Bronchoalveolar immunologic profile of acute human lung transplant allograft rejection.
Bronchoalveolar lavage fluid (BALF) offers a potential means to diagnose acute rejection and could provide insight into the immune mechanisms responsible for lung allograft rejection. Transbronchial biopsies from 29 bronchoscopic procedures were assessed for rejection. Concurrent BALF lymphocyte subsets were examined by flow cytometry, including CD4 and CD8 T cells and their activation status by CD38 expression, natural killer (NK), NK-like T (NT), B, regulatory T, and invariant receptor NK-T cells. Percentages of CD4 were reduced, and CD8 and activation of CD4 T cells correlated with rejection. There were trends for increased NT, reduced NK, and increased B cell percentages with rejection, suggesting potential roles of these cells. Among regulatory cells, the percentages of regulatory T cells decreased and CD4/CD8 invariant NK-T cells increased during rejection, suggesting a proinflammatory profile. A unique BALF lymphocyte profile was associated with rejection and may provide insight into the pathogenesis of allograft rejection.
Gregson
Aric L
AL
Division of Infectious Diseases, Department of Medicine, University of California, Los Angeles, CA 90095, USA. agregson@mednet.ucla.edu
Hoji
Aki
A
Saggar
Rajan
R
Ross
David J
DJ
Kubak
Bernard M
BM
Jamieson
Beth D
BD
Weigt
S Samuel
SS
Lynch
Joseph P
JP
Ardehali
Abbas
A
Belperio
John A
JA
Yang
Otto O
OO
D000208:Acute Disease; D015703:Antigens, CD / Q000032:analysis; D016175:B-Lymphocyte Subsets / Q000276:immunology; D001402:B-Lymphocytes / Q000276:immunology; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D005434:Flow Cytometry; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D016040:Lung Transplantation / Q000276:immunology* / Q000473:pathology*; D011237:Predictive Value of Tests; D016176:T-Lymphocyte Subsets / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
D015703:Antigens, CD