Activation of eosinophils in the airways of lung transplantation patients.
Eosinophils are important inflammatory cells involved in liver and renal allograft rejection. The role of these cells is less well defined in lung allograft rejection. Eosinophils may be activated in lung rejection and release cytotoxic eosinophil cationic protein (ECP). Other states of disease in lung transplant recipients, such as cytomegalovirus (CMV) and bacterial infection, may also be associated with activated eosinophils. We postulated that ECP may be detectable and elevated in the airway lavage samples obtained from lung transplant patients and may contribute to disease pathogenesis.


METHODS
Fifty BAL samples were collected from 38 lung transplant patients. Their most recent pulmonary function test results within 1 week of collection were noted. The samples were analyzed for the concentration of ECP, WBC count and differential cell count, and total protein level. The results were analyzed to identify the presence of disease or abnormal lung function associated with a positive ECP test. Student's t test was used and a p value of <0.05 was considered significant.


RESULTS
We found that ECP levels were elevated in 36% (n=14) of the patients. Those patients with a positive test result were more likely to have acute rejection, CMV disease, or the presence of a cultured pathogen in BAL compared to patients with a negative test result (p<0.01).


CONCLUSIONS
The presence of BAL ECP is associated with disease in lung transplant patients. Since ECP is directly cytotoxic, it may contribute to disease pathogenesis.
Dosanjh
A K
AK
Department of Pediatric Pulmonary, Stanford University Medical School, Calif., USA.
Elashoff
D
D
Kawalek
A
A
Moss
R B
RB
Esrig
S
S
D000328:Adult; D015415:Biomarkers; D001706:Biopsy; D001798:Blood Proteins / Q000378:metabolism*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D018929:Cell Culture Techniques; D047091:Eosinophil Granule Proteins; D004804:Eosinophils / Q000502:physiology*; D005260:Female; D006084:Graft Rejection / Q000378:metabolism; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D007958:Leukocyte Count; D008168:Lung / Q000378:metabolism*; D016040:Lung Transplantation / Q000502:physiology; D008297:Male; D011237:Predictive Value of Tests; D012260:Ribonucleases
D015415:Biomarkers; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D018836:Inflammation Mediators; D012260:Ribonucleases