title: Mast cell phenotypes in the allograft after lung transplantation.
abstract: The burden of mast cell (MC) infiltration and their phenotypes, MC-tryptase (MCT ) and MC-tryptase/chymase (MCTC ), after lung transplantation (LT) has not been evaluated in human studies.
  
  
  
  We reviewed 20 transbronchial lung biopsy (TBLB) specimen from patients with early normal allograft (<6 months post-LT, n=5), late normal allograft (>6 months, n=5), A2 or worse acute cellular rejection (ACR, n=5), and chronic lung allograft dysfunction (CLAD, n=5). Slides were immunostained for tryptase and chymase. Total MC, MCT , MCTC and MCTC to-MCT ratio were compared between the four groups using a generalized linear mixed model.
  
  
  
  Irrespective of clinicopathologic diagnosis, MC burden tends to increase with time (r(2) =.56, P=.009). MCTC phenotype was significantly increased in the CLAD group (8.2±4.9 cells per HPF) in comparison with the other three groups (early normal: 1.6±1.7, P=.0026; late normal: 2.5±2.3, P=.048; ACR: 2.7±3.5, P=.021). Further, the ratio of MCTC to MCT was significantly increased in CLAD group as compared to the other three groups (P<.001 for all comparisons).
  
  
  
  The burden of MC may increase in the allograft as function of time. Patients with CLAD have an increased relative and absolute burden of MCTC phenotype MC. Future studies are needed to confirm these findings and evaluate the potential pathologic role of MCTC in allograft dysfunction.
authors.affiliation: Lung Transplant Program, Division of Pulmonary & Critical Care Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Banga
authors.affiliation: Department of Pathobiology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Yingchun
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Pathobiology, Cleveland Clinic, Cleveland, OH, USA.|Department of Allergy and Immunology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Fred H
authors.initials: FH
authors.lastname: Hsieh
mesh_terms: D000368:Aged; D064591:Allografts; D001706:Biopsy; D002452:Cell Count; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D008168:Lung / Q000473:pathology* / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008407:Mast Cells / Q000201:enzymology / Q000473:pathology*; D008875:Middle Aged; D010641:Phenotype; D011184:Postoperative Period; D012189:Retrospective Studies; D053802:Tryptases / Q000378:metabolism
chemical_list: D053802:Tryptases
keywords: acute cellular rejection; chronic lung allograft dysfunction; innate immunity; transbronchial lung biopsy