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Bronchiolitis obliterans syndrome

Y Yamada, E Vandermeulen, T Heigl, J Somers, A Vaneylen, S E Verleden, H Bellon, S De Vleeschauwer, E K Verbeken, D E Van Raemdonck, R Vos, G M Verleden, W Jungraithmayr, B M Vanaudenaerde
The single most important cause of late mortality after lung transplantation is chronic lung allograft dysfunction (CLAD). However, the pathological development of CLAD was not as simple as previously presumed and subclassification phenotypes, bronchiolitis obliterans syndrome (BOS) and restrictive CLAD (rCLAD), have been introduced. We want to re-investigate how CLAD manifests in the murine orthotopic lung transplant model and investigate the role of interleukin 17A (IL-17A) within this model. Orthotopic LTx was performed in CB57Bl6, IL-17 WT and IL-17 KO mice...
October 10, 2016: Transplant Immunology
Akihiko Kitahara, Seijiro Sato, Terumoto Koike, Masanori Tsuchida
We report here a case of fatal respiratory failure developed during chemotherapy for diffuse large B cell lymphoma that occurred late after lung transplantation. 25-year- old man underwent lung transplantation from brain death donor for respiratory failure due to interstitial pneumonia at the age of 16 years old. Two years after transplantation, his respiratory function decreased gradually. Chronic lung allograft dysfunction including bronchiolitis obliterans( BOS) and restrictive allograft syndrome was suspected and immunosuppression was enhanced...
October 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Tomohito Saito, Masaaki Sato, Yohei Taniguchi, Tomohiro Murakawa, Shaf Keshavjee
Chronic lung allograft dysfunction (CLAD) is a major limitation to long-term success of lung transplantation. Restrictive allograft syndrome (RAS) is a recently discovered subtype of CLAD, showing distinct clinical, pathological and radiological features compared with the major CLAD subtype, bronchiolitis obliterans syndrome (BOS). Introduction of the novel CLAD classification system that differentiates CLAD into BOS and RAS has stimulated research activities aiming delineation of the underlying pathological mechanism in the 2 CLAD subtypes...
October 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Hana Čipčić Paljetak, Linda Tomašković, Mario Matijašić, Mirjana Bukvić, Andrea Fajdetić, Donatella Verbanac, Mihaela Perića
5-LOX - 5-lipoxygenase; ACT - artemisinin-based combination therapies; ADME - absorption, distribution, metabolism and excretion; BAL - broncho alveolar lavage; CABP - community acquired bacterial pneumonia; cAMP - cyclic adenosine monophosphate; CAP - community-acquired pneumonia; CF - cystic fibrosis, BOS bronchiolitis obliterans syndrome; cGMP - cyclic guanosine monophosphate; COPD - chronic obstructive pulmonary disease; COX - cyclooxygenase; DPB - diffuse panbronchiolitis; HDACs - histone deacetylases; IBD - inflammatory bowel disease; IL-1p - interleukin 1p; IL-6 - interleukin 6; MIC - minimal inhibitory concentrations; MLSB - macrolide, lincosamide, streptogramin B; NSAIDs - non-steroidal anti-inflammatory drugs; OVA - ovalbumin; PDE4 - phosphodiesterase 4; PMA - phorbol 12-myristate 13-acetate; RA - rheumatoid arthritis; RTI - respiratory tract infections; SAHA - suberoylanilide hydroxamic acid; SAR - structure-activity-relationship; Th1 - type 1 helper T-cell; TNBS - trinitrobenzene sulfonic acid; TNF-α - tumour necrosis factor α; UN - United Nations, WHO - World Health Organisation...
