The beauty of brevityChanges in induced sputum in the presence of bronchiolitis obliterans syndrome and correlation with spirometry in single and bilateral lung transplant recipients
Section snippets
Patients
The South Manchester ethics committee approved this study. All transplant recipients were outpatients from the Wythenshawe Transplant Unit, and had given written informed consent. A total of 28 lung transplant recipients were included, comprising 4 heart lung recipients, 8 double lung recipients, and 16 single lung recipients. All these patients were attending the transplant unit for their routine clinic visit and were free from acute rejection and infection (acute or chronic). In total 43
Safety
There were no adverse events during sputum induction. In the transplant recipients the baseline FEV1 pre-induction ranged from 26.4% to 112.9% of the predicted FEV1. A fall in FEV1 of less than 10% was seen during 63.4% of the inductions from the transplant recipients. There was a trend (p = 0.07) towards a greater average fall in FEV1 postsputum induction in lung transplant recipients with BOS grades 1 to 3 (6.6%) compared to the transplant recipients with BOS grade 0 (2.2%).
Correlation with lung function and sputum neutrophilia
For the purpose of
Discussion
We are the first to report a negative correlation between induced sputum neutrophil counts and changes in lung function from best postoperative values, as measured by the FEV1, FEF50, and FEF25–75. Furthermore, we have shown that in the bilateral lung transplant group induced sputum neutrophil percentage and number of leukocytes per gram of induced sputum are significantly higher in the presence of BOS. In the single lung recipients induced sputum results may be affected by the contribution
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Cited by (9)
Long-term follow-up of the lung transplant patient
2014, Archivos de BronconeumologiaCitation Excerpt :A deterioration in FEV1 may be indicative of multiple problems, such as acute or chronic rejection, infection or hyperinflation of the native lung. FEV1 figures falling by more than 20% from baseline in 2 consecutive measurements obtained in a 3–6-week interval are considered a criterion for bronchiolitis obliterans syndrome (BOS), after other causes, such as infection, acute rejection or changes in bronchial anastomosis, have been ruled out.17,18 In addition, a fall in FEV1 must also be accompanied by a fall in FEV1/FVC, since a fall in FEV1 associated with a restrictive ventilatory deficit is not considered to be BOS.
Chronic Allograft Dysfunction
2011, Clinics in Chest MedicineCitation Excerpt :Several other surrogate markers of BOS have been proposed, but their clinical utility is limited by one or more of the following factors: they are invasive or potentially toxic, they are expensive, they are not widely available, or their predictive value has not been appropriately tested or is controversial. These surrogate markers include exhaled breath condensate,94 induced sputum,95 analysis of cellular composition and inflammatory markers in BAL fluid, and imaging techniques, such as CT—in particular, quantification of air trapping at full expiration (see Fig. 3),7,8,96 and hyperpolarized 3He MRI.97 All interventions that target risk factors and may prevent the development of BOS are valuable because therapy is often ineffective when BOS is established.
Natural killer cells and lung transplantation, roles in rejection, infection, and tolerance
2008, Transplant ImmunologyCitation Excerpt :This suggests that the link between NK cells and eosinophils is IL-5 dependent. The NK cell can also induce neutrophilia in the lung compartment, a phenomenon associated with chronic rejection [67] via MIP-1α, MIP-1β, IFN-γ and IL-8. Neutrophils secrete a range of effector molecules which disrupt graft tissue.
Comparison of Induced Sputum and Bronchoalveolar Lavage in Lung Transplant Recipients
2006, Journal of Heart and Lung TransplantationLong-Term Follow-Up of the Lung Transplant Patient
1970, Archivos de BronconeumologiaCitation Excerpt :A deterioration in FEV1 may be indicative of multiple problems, such as acute or chronic rejection, infection or hyperinflation of the native lung. FEV1 figures falling by more than 20% from baseline in 2 consecutive measurements obtained in a 3–6-week interval are considered a criterion for bronchiolitis obliterans syndrome (BOS), after other causes, such as infection, acute rejection or changes in bronchial anastomosis, have been ruled out.17,18 In addition, a fall in FEV1 must also be accompanied by a fall in FEV1/FVC, since a fall in FEV1 associated with a restrictive ventilatory deficit is not considered to be BOS.
Chronic allograft rejection: Epidemiology, diagnosis, pathogenesis, and treatment
2010, Seminars in Respiratory and Critical Care Medicine