Mechanisms for reduced pulmonary diffusing capacity in haematopoietic stem-cell transplantation recipients.
Lung diffusing capacity for CO (DLCO) is compromised in haematopoietic stem-cell transplantation (HSCT) recipients. We derived alveolar-capillary membrane conductance (DM,CO) and pulmonary capillary volume (VC) from DLCO and diffusing capacity for NO (DLNO). Forty patients were studied before and 6 weeks after HSCT. Before HSCT, DLNO and DLCO were significantly lower than in 30 healthy controls. DM,CO was ∼40% lower in patients than in controls (p<0.001), whereas VC did not differ significantly. After HSCT, DLNO and DM,CO further decreased, the latter by ∼22% from before HSCT (p<0.01) while VC did not change significantly. Lung density, serum CRP and reactive oxygen metabolites were significantly increased, with the latter being correlated (R2=0.71, p<0.001) with the decrement in DLNO. We conclude that DLNO and, to a lesser extent, DLCO are compromised before HSCT mainly due to a DM,CO reduction. A further reduction of DM,CO without VC loss occurs after HSCT, possibly related to development of oedema, or interstitial fibrosis, or both.
Fisiopatologia Respiratoria, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, Genoa, Italy. Electronic address: giovanni.barisione@hsanmartino.it.
Giovanni
G
Barisione
Ematologia 2, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, Genoa, Italy.
Andrea
A
Bacigalupo
Dipartimento di Medicina Interna e Specialità Mediche, Università di Genova, Genoa, Italy.
Claudia
C
Brusasco
Dipartimento di Medicina Sperimentale, Università di Genova, Genoa, Italy.
Chiara
C
Scanarotti
Dipartimento di Medicina Sperimentale, Università di Genova, Genoa, Italy.
Susanna
S
Penco
Dipartimento di Medicina Sperimentale, Università di Genova, Genoa, Italy.
Anna Maria
AM
Bassi
Ematologia 2, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, Genoa, Italy.
Teresa
T
Lamparelli
Radiologia, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, Genoa, Italy.
Alessandro
A
Garlaschi
Allergologia e Fisiopatologia Respiratoria, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy.
Riccardo
R
Pellegrino
Dipartimento di Medicina Interna e Specialità Mediche, Università di Genova, Genoa, Italy.
Vito
V
Brusasco
D000293:Adolescent; D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011653:Pulmonary Diffusing Capacity / Q000502:physiology*; D017382:Reactive Oxygen Species / Q000097:blood; D012129:Respiratory Function Tests; D013147:Spirometry; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D017382:Reactive Oxygen Species; D002097:C-Reactive Protein
Alveolar–capillary membrane conductance; Carbon monoxide; Lung density; Nitric oxide; Pulmonary capillary volume; Reactive oxygen metabolites