September 27, 2016: Current Topics in Medicinal Chemistry
Mohamed Zeriouh, Anton Sabashnikov, Prashant N Mohite, Bartlomiej Zych, Nikhil P Patil, Diana García-Sáez, Achim Koch, Alexander Weymann, Simona Soresi, Jens Wippermann, Thorsten Wahlers, Fabio De Robertis, Aron-Frederik Popov, André R Simon
OBJECTIVE: Zonal organ allocation system comprises organ procurement by teams within a specific geographical area of each retrieval team. Therefore, in a substantial number of cases organs are retrieved by 'foreign' teams and are sent for transplantation to the implanting centre. The aim of this study was to assess the impact of zonal organ allocation system on early- and long-term outcomes after lung transplantation (LTx). METHODS: Included were 331 consecutive patients who underwent LTx performed at Harefield Hospital between January 2007 and January 2015...
October 2, 2016: European Journal of Cardio-thoracic Surgery
Emily M Rosenberger, Annette J DeVito Dabbs, Andrea F DiMartini, Douglas P Landsittel, Joseph M Pilewski, Mary Amanda Dew
Mobile health (mHealth) interventions may help transplant recipients follow their complex medical regimen. Pocket Personal Assistant for Tracking Health (Pocket PATH) is one such intervention, tailored for lung transplant recipients. A randomized controlled trial showed Pocket PATH's superiority to usual care for promoting the self-management behaviors of adherence, self-monitoring and communication with clinicians during post-transplant year 1. Its long-term impact was unknown. Here, we examine associations between Pocket PATH exposure during year 1 and longer-term clinical outcomes-mortality and bronchiolitis obliterans syndrome (BOS)-among 182 recipients who survived the original trial...
September 24, 2016: American Journal of Transplantation
Julien Guihaire, Ryo Itagaki, Mandy Stubbendorff, Xiaoqin Hua, Tobias Deuse, Sebastian Ullrich, Elie Fadel, Peter Dorfmüller, Robert C Robbins, Hermann Reichenspurner, Udo Schumacher, Sonja Schrepfer
Bronchiolitis obliterans syndrome (BOS) is a main cause of allograft dysfunction and mortality after lung transplantation (LTx). A better understanding of BOS pathogenesis is needed to overcome this treatment-refractory complication. Orthotopic tracheal transplantation using human bronchus was performed in Brown Norway (BN) and nude (RNU) rats. Allografts were recovered in both strains at Day 7 (BN7 , n = 6; RNU7 , n = 7) or Day 28 (BN28 , n = 6; RNU28 , n = 6). Immune response of the host against the bronchial graft was assessed...
September 10, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Su-Bei Zhang, Xin Sun, Qi Wu, Jun-Ping Wu, Huai-Yong Chen
BACKGROUND: Bronchiolitis obliterans syndrome (BOS) often develops in transplant patients and results in injury to the respiratory and terminal airway epithelium. Owing to its rising incidence, the pathogenesis of BOS is currently an area of intensive research. Studies have shown that injury to the respiratory epithelium results in dysregulation of epithelial repair. Airway epithelial regeneration is supported by stromal cells, including fibroblasts. This study aimed to investigate whether the supportive role of lung fibroblasts is altered in BOS...
2016: Chinese Medical Journal
Stefano Di Carlo, Elena Rossi, Gianfranco Politano, Simona Inghilleri, Patrizia Morbini, Fiorella Calabrese, Alfredo Benso, Alessandro Savino, Emanuela Cova, Davide Zampieri, Federica Meloni
The pathogenesis of Bronchiolitis Obliterans Syndrome (BOS), the main clinical phenotype of chronic lung allograft dysfunction, is poorly understood. Recent studies suggest that epigenetic regulation of microRNAs might play a role in its development. In this paper we present the application of a complex computational pipeline to perform enrichment analysis of miRNAs in pathways applied to the study of BOS. The analysis considered the full set of miRNAs annotated in miRBase (version 21), and applied a sequence of filtering approaches and statistical analyses to reduce this set and to score the candidate miRNAs according to their potential involvement in BOS development...
