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  1 / 13107 MEDLINE  
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[PMID]:28457921
[Au] Autor:Budding K; Rossato M; van de Graaf EA; Kwakkel-van Erp JM; Radstake TRDJ; Otten HG
[Ad] Endereço:Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: k.budding@umcutrecht.nl.
[Ti] Título:Serum miRNAs as potential biomarkers for the bronchiolitis obliterans syndrome after lung transplantation.
[So] Source:Transpl Immunol;42:1-4, 2017 06.
[Is] ISSN:1878-5492
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Lung transplantation (LTx) is the last treatment for patients suffering from end-stage lung diseases. Survival post-LTx is hampered by the development of the bronchiolitis obliterans syndrome (BOS) and diagnosis is often late. Given the urgent clinical need to recognize BOS patients at an early stage, we analyzed circulating miRNAs to identify possible stratification markers for BOS development post-transplantation. Therefore, pro-fibrotic (miR-21, miR-155), anti-fibrotic (miR-29a) and fibrosis-unrelated (miR-103, miR-191) miRNAs were analyzed in serum of end-stage lung disease patients and during LTx follow-up. Significant elevated levels of serum miRNAs were observed for all investigated miRNAs in both chronic obstructive pulmonary disease and interstitial lung disease patients compared to healthy controls. The same miRNAs were also significantly increased in the serum of BOS+ vs. BOS- patients. Most importantly, miR-21, miR-29a, miR-103, and miR-191 levels were significantly higher in BOS+ patients prior to clinical BOS diagnosis. We demonstrated that a selected group of miRNAs investigated is elevated in end-stage lung disease and BOS+ patients, prior to clinical BOS diagnosis. Even if further research is expedient on the prognostic value of circulating miRNAs in BOS and lung conditions in general, these results strongly suggest that circulating miRNAs could be used as potential biomarkers for BOS development.
[Mh] Termos MeSH primário: Bronquiolite Obliterante/sangue
Transplante de Pulmão
MicroRNAs/sangue
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Doença Pulmonar Obstrutiva Crônica/sangue
Estudos Retrospectivos
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (MicroRNAs)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28449046
[Au] Autor:Riera J; Maldonado C; Mazo C; Martínez M; Baldirà J; Lagunes L; Augustin S; Roman A; Due M; Rello J; Levine DJ
[Ad] Endereço:Department of Critical Care, Vall d'Hebron University Hospital, Barcelona, Spain.
[Ti] Título:Prone positioning as a bridge to recovery from refractory hypoxaemia following lung transplantation.
[So] Source:Interact Cardiovasc Thorac Surg;25(2):292-296, 2017 08 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Refractory hypoxaemia is the leading cause of mortality in the postoperative period after lung transplantation. The role of prone positioning as a rescue therapy in this setting has not been assessed. We evaluated its effects in lung transplant recipients presenting refractory hypoxaemia following the surgery. METHODS: Prospectively collected data from 131 consecutive adult patients undergoing lung transplantation between January 2013 and December 2014 were evaluated. Twenty-two patients received prone position therapy. Indications, associated complications, time to initiation and duration of the manoeuvre were analysed and the effects of prone position on gas exchange were evaluated. Finally, outcomes in this cohort were compared against the rest of lung transplant recipients. RESULTS: Prone positioning was more frequently implemented within the first 72 h (68.2%) and its main indication was primary graft dysfunction. The manoeuvre was maintained during a median of 21 h. After prone position, the pressure of arterial oxygen/fraction of inspired oxygen ratio significantly increased from 81.0 mmHg [interquartile range (IQR) 71.5-104.0] to 220.0 (IQR 160.0-288.0) (P < 0.001). No complications related with the technique were reported. Patients who underwent the manoeuvre had longer hospital stay [50.0 days (IQR 36.0-67.0) vs 30.0 (IQR 23.0-56.0), P = 0.006] than the rest of the population. No differences were found comparing either 1-year mortality (9.1% vs 15.6%; P = 0.740) or 1-year graft function [forced expiratory volume in 1 second of 70.0 (IQR 53.0-83.0) vs 68.0 (IQR 53.5-80.5), P = 0.469]. CONCLUSIONS: Prone positioning is safe and significantly improves gas exchange in patients with refractory hypoxaemia after lung transplantation. It should be considered as a possible treatment in these patients.
