title: Monocyte chemoattractant protein-1 levels in bronchoalveolar lavage fluid of lung-transplanted patients treated with tacrolimus as rescue treatment for refractory acute rejection.
abstract: BACKGROUND
  Cytokines are important mediators of the complex process of extravasation and influx of peripheral mononuclear cells into a site of graft injury, an action that may be affected by the immunosuppressive regimen. The aim of this study was to compare the effect of different immunosuppressive regimens on cytokine expression in the grafted lung.
  
  
  METHODS
  We analyzed the cytokine profiles in broncho-alveolar lavage fluid (BAL-F) from 18 lung transplanted patients undergoing a shift from a cyclosporine- to a tacrolimus-based triple therapy regimen due to refractory acute rejection.
  
  
  RESULTS
  Three months after the conversion to tacrolimus, BAL-F levels of interleukin 8 (IL8), IL18, IL12 and IL10 were not significantly different than those measured before conversion. In contrast, monocyte chemoattractant protein-1 (MCP-1) levels showed a significant and sustained decrease in BAL-F during tacrolimus therapy. In addition the levels of gamma interferon (IFN-gamma) in the BAL-F were decreased albeit not significantly.
  
  
  CONCLUSIONS
  These findings suggest that the clinical and functional stabilization of patients observed after conversion to a tacrolimus based regimen, may be due, at least in part, to the induced down-regulation of MCP-1 production.
authors.affiliation: Department of Haematological Pneumological and Cardiovascular Sciences, Divisions of Pneumology and Cardiac Surgery, University of Pavia, IRCCS San Matteo, Pavia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Meloni
authors.forename: A
authors.initials: A
authors.lastname: Cascina
authors.forename: E
authors.initials: E
authors.lastname: Paschetto
authors.forename: A
authors.initials: A
authors.lastname: Marone Bianco
authors.forename: M
authors.initials: M
authors.lastname: Morosini
authors.forename: C
authors.initials: C
authors.lastname: Pellegrini
authors.forename: A
authors.initials: A
authors.lastname: Fietta
authors.forename: P
authors.initials: P
authors.lastname: Vitulo
authors.forename: E
authors.initials: E
authors.lastname: Pozzi
authors.forename: M
authors.initials: M
authors.lastname: Viganò
mesh_terms: D000208:Acute Disease; D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D018932:Chemokine CCL2 / Q000032:analysis*; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D006084:Graft Rejection / Q000188:drug therapy* / Q000473:pathology; D016041:Heart-Lung Transplantation / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007378:Interleukins / Q000032:analysis; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D018932:Chemokine CCL2; D007166:Immunosuppressive Agents; D007378:Interleukins; D016559:Tacrolimus