lung development and many lung diseases such as Chronic Obstructive Pulmonary Disease (COPD), lung cancer and pulmonary fibrosis. Here, integrating morphological observations with underlying molecular mechanisms, we highlight the functional role of EMT in lung development and injury repair, and discuss how it can contribute to pathogenesis of chronic lung disease. We discuss the evidence of manifestation of EMT and its potential driving role in COPD, idiopathic pulmonary fibrosis (IPF), bronchiolitis obliterans syndrome (BOS), and lung cancer, while noting that all cells need not display a full EMT in any of these contexts, i...
June 24, 2017: Developmental Dynamics: An Official Publication of the American Association of Anatomists
https://www.readbyqxmd.com/read/28530085/-long-term-treatment-with-macrolides-in-chronic-lung-diseases
#7
REVIEW
Michal Shteinberg, Sonia Schneer, Ophir Lavon, Yochai Adir
Macrolide agents have both antibacterial properties as well as various effects on the inflammatory system. In recent years there is growing evidence regarding the favourable effects of macrolides in a range of chronic respiratory conditions. Historically, erythromycin and clarithromycin were found to stabilize pulmonary deterioration in diffuse panbronchiolitis. In cystic fibrosis patients colonized with pseudomonas aeruginosa, long term treatment with azithromycin reduces exacerbations and presents improved lung function...
September 2016: Harefuah
https://www.readbyqxmd.com/read/28488260/cessation-of-extracorporeal-photopheresis-in-chronic-lung-allograft-dysfunction-effects-on-clinical-outcome-in-adults
#8
Cécile A Robinson, Lars Huber, Christian Murer, Macé Schuurmans, Malcolm Kohler, Günther Hofbauer, Christian Benden
BACKGROUND: Extracorporeal photopheresis (ECP) has been reported to be safe and the ultimate treatment option in lung transplant recipients with chronic lung allograft dysfunction (CLAD), the main overall cause of mortality in lung transplant recipients. However, ECP is not reimbursed in selected health jurisdictions, and reimbursement by health insurance providers is a major issue. In Switzerland, ECP is not recognised by the health authorities as a therapy option for CLAD; thus by the end of 2014, ECP had to be stopped in the majority of adult lung transplant recipients cared for at the University Hospital Zurich because of lack of continuous funding...
May 10, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28469930/early-extracellular-matrix-changes-are-associated-with-later-development-of-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#9
Catharina Müller, Annika Andersson-Sjöland, Hans Henrik Schultz, Leif T Eriksson, Claus B Andersen, Martin Iversen, Gunilla Westergren-Thorsson
BACKGROUND: Chronic lung allograft dysfunction in the form of bronchiolitis obliterans syndrome (BOS) is the main cause of death beyond 1-year post-lung transplantation. The disease-initiating triggers as well as the molecular changes leading to fibrotic alterations in the transplanted lung are largely unknown. The aim of this study was to identify potential early changes in the extracellular matrix (ECM) in different compartments of the transplanted lung prior to the development of BOS...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28457921/serum-mirnas-as-potential-biomarkers-for-the-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#10
K Budding, M Rossato, E A van de Graaf, J M Kwakkel-van Erp, T R D J Radstake, H G Otten
Lung transplantation (LTx) is the last treatment for patients suffering from end-stage lung diseases. Survival post-LTx is hampered by the development of the bronchiolitis obliterans syndrome (BOS) and diagnosis is often late. Given the urgent clinical need to recognize BOS patients at an early stage, we analyzed circulating miRNAs to identify possible stratification markers for BOS development post-transplantation. Therefore, pro-fibrotic (miR-21, miR-155), anti-fibrotic (miR-29a) and fibrosis-unrelated (miR-103, miR-191) miRNAs were analyzed in serum of end-stage lung disease patients and during LTx follow-up...