[Mh] Termos MeSH primário: Hipóxia/reabilitação
Transplante de Pulmão/efeitos adversos
Posicionamento do Paciente/métodos
Modalidades de Fisioterapia
Disfunção Primária do Enxerto/reabilitação
Decúbito Ventral
Recuperação de Função Fisiológica
[Mh] Termos MeSH secundário: Feminino
Seguimentos
Seres Humanos
Hipóxia/etiologia
Hipóxia/fisiopatologia
Masculino
Meia-Idade
Disfunção Primária do Enxerto/complicações
Estudos Prospectivos
Síndrome do Desconforto Respiratório do Adulto/etiologia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivx073


  3 / 13107 MEDLINE  
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[PMID]:27773452
[Au] Autor:Xu Z; Sharma M; Gelman A; Hachem R; Mohanakumar T
[Ad] Endereço:Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA; Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
[Ti] Título:Significant role for microRNA-21 affecting toll-like receptor pathway in primary graft dysfunction after human lung transplantation.
[So] Source:J Heart Lung Transplant;36(3):331-339, 2017 Mar.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: MicroRNAs (miRNAs) were recently identified as modulators of immune responses after human lung transplantation (LTx). This study was undertaken to assess the contribution of miRNAs to the pathogenesis of primary graft dysfunction (PGD) after LTx. METHODS: Of the 39 recipients, 14 (35.9%) developed Grade 3 PGD (i.e., severe PGD) within the first 72 hours of LTx. The remaining 25 recipients (64.1%) had Grade 2 or less PGD, and served as the control group. miRNAs were isolated from cells purified by bronchoalveolar lavage (BAL). Bioinformatic prediction and validation by luciferase reporter assays were performed to identify targets regulated by miR-21. Transfection of human monocytic cell line (THP-1) was conducted to determine miR-21's cellular function. RESULTS: Pilot miRNA profiling of donor BAL samples before implantation in PGD (n = 6) revealed significant upregulation in 44 miRNAs and downregulation in 80 miRNAs compared with control (n = 6). Validation using a separate cohort demonstrated significant underexpression of miR-21 in patients with severe PGD. Furthermore, underexpression of miR-21 levels was negatively correlated with clinical PGD grades (Grade 2 PGD vs Grade 0 PGD: p = 0.042; Grade 3 PGD vs Grade 0 PGD: p = 0.004). Molecular analysis demonstrated that miR-21 targeted key components in the toll-like receptor (TLR) signaling pathway, including TLR4, IRAK3 and CXCL10. Further, incubation of THP-1 cells with cell-free BAL from severe PGD resulted in transactivation of inflammatory cytokines interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α). In contrast, increased expression of miR-21 resulted in marked suppression of IL-1-ß and TNF-α production. CONCLUSIONS: Underexpression of miR-21 may lead to the development of severe PGD by activating key components of the TLR pathway.
[Mh] Termos MeSH primário: Regulação da Expressão Gênica
Transplante de Pulmão/efeitos adversos
MicroRNAs/genética
Disfunção Primária do Enxerto/genética
Receptores Toll-Like/genética
[Mh] Termos MeSH secundário: Adulto
Western Blotting
Líquido da Lavagem Broncoalveolar
Estudos de Coortes
Feminino
Seres Humanos
Transplante de Pulmão/métodos
Masculino
Meia-Idade
Disfunção Primária do Enxerto/fisiopatologia
Prognóstico
Reação em Cadeia da Polimerase em Tempo Real/métodos
Estudos Retrospectivos
Papel (Figurativo)
Sensibilidade e Especificidade
Transdução de Sinais/genética
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (MIRN21 microRNA, human); 0 (MicroRNAs); 0 (Toll-Like Receptors)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  4 / 13107 MEDLINE  
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[PMID]:27773453
[Au] Autor:Liu Y; Vela M; Rudakevych T; Wigfield C; Garrity E; Saunders MR
[Ad] Endereço:Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.
