TNFalpha, interleukin-10 and interleukin-18 expression in cells of the bronchoalveolar lavage in patients with pulmonary complications following bone marrow or peripheral stem cell transplantation: a preliminary study.
Pulmonary complications pose a major clinical problem after bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT). The underlying pathophysiological mechanisms are under investigation. Twenty patients with infectious or non-infectious pulmonary complications after BMT or PBSCT underwent bronchoalveolar lavage (BAL) and tumor necrosis factor-alpha (TNFalpha), interleukin-10 (IL-10) and interleukin-18 (IL-18) mRNA expression was determined in BAL cells in comparison to 11 healthy volunteers. Patients were divided into two groups (infectious pneumonia, n = 14 or idiopathic pneumonia syndrome (IPS)/bronchiolitis obliterans (BO), n = 6). TNFalpha expression was significantly increased in both patient groups compared to the control (0.40 +/- 0.07 and 0.39 +/- 0.09 vs 0.15 +/- 0.05; P < 0.05; semiquantitative PCR analysis; mean +/- s.e.m.). IL-10 expression was significantly elevated the group of patients with infectious pneumonia in comparison to normal controls (0.15 +/- 0.06 vs 0.01 +/- 0.01; P < 0.05) but not in patients with IPS/BO (0.05 +/- 0.04; P > 0.05). However, IL-10 was not expressed in BAL cells of all patients and control individuals. IL-18 expression was significantly decreased in the both patient groups (1.47 +/- 0.24 and 1.79 +/- 0.63) in comparison to the control group (4.29 +/- 0.77; P < 0.05). Survival analysis showed a significant association between elevation of TNFalpha and poor prognosis (P < 0.05). These results highlight the immunoregulatory disturbances in the lungs after BMT/PBSCT.
Hauber
H-P
HP
Department of Internal Medicine, Pulmonology, University Hospital Eppendorf, Germany.
Mikkilä
A
A
Erich
J M
JM
Kröger
N
N
Meyer
A
A
Schoder
V
V
Zander
A R
AR
Pforte
A
A
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001989:Bronchiolitis Obliterans / Q000209:etiology / Q000378:metabolism / Q000401:mortality; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology*; D016022:Case-Control Studies; D016207:Cytokines / Q000096:biosynthesis* / Q000235:genetics; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000096:biosynthesis / Q000235:genetics; D020382:Interleukin-18 / Q000096:biosynthesis / Q000235:genetics; D008171:Lung Diseases / Q000209:etiology / Q000378:metabolism* / Q000401:mortality; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D010865:Pilot Projects; D011379:Prognosis; D012333:RNA, Messenger / Q000032:analysis; D012141:Respiratory Tract Infections / Q000209:etiology / Q000378:metabolism / Q000401:mortality; D016019:Survival Analysis; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000235:genetics
D015415:Biomarkers; D016207:Cytokines; D020382:Interleukin-18; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10