2016: PloS One
Elly Vandermeulen, Stijn E Verleden, Hannelore Bellon, David Ruttens, Elise Lammertyn, Sandra Claes, Jennifer Vandooren, Estafania Ugarte-Berzal, Dominique Schols, Marie-Paule Emonds, Dirk E Van Raemdonck, Ghislain Opdenakker, Geert M Verleden, Robin Vos, Bart M Vanaudenaerde
BACKGROUND: Recently, antibody mediated rejection (AMR) has been associated with a higher incidence of chronic lung allograft dysfunction (CLAD) and mortality after lung transplantation (LTx). We investigated markers related to AMR and matrix remodeling in CLAD, with special attention for its two phenotypes being bronchiolitis obliterans syndrome (BOS) and restrictive CLAD (rCLAD). METHODS: Immunoglobulins (IgA, IgE, IgG1-IgG4, total IgG and IgM) and complement (C4d and C1q) were quantified in lung lavage samples at the moment of BOS (n=15) or RAS (n=16) diagnosis; and were compared to stable transplant patients who served as control (n=14)...
September 2016: Transplant Immunology
Sushma K Cribbs, James M Beck
Significant advances in culture-independent methods have expanded our knowledge about the diversity of the lung microbial environment. Complex microorganisms and microbial communities can now be identified in the distal airways in a variety of respiratory diseases, including cystic fibrosis (CF) and the posttransplantation lung. Although there are significant methodologic concerns about sampling the lung microbiome, several studies have now shown that the microbiome of the lower respiratory tract is distinct from the upper airway...
August 4, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
Guang-Shing Cheng, Barry Storer, Jason W Chien, Madan Jagasia, Jesse J Hubbard, Linda Burns, Vincent T Ho, Joseph Pidala, Jeanne Palmer, Laura Johnston, Sebastian Mayer, Kristina Crothers, Iskra Pusic, Stephanie J Lee, Kirsten M Williams
RATIONALE: The natural history of lung function in patients with bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic cell transplantation is poorly characterized. Understanding the trajectory of lung function is necessary for prompt clinical recognition, treatment, and the rational design of prospective studies. OBJECTIVES: To describe the longitudinal trajectory of lung function parameters including FEV1 in patients with BOS after hematopoietic cell transplantation...
August 11, 2016: Annals of the American Thoracic Society
Osamu Watanabe, Takao Tsuji, Ryota Kikuchi, Masayuki Itoh, Hiroyuki Nakamura, Kazutetsu Aoshiba
Recent evidence suggests that epithelial-mesenchymal transition (EMT) is involved in the pathogenesis of airway obstructive diseases, such as chronic obstructive pulmonary disease, asthma and bronchiolitis obliterans syndrome after lung transplantation. However, whether EMT occurs in an experimental model of airway fibrosis is not well known. We explored evidence of EMT in a murine model of airway fibrosis induced by repeated exposure to naphthalene. Mice were administered intraperitoneal injections of naphthalene or corn oil vehicle once weekly for 14 consecutive weeks...
October 2016: Experimental and Toxicologic Pathology: Official Journal of the Gesellschaft Für Toxikologische Pathologie
Mary H Foster
Basement membrane components are targets of autoimmune attack in diverse diseases that destroy kidneys, lungs, skin, mucous membranes, joints, and other organs in man. Epitopes on collagen and laminin, in particular, are targeted by autoantibodies and T cells in anti-glomerular basement membrane glomerulonephritis, Goodpasture's disease, rheumatoid arthritis, post-lung transplant bronchiolitis obliterans syndrome, and multiple autoimmune dermatoses. This review examines major diseases linked to basement membrane autoreactivity, with a focus on investigations in patients and animal models that advance our understanding of disease pathogenesis...