[Ti] Título:Patient factors associated with lung transplant referral and waitlist for patients with cystic fibrosis and pulmonary fibrosis.
[So] Source:J Heart Lung Transplant;36(3):264-271, 2017 Mar.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Since 2005, the Lung Allocation Score (LAS) has prioritized patient benefit and post-transplant survival, reducing waitlist to transplant time to <200 days and decreasing mortality on the waitlist. A current challenge is the wait for the waitlist-the time between the patient's transplant-eligible diagnosis and waitlist registration. METHODS: We investigated whether sociodemographic (age, sex, race, insurance, marital status, median household income) and clinical (forced expiratory volume in 1 second [FEV ] percent of predicted, body mass index, depression/anxiety, alcohol/substance misuse, absolute/relative contraindications) factors influenced referral and waitlist registration. We conducted a retrospective cohort study through chart review of hospitalized patients on the University of Chicago general medicine service from 2006 to 2014 who met transplant-eligible criteria and ICD-9 billing codes for cystic fibrosis (CF) and pulmonary fibrosis (PF). We analyzed the times from transplant eligibility to referral, work-up and waitlisting using Kaplan-Meier curves and log-rank tests. RESULTS: Overall, the referral rate for transplant-eligible patients was 64%. Of those referred, approximately 36% reach the lung transplant waitlist. Referred CF patients were significantly more likely to reach the transplant waitlist than PF patients (CF 60% vs PF 22%, p < 0.05). In addition, CF patients had a shorter wait from transplant eligibility to waitlist than PF patients (329 vs 2,369 days, respectively [25th percentile], p < 0.05). Patients with PF and CF both faced delays from eligibility to referral and waitlist. CONCLUSIONS: Quality improvement efforts are needed to better identify and refer appropriate patients for lung transplant evaluation. Targeted interventions may facilitate more efficient evaluation completion and waitlist appearance.
[Mh] Termos MeSH primário: Fibrose Cística/cirurgia
Transplante de Pulmão/métodos
Fibrose Pulmonar/cirurgia
Encaminhamento e Consulta/estatística & dados numéricos
Listas de Espera
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Adulto
Estudos de Coortes
Comorbidade
Fibrose Cística/diagnóstico
Fibrose Cística/mortalidade
Feminino
Rejeição de Enxerto
Sobrevivência de Enxerto
Seres Humanos
Cobertura do Seguro
Estimativa de Kaplan-Meier
Transplante de Pulmão/mortalidade
Masculino
Meia-Idade
Seleção de Pacientes
Fibrose Pulmonar/diagnóstico
Fibrose Pulmonar/mortalidade
Testes de Função Respiratória
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Estatísticas não Paramétricas
Análise de Sobrevida
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28749818
[Au] Autor:Lehingue S; Rambaud R; Guervilly C; Adda M; Forel JM; Cassir N; Zandotti C; Hraiech S; Papazian L
[Ad] Endereço:Réanimation des Détresses Respiratoires et Infections Sévères, Aix-Marseille University, APHM, Hôpital Nord, Marseille, France.
[Ti] Título:Fatal Septic Shock Triggered by Donor Transmitted Varicella Zoster Virus Reinfection 3 Days After Lung Transplantation.
[So] Source:Transplantation;101(12):e351-e352, 2017 12.
[Is] ISSN:1534-6080
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Herpesvirus Humano 3/patogenicidade
Transplante de Pulmão/efeitos adversos
Pulmão/virologia
Insuficiência de Múltiplos Órgãos/virologia
Choque Séptico/virologia
Doadores de Tecidos
Infecção pelo Vírus da Varicela-Zoster/transmissão
Infecção pelo Vírus da Varicela-Zoster/virologia
[Mh] Termos MeSH secundário: Adulto
Evolução Fatal
Feminino
Seres Humanos
Masculino
Meia-Idade
Insuficiência de Múltiplos Órgãos/diagnóstico
Choque Séptico/diagnóstico
Infecção pelo Vírus da Varicela-Zoster/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1097/TP.0000000000001899


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[PMID]:29184964
[Au] Autor:Costa C; Di Nauta A; Rittà M; Sinesi F; Bianco G; Sidoti F; Solidoro P; Cavallo R
[Ad] Endereço:Microbiology and Virology Unit, Laboratory of Virology.
