HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nicod, L. P. Search for Related Content PubMed PubMed Citation Articles by Nicod, L. P.

Mechanisms of Airway Obliteration after Lung Transplantation

Clinic and Policlinic of Pneumology, Inselspital, Bern, Switzerland

Correspondence and requests for reprints should be addressed to Laurent P. Nicod, Clinic and Policlinic of Pneumology, Inselspital, CH 3010 Bern, Switzerland. E-mail: laurent.nicod{at}insel.ch

ABSTRACT

Post-transplant bronchiolitis obliterans, also called bronchiolitis obliterans syndrome, affects up to 50–60% of patients who survive 5 yr after surgery according to its clinical definition, which is based on the degree of obstructive airway disease. Alloimmune-independent and -dependent mechanisms produce injuries and inflammation of epithelial cells and subepithelial structures, leading to aberrant tissue repair. The triggering of innate immunity by various infections or chemical injuries after, for example, gastroesophageal reflux, may lead to the release of danger signals that are able to activate dendritic cells, a crucial link with adaptive immunity. Inflammation can also increase the expression and display of major histocompatibility alloantigens and thus favor the initiation of rejection episodes. These phenomena may be limited in time and location or may be protracted. Reducing the risk of alloimmune-independent factors may be as important as treating acute episodes of lung rejection. Excessive immunosuppression may be deleterious by increasing the risk of infection, thereby triggering innate and adaptive immunity. New potential therapeutic targets are emerging from the research performed on leukotriene receptors, chemokine receptors, and growth factors. Neutralizing these molecules reduces the initial mononuclear and polynuclear infiltrates or the subsequent fibroproliferative process and the neovascular changes, feeding this process.

Key Words: adaptive immunity • dendritic cells • infections • innate immunity

This article has been cited by other articles:

				K. L. Vandemheen, A. O'Connor, S. C. Bell, A. Freitag, P. Bye, A. Jeanneret, Y. Berthiaume, N. Brown, P. Wilcox, G. Ryan, et al. Randomized Trial of a Decision Aid for Patients with Cystic Fibrosis Considering Lung Transplantation Am. J. Respir. Crit. Care Med., October 15, 2009; 180(8): 761 - 768. [Abstract] [Full Text] [PDF]

				K. M. Williams, J. W. Chien, M. T. Gladwin, and S. Z. Pavletic Bronchiolitis Obliterans After Allogeneic Hematopoietic Stem Cell Transplantation JAMA, July 15, 2009; 302(3): 306 - 314. [Abstract] [Full Text] [PDF]

				C Ward, K Eger, J Diboll, D Jones, M A Haniffa, M Brodlie, A Fisher, J L Lordan, P A Corris, and C M U Hilkens Bronchial epithelial cells cultured from clinically stable lung allograft patients promote the development of macrophages from monocytes rather than dendritic cells Thorax, May 1, 2009; 64(5): 430 - 435. [Abstract] [Full Text] [PDF]

				Y. Li Ng, N. Paul, D. Patsios, A. Walsham, T.-B. Chung, S. Keshavjee, and G. Weisbrod Imaging of Lung Transplantation: Review Am. J. Roentgenol., March 1, 2009; 192(3_Supplement): S1 - S13. [Abstract] [Full Text] [PDF]

				Y. Li Ng, N. Paul, D. Patsios, A. Walsham, T.-B. Chung, S. Keshavjee, and G. Weisbrod Imaging of Lung Transplantation: Self-Assessment Module Am. J. Roentgenol., March 1, 2009; 192(3_Supplement): S14 - S19. [Abstract] [Full Text] [PDF]

				M. P. Keane The role of chemokines and cytokines in lung fibrosis Eur. Respir. Rev., December 1, 2008; 17(109): 151 - 156. [Abstract] [Full Text] [PDF]

				R. G. Crystal, S. H. Randell, J. F. Engelhardt, J. Voynow, and M. E. Sunday Airway Epithelial Cells: Current Concepts and Challenges Proceedings of the ATS, September 15, 2008; 5(7): 772 - 777. [Abstract] [Full Text] [PDF]

				K. Blondeau, V. Mertens, B. A. Vanaudenaerde, G. M. Verleden, D. E. Van Raemdonck, D. Sifrim, and L. J. Dupont Gastro-oesophageal reflux and gastric aspiration in lung transplant patients with or without chronic rejection Eur. Respir. J., April 1, 2008; 31(4): 707 - 713. [Abstract] [Full Text] [PDF]

				L. B. Ware Clinical Year in Review III: Asthma, Lung Transplantation, Cystic Fibrosis, Acute Respiratory Distress Syndrome Proceedings of the ATS, September 15, 2007; 4(6): 489 - 493. [Full Text] [PDF]