August 2, 2016: Matrix Biology: Journal of the International Society for Matrix Biology
Sasiharan Sithamparanathan, Logan Thirugnanasothy, Stephen Clark, John H Dark, Andrew J Fisher, Kate F Gould, Asif Hasan, James L Lordan, Gerard Meachery, Gareth Parry, Paul A Corris
BACKGROUND: Lung transplant recipients have reduced long-term survival compared with other solid organ recipients. There is a lack of published data on the characteristics of very long term survivors. METHODS: We describe the demographics, clinical history and post-procedure function of all lung transplant recipients who have survived greater than 20 years at our centre. RESULTS: At the time of analysis there were 21 (16.4%) of 128 patients who survived over 20 years...
August 2016: Respiratory Medicine
Deepa Raghavan, Ang Gao, Chul Ahn, Vaidehi Kaza, James Finklea, Fernando Torres, Raksha Jain
BACKGROUND: The overall life expectancy of women with cystic fibrosis (CF) is shorter compared with men with CF without accounting for lung transplant recipients. However, it is unclear how donor and recipient gender impact long-term outcomes in patients with CF who undergo lung transplantation. The purpose of this study was to determine if the gender disadvantage seen in women with CF before transplant continues to exist after lung transplant and if this is impacted by donor gender. METHODS: Patients with CF entered in the International Society for Heart and Lung Transplantation registry who were at least 18 years old and received a lung transplant between January 2000 and December 2012 were included and divided into groups based on donor-recipient gender combinations...
June 24, 2016: Journal of Heart and Lung Transplantation
J W Awori Hayanga, Jonathan K Aboagye, Heather K Hayanga, James D Luketich, Jonathan D'Cunha
BACKGROUND: In this study we sought to determine survival rates after use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung re-transplantation (re-LT). METHODS: Propensity-adjusted analysis was performed on data from the Scientific Registry of Transplant Recipients (SRTR) to evaluate survival in recipients between the years 1988 and 2012, based on the use of ECMO before re-LT. RESULTS: A total of 854 adult re-LT recipients were identified...
July 2016: Journal of Heart and Lung Transplantation
Felix Doellinger, Oliver Weinheimer, Isabella Zwiener, Eckhard Mayer, Roland Buhl, Ute Lina Fahlenkamp, Christoph Dueber, Tobias Achenbach
BACKGROUND: The aim of our retrospective study was to determine whether a dedicated software for assessment of airway morphology can detect differences in airway dimensions between patients with and without bronchiolitis obliterans syndrome (BOS), regarded as the clinical correlate of chronic lung allograft rejection. METHODS: 12 patients with and 14 patients without diagnosis of BOS were enrolled in the study. Evaluation of bronchial wall area percentage (WA%) and bronchial wall thickness (WT) in all follow-up CT scans was performed using a semiautomatic airway assessment tool...
August 2016: European Journal of Radiology
N Tanaka, Y Kunihiro, T Kobayashi, T Yujiri, S Kido, K Ueda, N Matsunaga
Idiopathic pneumonia syndrome (IPS) is an acute lung dysfunction of non-infectious aetiology and a severe complication following haematopoietic stem cell transplantation (HSCT). Recently, the American Thoracic Society (ATS) updated the concept of IPS and extended the concept to a wider range; it defined IPS as "an idiopathic syndrome of pneumopathy after HSCT, with evidence of widespread alveolar injury and in which infectious aetiologies and cardiac dysfunction, acute renal failure, or iatrogenic fluid overload have been excluded...
October 2016: Clinical Radiology
Recep Akgedik, Harun Karamanlı, İlknur Aytekin, Ali Bekir Kurt, Hasan Öztürk, Canan Eren Dağlı
BACKGROUND AND AIM: In patients with pulmonary embolism (PE), a pulmonary radiograph may reveal oligemic fields (the Westermark sign) associated with sites of occlusion of the pulmonary arteries, interruption or loss of the artery line (the knuckle sign), and even unilateral hyperlucency attributable to reduced overall lung vascularity. In Swyer-James-Macleod Syndrome (SJMS), which develops as a result of bronchiolitis obliterans, unilateral hyperlucency is evident because of emphysema and hypoplasia of the pulmonary artery and its branches...
July 12, 2016: Clinical Respiratory Journal
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