[Ti] Título:Development of an EliSPOT assay for HSV-1 and clinical validation in lung transplant patients.
[So] Source:New Microbiol;40(4):251-257, 2017 Oct.
[Is] ISSN:1121-7138
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Cellular immunity plays a major role in the control of HSV-1 infection/reactivation with a potential impact on the clinical-therapeutic management of immunocompromised patients, such as transplant recipients. Herein, we quantitatively evaluated T-cell response directed at HSV-1 by a newly developed IFN-γ EliSPOT assay in 53 patients (including 45 lung transplant recipients and eight subjects in waiting list). Overall, 62.2% of transplant patients and 62.5% of subjects on the waiting list showed a response to HSV-1 with no significant difference in the level of virus-specific cellular immunity. Response tended to be lower in the first three months posttransplantation with a progressive recovery of pretransplantation status by the second year and in the presence of HSV-1 DNA positivity in bronchoalveolar lavage. As expected, no response was found in seronegative patients. No significant difference in the level of response according to IgM and IgG status was found. Further studies are required to define the role of HSV-1 specific immune response for the clinical-therapeutic management of lung transplant patients and in other clinical settings and to define cut-off levels discriminating between absence/low and strong response to be related to the risk of viral infection/reactivation.
[Mh] Termos MeSH primário: ELISPOT/métodos
Herpes Simples/diagnóstico
Herpesvirus Humano 1/imunologia
Imunidade Celular
Transplante de Pulmão/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Feminino
Herpes Simples/virologia
Herpesvirus Humano 1/isolamento & purificação
Herpesvirus Humano 1/fisiologia
Seres Humanos
Masculino
Meia-Idade
Linfócitos T/imunologia
Transplantados
Ativação Viral
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE


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[PMID]:28452921
[Au] Autor:Noda K; Tane S; Haam SJ; D'Cunha J; Hayanga AJ; Luketich JD; Shigemura N
[Ad] Endereço:Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
[Ti] Título:Targeting Circulating Leukocytes and Pyroptosis During Ex Vivo Lung Perfusion Improves Lung Preservation.
[So] Source:Transplantation;101(12):2841-2849, 2017 12.
[Is] ISSN:1534-6080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The role of the circulating leukocytes in lungs and their relationship with circulating proinflammatory cytokines during ischemia-reperfusion injury is not well understood. Using ex vivo lung perfusion (EVLP) to investigate the pathophysiology of isolated lungs, we aimed to identify a therapeutic target to optimize lung preservation leading to successful lung transplantation. METHODS: Rat heart-lung blocks were placed on EVLP for 4 hours with or without a leukocyte-depleting filter (LF). After EVLP, lung grafts were transplanted, and posttransplant outcomes were compared. RESULTS: Lung function was significantly better in lung grafts on EVLP with a LF than in lungs on EVLP without a LF. The interleukin (IL)-6 levels in the lung grafts and EVLP perfusate were also significantly lower after EVLP with a LF. Interestingly, IL-6 levels in the perfusate did not increase after the lungs were removed from the EVLP circuit, indicating that the cells trapped by the LF were not secreting IL-6. The trapped cells were analyzed with flow cytometry to detect apoptosis and pyroptosis; 26% were pyroptotic (Caspase-1-positive). After transplantation, there was better graft function and less inflammatory response if a LF was used or a caspase-1 inhibitor was administered during EVLP. CONCLUSIONS: Our data demonstrated that circulating leukocytes derived from donor lungs, and not circulating proinflammatory cytokines substantially impaired the quality of lung grafts through caspase-1-induced pyroptotic cell death during EVLP. Removing these cells with a LF and/or inhibiting pyroptosis of the cells can be a new therapeutic approach leading to long-term success after lung transplantation.
