A novel approach to the assessment of lymphocytic bronchiolitis after lung transplantation-transbronchial brush

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dc.contributor.authorChambers, D.
dc.contributor.authorHodge, S.
dc.contributor.authorHodge, G.
dc.contributor.authorYerkovich, S.
dc.contributor.authorKermeen, F.
dc.contributor.authorReynolds, P.
dc.contributor.authorHolmes, M.
dc.contributor.authorHopkins, P.
dc.date.issued2011
dc.description.abstract<h4>Background</h4>Lymphocytic bronchiolitis (LB) is the strongest risk factor for subsequent allograft loss due to bronchiolitis obliterative syndrome (BOS); however, it is poorly assessed by transbronchial biopsy (TBBx) because of sampling error, interpretation error and the presence of non-alloimmune airway inflammation. We hypothesized that flow cytometric evaluation of bronchiolar brushings (transbronchial brush, TBBr) may be a better approach.<h4>Methods</h4>Transbronchial brushings (2 to 3 cm from the pleural surface under radiologic guidance) were obtained prior to TBBx in 32 patients and analyzed by flow cytometry. We assessed the proportion of nucleated cells that were CD3(+)CD103(+) (epithelial-specific T cells).<h4>Results</h4>No adverse events occurred; 0.5% (0.27 to 0.84) of the cells were epithelial-specific T cells and numbers increased with episodes of Grade A1 rejection (p < 0.01) and in patients with BOS (p = 0.02). Viral and invasive fungal infection were associated with marked infiltration with CD103(-) T cells (p < 0.01).<h4>Conclusion</h4>TBBr is simple to obtain, low risk, quantitative, and can discriminate between infective and alloimmune LB. It may be a valuable addition to current lung allograft assessment.
dc.description.statementofresponsibilityDaniel C. Chambers, Sandra Hodge, Greg Hodge, Stehanie T. Yerkovich, Fiona D. Kermeen, Paul Reynolds, Mark Holmes and Peter M.A. Hopkins
dc.identifier.citationJournal of Heart and Lung Transplantation, 2011; 30(5):544-551
dc.identifier.doi10.1016/j.healun.2010.10.018
dc.identifier.issn1053-2498
dc.identifier.issn1557-3117
dc.identifier.orcidHodge, S. [0000-0002-3602-9927] [0000-0002-9401-298X]
dc.identifier.orcidReynolds, P. [0000-0002-2273-1774]
dc.identifier.urihttp://hdl.handle.net/2440/71679
dc.language.isoen
dc.publisherElsevier Science Inc
dc.rightsCopyright © 2011 Elsevier B.V.
dc.source.urihttps://doi.org/10.1016/j.healun.2010.10.018
dc.subjectBronchi
dc.subjectT-Lymphocytes
dc.subjectHumans
dc.subjectBronchiolitis
dc.subjectBronchiolitis Obliterans
dc.subjectIntegrin alpha Chains
dc.subjectAntigens, CD
dc.subjectDiagnostic Techniques, Respiratory System
dc.subjectBronchoscopy
dc.subjectLung Transplantation
dc.subjectFlow Cytometry
dc.subjectRisk Factors
dc.subjectCross-Sectional Studies
dc.subjectGraft Rejection
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.titleA novel approach to the assessment of lymphocytic bronchiolitis after lung transplantation-transbronchial brush
dc.typeJournal article
pubs.publication-statusPublished

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