June 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28457374/efficacy-of-extracorporeal-photopheresis-in-patients-with-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#11
Y Pecoraro, C Carillo, D Diso, S Mantovani, G Cimino, T De Giacomo, P Troiani, M Shafii, L Gherzi, D Amore, E A Rendina, F Venuta, M Anile
BACKGROUND: Lung transplantation (LT) is only therapeutic option for patients affected by chronic respiratory failure. Chronic rejection, also known as bronchiolitis obliterans syndrome (BOS), is still the main cause of death and the most important factor that influences post-transplantation quality of life. Currently available therapies have not been proven to result in significant benefit in the prevention or treatment of BOS. Extracorporeal photopheresis (ECP) seems to reduce the rate of lung function decline in transplant recipients with progressive BOS...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28415888/bioengineered-gold-nanoparticles-targeted-to-mesenchymal-cells-from-patients-with-bronchiolitis-obliterans-syndrome-does-not-rise-the-inflammatory-response-and-can-be-safely-inhaled-by-rodents
#12
Emanuela Cova, Simona Inghilleri, Laura Pandolfi, Monica Morosini, Sara Magni, Miriam Colombo, Davide Piloni, Chiara Finetti, Gabriele Ceccarelli, Laura Benedetti, Maria Gabriella Cusella, Manuela Agozzino, Fabio Corsi, Raffaele Allevi, Simona Mrakic-Sposta, Sarah Moretti, Simona De Gregori, Davide Prosperi, Federica Meloni
The use of gold nanoparticles (GNPs) as drug delivery system represents a promising issue for diseases without effective pharmacological treatment due to insufficient local drug accumulation and excessive systemic toxicity. Bronchiolitis obliterans syndrome (BOS) represents about 70% of cases of chronic lung allograft dysfunction, the main challenge to long-term lung transplantation. It is believed that due to repeated insults to epithelial bronchiolar cells local inflammatory response creates a milieu that favors epithelial-mesenchymal transition and activation of local mesenchymal cells (MCs) leading to airway fibro-obliteration...
April 27, 2017: Nanotoxicology
https://www.readbyqxmd.com/read/28390643/a-46-year-old-man-with-dyspnea-hypoxemia-and-radiographic-asymmetry-after-redo-bilateral-lung-transplantation
#13
Sofya Tokman, Michael A Smith, A Samad Hashimi, Ashraf Omar
A 46-year-old man underwent redo bilateral sequential lung transplantation for rapidly progressive bronchiolitis obliterans syndrome that developed 3.5 years after initial transplantation. In the operating room, he was sedated and intubated with a dual lumen endotracheal tube with subsequent single right-lung ventilation and left allograft implantation. His pulmonary arterial pressure became elevated with reperfusion of the newly implanted left lung, which required initiation of cardiopulmonary bypass to facilitate implantation of the right lung...
April 2017: Chest
https://www.readbyqxmd.com/read/28273385/effect-of-aerosolized-antipseudomonals-on-pseudomonas-positivity-and-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#14
Cody A Moore, Joseph M Pilewski, Raman Venkataramanan, Keven M Robinson, Matthew R Morrell, Stephen R Wisniewski, Adriana Zeevi, John F McDyer, Christopher R Ensor
PURPOSE: To describe the effects of aerosolized antipseudomonals (AAPs) on Pseudomonas (PS) culture positivity, bronchiolitis obliterans syndrome (BOS), and acute cellular rejection (ACR) in lung transplant recipients (LTRs). METHODS: Single-center, retrospective cohort study was performed of adult LTRs treated with either AAP for ≥28 days vs no AAP therapy or AAP therapy <28 days, indexed to a matched median date post lung transplantation (LT). Primary outcome was freedom from PS positivity by positive bronchoalveolar lavage or bronchial wash at 1 year...
March 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28267558/rapid-detection-of-donor-cell-free-dna-in-lung-transplant-recipients-with-rejections-using-donor-recipient-hla-mismatch
#15
Jun Zou, Brian Duffy, Michael Slade, Andrew Lee Young, Nancy Steward, Ramsey Hachem, T Mohanakumar
Fiberoptic bronchoscopy and transbronchial lung biopsy are currently the gold standard for detection of acute rejection following human lung transplantation (LTx). However, these surveillance procedures are expensive and invasive. Up to now, there are few new methods that have demonstrated clinical utility for detecting early stages of rejection following human lung transplantation. We optimized and technically validated a novel method to quantify donor-derived circulating cell free DNA (DcfDNA) that can be used as an early biomarker for lung allograft rejection...