[Mh] Termos MeSH primário: Leucócitos/citologia
Transplante de Pulmão/métodos
Pulmão/patologia
Pulmão/fisiologia
Preservação de Órgãos/métodos
Piroptose
[Mh] Termos MeSH secundário: Animais
Ponte Cardiopulmonar
Caspase 1/metabolismo
Citocinas/metabolismo
Seres Humanos
Inflamação
Interleucina-6/metabolismo
Leucócitos/metabolismo
Masculino
Microcirculação
Perfusão
Ratos
Ratos Endogâmicos Lew
Testes de Função Respiratória
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cytokines); 0 (Interleukin-6); EC 3.4.22.36 (Caspase 1)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/TP.0000000000001798


  8 / 13107 MEDLINE  
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[PMID]:29178919
[Au] Autor:Fakhro M; Broberg E; Algotsson L; Hansson L; Koul B; Gustafsson R; Wierup P; Ingemansson R; Lindstedt S
[Ad] Endereço:Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden. mohammed.fakhro@med.lu.se.
[Ti] Título:Double lung, unlike single lung transplantation might provide a protective effect on mortality and bronchiolitis obliterans syndrome.
[So] Source:J Cardiothorac Surg;12(1):100, 2017 Nov 25.
[Is] ISSN:1749-8090
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Survival after lung transplantation (LTx) is often limited by bronchiolitis obliterans syndrome (BOS). METHOD: Survey of 278 recipients who underwent LTx. The endpoint used was BOS (BOS grade ≥ 2), death or Re-lung transplantation (Re-LTx) assessed by competing risk regression analyses. RESULTS: The incidence of BOS grade ≥ 2 among double LTx (DLTx) recipients was 16 ± 3% at 5 years, 30 ± 4% at 10 years, and 37 ± 5% at 20 years, compared to single LTx (SLTx) recipients whose corresponding incidence of BOS grade ≥ 2 was 11 ± 3%, 20 ± 4%, and 24 ± 5% at 5, 10, and 20 years, respectively (p > 0. 05). The incidence of BOS grade ≥ 2 by major indications ranked in descending order: other, PF, CF, COPD, PH and AAT1 (p < 0. 05). The mortality rate by major indication ranked in descending order: COPD, PH, AAT1, PF, Other and CF (p < 0. 05). CONCLUSION: No differences were seen in the incidence of BOS grade ≥ 2 regarding type of transplant, however, DLTx recipients showed a better chance of survival despite developing BOS compared to SLTx recipients. The highest incidence of BOS was seen among CF, PF, COPD, PH, and AAT1 recipients in descending order, however, CF and PF recipients showed a better chance of survival despite developing BOS compared to COPD, PH, and AAT1 recipients.
[Mh] Termos MeSH primário: Bronquiolite Obliterante/etiologia
Transplante de Pulmão/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Bronquiolite Obliterante/epidemiologia
Bronquiolite Obliterante/prevenção & controle
Criança
Feminino
Seres Humanos
Incidência
Transplante de Pulmão/métodos
Masculino
Meia-Idade
Taxa de Sobrevida/tendências
Suécia/epidemiologia
Síndrome
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1186/s13019-017-0666-5


  9 / 13107 MEDLINE  
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[PMID]:29228414
[Au] Autor:Wada A; Kohno M; Oiwa K; Hashimoto R; Koizumi T; Nakamura Y; Nakagawa T; Masuda R; Kaga K; Iwazaki M
[Ti] Título:Temporal Changes of Inflammatory Cytokine Profiles in Epithelial Lining Fluid in a Canine Lung Transplant Model.
[So] Source:Tokai J Exp Clin Med;42(4):165-175, 2017 Dec 20.
