The use of allopurinol in the inhibition of obliterative bronchiolitis of the transplanted lung.
Long-term survival following lung transplantation has been limited primarily by the development in patients' lungs of a rejection-related obliteration of terminal bronchioles by fibroblasts. It is known to result from frequent and persistent acute lung rejection and its physiological features include a progressive decline in the lung function measurement of forced expiratory volume in 1 s. We report the dramatic effect on this hitherto usually fatal condition of a specific inhibition of purine metabolism at the xanthine oxidase enzyme by the hypoxanthine analogue allopurinol. The effect of this drug in heart-lung transplant patients with deteriorating lung function in reducing the rate of rejection and in stabilizing lung function was apparent over as short a follow-up period as 3 months and in ten patients. Although the follow-up time is short, we believe the effects are so striking as to require reporting although the mechanisms of this phenomenon are not yet well understood.
Scott
J P
JP
Division of Thoracic Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Wallwork
J
J
D000328:Adult; D000493:Allopurinol / Q000627:therapeutic use*; D001989:Bronchiolitis Obliterans / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000187:drug effects; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007958:Leukocyte Count; D016040:Lung Transplantation / Q000009:adverse effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D016166:Free Radical Scavengers; D000493:Allopurinol