title: Multidrug resistance in lung allograft recipients: possible correlation with the development of acute and chronic rejection.
abstract: The expression of drug resistance antigens in mononuclear inflammatory cells was studied in transbronchial lung biopsy specimens of lung allograft recipients who experienced steroid-sensitive and steroid-resistant bouts of acute rejection and bronchiolitis obliterans. Immunostains for C494 and C219 epitopes of p-glycoprotein and human metallothionein revealed that (1) mononuclear cells expressing these antigens are present in the lung allograft during rejection, (2) that steroid-resistant acute rejection is associated with increased percentages of C494 and metallothionein-positive cells as compared to steroid-sensitive cases, (3) that bronchiolitis obliterans was associated with a higher percentage of cells with drug-resistant antigen expression, and (4) that steroid-resistant bronchiolitis obliterans is associated with the highest percentage of C494 and metallothionein-positive cells in the five clinical situations studied. P-glycoprotein and metallothionein expression may be a marker of aggressive or persistent cases of acute rejection and bronchiolitis obliterans.
authors.affiliation: Department of Pathology, Montefiore University Hospital, University of Pittsburgh School of Medicine, PA 15213-3241.
authors.forename: S A
authors.initials: SA
authors.lastname: Yousem
authors.forename: D
authors.initials: D
authors.lastname: Sartori
authors.forename: E
authors.initials: E
authors.lastname: Sonmez-Alpan
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000208:Acute Disease; D001989:Bronchiolitis Obliterans / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D002908:Chronic Disease; D004351:Drug Resistance; D006084:Graft Rejection / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000737:chemistry / Q000473:pathology; D016040:Lung Transplantation / Q000009:adverse effects; D008562:Membrane Glycoproteins / Q000032:analysis; D008668:Metallothionein / Q000032:analysis; D013256:Steroids / Q000627:therapeutic use
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D008562:Membrane Glycoproteins; D013256:Steroids; D008668:Metallothionein