[Is] ISSN:2185-2243
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Ischemia-reperfusion injury resulting in post-transplant lung dysfunction involves a complicated network of cytokines that has yet to be fully investigated. We analyzed temporal changes in cytokine levels in epithelial lining fluid (ELF) from the distal airways of a canine lung transplantation model. METHODS: Ischemic time was set to 18 hours to enhance lung injury in a left single-lung transplantation model. ELF was collected via bronchoscopic microsampling, a minimally-invasive technique allowing repeated sampling, hourly up to 5 hours after reperfusion started. We compared levels of pro-inflammatory cytokines in ELF with those at baseline (time zero), and with a sham-operated control group. RESULTS: Concentrations of tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) significantly increased immediately after the start of lung reperfusion in the transplant group relative to the sham group (P < 0.005 and P < 0.05, respectively); both were sustained through the 5 hours. Interferon gamma (IFN-γ levels were significantly reduced 3 h after reperfusion started (P < 0.05). CONCLUSIONS: We found time- and cytokine-dependent changes in TNF-α, IL-6, and IFN-γ in ELF from the lung transplantation model. These specific changes in the cytokine profile may relate to the mechanism underlying post-transplant lung dysfunction.
[Mh] Termos MeSH primário: Mediadores da Inflamação/metabolismo
Interferon gama/metabolismo
Interleucina-6/metabolismo
Transplante de Pulmão
Pulmão/metabolismo
Mucosa Respiratória/metabolismo
Fator de Necrose Tumoral alfa/metabolismo
[Mh] Termos MeSH secundário: Animais
Cães
Modelos Animais
Traumatismo por Reperfusão/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Inflammation Mediators); 0 (Interleukin-6); 0 (Tumor Necrosis Factor-alpha); 82115-62-6 (Interferon-gamma)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


  10 / 13107 MEDLINE  
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[PMID]:28457418
[Au] Autor:Carraro RM; Nascimento ECT; Szachnowicz S; Camargo PCLB; Campos SV; Afonso JE; Samano MN; Pêgo-Fernandes PM; Dolhnikoff M; Teixeiraa RHOB; Costa AN
[Ad] Endereço:Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. Electronic address: carraro.rafael@gmail.com.
[Ti] Título:Histopathological Findings Associated With Gastroesophageal Reflux Disease and Aspiration After Lung Transplantation: Initial Brazilian Single-Center Experience.
[So] Source:Transplant Proc;49(4):886-889, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gastro-esophageal reflux disease (GERD) and broncho-aspiration (BA) are known to increase the risk for chronic lung allograft dysfunction (CLAD). However, specific lung injury mechanisms are not clearly known. The objective of the study was to describe histopathological findings in surveillance lung transbronchial biopsies that can be correlated with episodes of BA in the lung allograft. METHODS: This retrospective analysis of surveillance transbronchial biopsies was performed in lung transplant recipients, with available data of broncho-alveolar fluid (cultures and cytology), lung function parameters, and esophageal functional tests. RESULTS: Were analyzed 11 patients, divided into 3 groups: (1) GERD group: 4 patients with GERD and CLAD diagnosis; (2) control group: 2 patients without GERD or CLAD; and (3) BA group: 5 patients with foreign material in lung biopsies. A histopathological pattern of neutrophilic bronchitis (NB) was present in 4 of 4 cases in the GERD group and in 1 of 5 cases in the BA group in 2 or more biopsy samples; culture samples were all negative; the 5 NB-positive patients developed CLAD and died (3/5) or needed re-transplantation (2/5). The other 3 patients in the BA group had GERD without NB or CLAD. Both patients in the control group had transient NB in biopsies with positive cultures but remained free of CLAD. CONCLUSIONS: Surveillance transbronchial biopsies may provide useful information other than the evaluation of acute cellular rejection and can help to identify high-risk patients for allograft dysfunction related to gastro-esophageal reflux.
[Mh] Termos MeSH primário: Refluxo Gastroesofágico/patologia
Transplante de Pulmão/efeitos adversos
Complicações Pós-Operatórias/patologia
Aspiração Respiratória de Conteúdos Gástricos/patologia
[Mh] Termos MeSH secundário: Adulto
Biópsia
Brasil
Feminino
Refluxo Gastroesofágico/etiologia
Seres Humanos
Pulmão/patologia
Pulmão/fisiopatologia
Transplante de Pulmão/métodos
Masculino
Meia-Idade
Complicações Pós-Operatórias/etiologia
Aspiração Respiratória de Conteúdos Gástricos/etiologia
Estudos Retrospectivos
Transplante Homólogo
Transplantes/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE



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