BAL neutrophilia in XXXX -treated lung transplant recipients: Clinical significance.

@entity1 @entity650 @entity1356 @entity4580 @entity133 @entity1193 @entity12868 @entity2842 @entity5924 @entity4155 @entity14700 @entity3646 @entity687 @entity10557
BACKGROUND: @entity4580 decreases airway neutrophilia and can prevent chronic lung allograft dysfunction (CLAD) after lung transplantation (LTx). It also can be used to treat @entity5924 , as it decreases the submucosal infiltrating @entity4155 positive lymphocytes. Some @entity1 , while receiving @entity4580 , (re)develop increased airway neutrophilia, which we hypothesize to result in worse outcome and to be regulated by an @entity4155 -independent mechanism. METHODS: LTx recipients, transplanted between 2001 and 2012, were investigated and categorized in a study group of @entity1 with @entity133 (BAL) neutrophilia (>= 15%) and a matched control group with low BAL neutrophilia (<15%), both groups while already being on @entity4580 treatment. CLAD-free and overall survival were compared between groups. Cell differentials and 33 proteins in BAL were analyzed to identify underlying mechanisms. RESULTS: The study group (n=72) demonstrated a significantly lower CLAD-free (p=0.015) and overall survival (p=0.041) compared to the control group (n=37). Absolute BAL neutrophils and eosinophils were increased in the study group, which was paralleled by elevated inflammatory cytokines ( @entity1356 / @entity1193 , @entity3646 and @entity650 ) and chemokines ( @entity687 / @entity687 , @entity2842 / @entity2842 , @entity10557 / @entity10557 , @entity12868 / @entity12868 , @entity14700 /eotaxin) concentrations compared to the control group (all p<0.05). CONCLUSION: @entity1 with elevated airway neutrophilia despite @entity4580 , experience worse CLAD-free and overall survival. In these @entity1 , @entity1356 might play a central role giving rise to neutrophils, eosinophils, macrophages and B-cells. This provides an opportunity to further investigate the modulation of this pathway.