April 2017: Human Immunology
https://www.readbyqxmd.com/read/28245130/-1-h-nmr-to-evaluate-the-metabolome-of-bronchoalveolar-lavage-fluid-balf-in-bronchiolitis-obliterans-syndrome-bos-toward-the-development-of-a-new-approach-for-biomarker-identification
#16
Carlotta Ciaramelli, Marco Fumagalli, Simona Viglio, Anna Maria Bardoni, Davide Piloni, Federica Meloni, Paolo Iadarola, Cristina Airoldi
This report describes the application of NMR spectroscopy to the profiling of metabolites in bronchoalveolar lavage fluid (BALf) of lung transplant recipients without bronchiolitis obliterans syndrome (BOS) (stable, S, n = 10), and with BOS at different degrees of severity (BOS 0p, n = 10; BOS I, n = 10). Through the fine-tuning of a number of parameters concerning both sample preparation/processing and variations of spectra acquisition modes, an efficient and reproducible protocol was designed for the screening of metabolites in a pulmonary fluid that should reflect the status of airway inflammation/injury...
March 14, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/28244139/quantitative-computed-tomography-assessment-of-bronchiolitis-obliterans-syndrome-after-lung-transplantation
#17
Lee Gazourian, Samuel Ash, Emily E K Meserve, Alejandro Diaz, Raul San Jose Estepar, Souheil Y El-Chemaly, Ivan O Rosas, Miguel Divo, Anne L Fuhlbrigge, Phillip C Camp, Vincent T Ho, Ami S Bhatt, Hilary J Goldberg, Lynette M Sholl, George R Washko
BACKGROUND: Bronchiolitis obliterans syndrome (BOS) is a clinical manifestation of chronic allograft rejection following lung transplantation. We examined the quantitative measurements of the proximal airway and vessels and pathologic correlations in subjects with BOS. METHODS: Patients who received a lung transplant at the Brigham and Women's Hospital between December 1, 2002 and December 31, 2010 were included in this study. We characterized the quantitative CT measures of proximal airways and vessels and pathological changes...
May 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28240604/autocrine-lysophosphatidic-acid-signaling-activates-%C3%AE-catenin-and-promotes-lung-allograft-fibrosis
#18
Pengxiu Cao, Yoshiro Aoki, Linda Badri, Natalie M Walker, Casey M Manning, Amir Lagstein, Eric R Fearon, Vibha N Lama
Tissue fibrosis is the primary cause of long-term graft failure after organ transplantation. In lung allografts, progressive terminal airway fibrosis leads to an irreversible decline in lung function termed bronchiolitis obliterans syndrome (BOS). Here, we have identified an autocrine pathway linking nuclear factor of activated T cells 2 (NFAT1), autotaxin (ATX), lysophosphatidic acid (LPA), and β-catenin that contributes to progression of fibrosis in lung allografts. Mesenchymal cells (MCs) derived from fibrotic lung allografts (BOS MCs) demonstrated constitutive nuclear β-catenin expression that was dependent on autocrine ATX secretion and LPA signaling...
April 3, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28144069/a-severe-mycoplasma-pneumoniae-pneumonia-inducing-an-acute-antibody-mediated-pulmonary-graft-rejection
#19
Sarah Démir, Julien Saison, Agathe Sénéchal, Jean-Francois Mornex
A 40-year-old cystic fibrosis woman with a history of double-lung transplantation 2 years previously was admitted for a progressive respiratory distress. Physical examination revealed fever (39°C) and diffuse bilateral lung crackles. Laboratory findings included severe hypoxemia and inflammatory syndrome. Bronchoalveolar lavage and serological test were positive for mycoplasma pneumonia. As the patient did not improve after 3 days of antibiotics and donor-specific HLA antibodies had been detected, an acute antibody-mediated graft rejection was treated with high-dose corticosteroids, plasma exchange, intravenous immunoglobulin, and rituximab...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28131664/survival-and-outcomes-after-lung-transplantation-for-non-scleroderma-connective-tissue-related-interstitial-lung-disease
#20
Andrew M Courtwright, Souheil El-Chemaly, Paul F Dellaripa, Hilary J Goldberg
BACKGROUND: Patients with non-scleroderma connective tissue-related lung disease (NS-CTLD), including rheumatoid arthritis, idiopathic inflammatory myopathies, Sjögren syndrome, mixed connective tissue disease, and systemic lupus erythematosus, may be at risk for worse outcomes after lung transplantation because of immune dysregulation or extrapulmonary manifestations of their underlying disease. We compared survival, acute and chronic rejection, and extrapulmonary organ dysfunction after transplantation in patients with NS-CTLD and idiopathic pulmonary fibrosis (IPF)...
December 31, 2016: Journal of Heart and Lung Transplantation
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