Acute lung rejection (ALR) is a relatively frequent complication during the first year after lung transplantation (LT). It is characterized by perivascular/bronchial mononuclear inflammation mediated by several cytokines. The aim of our study was to monitor a panel of cytokines extracted from the bronchoalveolar lavage (BAL) during the first year after LT and correlate them with clinical ALR. Twenty double lung transplant recipients were prospectively assessed. Fifteen (75%) were affected by cystic fibrosis (CF). BAL was collected at seven different steps (pretransplant, immediately post-transplant, after 1 week, 1, 3, 6 months and 1 year). A panel of six cytokines was analysed: tumour necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, IL-8, macrophage inflammatory protein (MIP)-1 alpha and IL-10. We correlated the cytokine levels with clinical ALR episodes, bacterial and cytomegalovirus (CMV) infections. One hundred and thirty-eight BAL samples were collected and analysed. In CF patients, the levels of proinflammatory cytokines significantly dropped immediately after the transplant while they increased in all the other patients. Four patients (20%) died between 6 months and 1 year. Nine patients (45%) showed one clinical ALR episode within 6 months; in 6 (30%) patients, a bacterial pneumonia was diagnosed and 5 (25%) developed CMV infection. No differences with the complication rate between CF and non-CF patients were observed. During the infection episodes, all proinflammatory cytokines increased with low levels of IL-10; in case of ALR, levels of IL-1 beta and MIP-1 alpha increased significantly (P = 0.01 and P < 0.0001), IL-10 levels were higher compared with the infection episodes (P = 0.03). No significant changes were observed for TNF-alpha, IL-6 and IL-8. The BAL cytokine profile (IL-1 beta, MIP-1 alpha and IL-10) seems useful to differentiate ALR and infections.

Role of cytokine profile in the differential diagnosis between acute lung rejection and pulmonary infections after lung transplantation / Patella, Miriam; Anile, Marco; DEL PORTO, Paola; Diso, Daniele; Pecoraro, Ylenia; Onorati, Ilaria; Mantovani, Sara; DE GIACOMO, Tiziano; Ascenzioni, Fiorentina; Rendina, Erino Angelo; Venuta, Federico. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - ELETTRONICO. - 47:6(2015), pp. 1031-1036. [10.1093/ejcts/ezu395]

Role of cytokine profile in the differential diagnosis between acute lung rejection and pulmonary infections after lung transplantation

PATELLA, MIRIAM
;
ANILE, MARCO;DEL PORTO, Paola;DISO, DANIELE;PECORARO, YLENIA;ONORATI, ILARIA;Sara Mantovani;DE GIACOMO, Tiziano;ASCENZIONI, Fiorentina;RENDINA, Erino Angelo;VENUTA, Federico
2015

Abstract

Acute lung rejection (ALR) is a relatively frequent complication during the first year after lung transplantation (LT). It is characterized by perivascular/bronchial mononuclear inflammation mediated by several cytokines. The aim of our study was to monitor a panel of cytokines extracted from the bronchoalveolar lavage (BAL) during the first year after LT and correlate them with clinical ALR. Twenty double lung transplant recipients were prospectively assessed. Fifteen (75%) were affected by cystic fibrosis (CF). BAL was collected at seven different steps (pretransplant, immediately post-transplant, after 1 week, 1, 3, 6 months and 1 year). A panel of six cytokines was analysed: tumour necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, IL-8, macrophage inflammatory protein (MIP)-1 alpha and IL-10. We correlated the cytokine levels with clinical ALR episodes, bacterial and cytomegalovirus (CMV) infections. One hundred and thirty-eight BAL samples were collected and analysed. In CF patients, the levels of proinflammatory cytokines significantly dropped immediately after the transplant while they increased in all the other patients. Four patients (20%) died between 6 months and 1 year. Nine patients (45%) showed one clinical ALR episode within 6 months; in 6 (30%) patients, a bacterial pneumonia was diagnosed and 5 (25%) developed CMV infection. No differences with the complication rate between CF and non-CF patients were observed. During the infection episodes, all proinflammatory cytokines increased with low levels of IL-10; in case of ALR, levels of IL-1 beta and MIP-1 alpha increased significantly (P = 0.01 and P < 0.0001), IL-10 levels were higher compared with the infection episodes (P = 0.03). No significant changes were observed for TNF-alpha, IL-6 and IL-8. The BAL cytokine profile (IL-1 beta, MIP-1 alpha and IL-10) seems useful to differentiate ALR and infections.
2015
Acute lung rejection; Bronchiolitis obliterans; Bronchoalveolar lavage; Cytokines; Lung transplantation; Acute Disease; Adult; Bronchoalveolar Lavage Fluid; Cytokines; Female; Graft Rejection; Humans; Lung Transplantation; Male; Middle Aged; Prospective Studies; Respiratory Tract Infections; Surgery; Pulmonary and Respiratory Medicine; Cardiology and Cardiovascular Medicine
01 Pubblicazione su rivista::01a Articolo in rivista
Role of cytokine profile in the differential diagnosis between acute lung rejection and pulmonary infections after lung transplantation / Patella, Miriam; Anile, Marco; DEL PORTO, Paola; Diso, Daniele; Pecoraro, Ylenia; Onorati, Ilaria; Mantovani, Sara; DE GIACOMO, Tiziano; Ascenzioni, Fiorentina; Rendina, Erino Angelo; Venuta, Federico. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - ELETTRONICO. - 47:6(2015), pp. 1031-1036. [10.1093/ejcts/ezu395]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/624579
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