Immunological diversity in phenotypes of chronic lung allograft dysfunction: a comprehensive immunohistochemical analysis
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- 作者：Elly Vandermeulen ; Elise Lammertyn ; Stijn E. Verleden ; David Ruttens ; Hannelore Bellon ; Mario Ricciardi ; Jana Somers ; Ken R. Bracke ; Kathleen Van Den Eynde ; Thomas Tousseyn ; Guy G. Brusselle ; Erik K. Verbeken ; Johny Verschakelen ; Marie-Paule Emonds ; Dirk E. Van Raemdonck ; Geert M. Verleden ; Robin Vos and Bart M. Vanaudenaerde
- 刊名：Transplant International
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：30
- 期：2
- 页码：134-143
- 全文大小：608K
- ISSN：1432-2277
文摘
Chronic rejection after organ transplantation is defined as a humoral- and cell-mediated immune response directed against the allograft. In lung transplantation, chronic rejection is nowadays clinically defined as a cause of chronic lung allograft dysfunction (CLAD), consisting of different clinical phenotypes including restrictive allograft syndrome (RAS) and bronchiolitis obliterans syndrome (BOS). However, the differential role of humoral and cellular immunity is not investigated up to now. Explant lungs of patients with end-stage BOS (n = 19) and RAS (n = 18) were assessed for the presence of lymphoid (B and T cells) and myeloid cells (dendritic cells, eosinophils, mast cells, neutrophils, and macrophages) and compared to nontransplant control lung biopsies (n = 21). All myeloid cells, with exception of dendritic cells, were increased in RAS versus control (neutrophils, eosinophils, and mast cells: all P < 0.05, macrophages: P < 0.001). Regarding lymphoid cells, B cells and cytotoxic T cells were increased remarkably in RAS versus control (P < 0.001) and in BOS versus control (P < 0.01). Interestingly, lymphoid follicles were restricted to RAS (P < 0.001 versus control and P < 0.05 versus BOS). Our data suggest an immunological diversity between BOS and RAS, with a more pronounced involvement of the B-cell response in RAS characterized by a structural organization of lymphoid follicles. This may impact future therapeutic approaches.