title: Serum thymus and activation regulated chemokine levels post-lung transplantation as a predictor for the bronchiolitis obliterans syndrome.
abstract: The main reason for mortality after lung transplantation is the bronchiolitis obliterans syndrome (BOS), which represents chronic rejection. As soluble CD30, which is produced mainly by activated T helper 2 (Th2) cells, was shown to be related to development of BOS, we aimed to investigate the relation between development of BOS and Th2 chemoattractant thymus and activation regulated chemokine (TARC/CCL17). In 54 patients we measured serum TARC levels prior to transplantation by enzyme-linked immunosorbent assay, and in 44 of these patients sera were analysed at months 1, 2 and 3 after lung transplantation. In addition, longitudinal measurements were performed in sera from eight healthy controls and 14 patients, the latter taken over a period of 2 years post-transplantation from seven patients developing BOS plus seven clinically matched BOS-free patients. Median serum TARC levels post-transplantation of patients who developed BOS were significantly lower than those of the matched BOS-free patients (P = 0.05). A receiver operating characteristics analysis (area under the curve 0.77), together with a Kaplan-Meyer analysis, showed that serum TARC levels below 325 pg/ml in the first month post-transplantation can predict development of BOS post-transplantation (P = 0.001). In contrast, pretransplant serum TARC levels were not significantly different between patients developing BOS, BOS-free patients or healthy controls. In conclusion, pretransplantation serum TARC levels do not predict the development of BOS post-transplantation, but measurement of the serum TARC levels in the first month directly after transplantation can provide us with a tool to identify the group at risk of developing BOS.
authors.affiliation: Department of Immunology, University Medical Centre Utrecht, Utrecht, the Netherlands. a.paantjens@umcutrecht.nl
authors.forename: A W M
authors.initials: AW
authors.lastname: Paantjens
authors.forename: J M
authors.initials: JM
authors.lastname: Kwakkel-van Erp
authors.forename: W G J
authors.initials: WG
authors.lastname: van Ginkel
authors.forename: D A
authors.initials: DA
authors.lastname: van Kessel
authors.forename: J M M
authors.initials: JM
authors.lastname: van den Bosch
authors.forename: E A
authors.initials: EA
authors.lastname: van de Graaf
authors.forename: H G
authors.initials: HG
authors.lastname: Otten
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001989:Bronchiolitis Obliterans / Q000175:diagnosis* / Q000209:etiology; D054414:Chemokine CCL17 / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011184:Postoperative Period; D011379:Prognosis
chemical_list: D015415:Biomarkers; D054414:Chemokine CCL17
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