[ : hyPotheses - Lung Immunogenicity , Rejection , and Obliterative Bronchiolitis *
نویسندگان
چکیده
irway disease associated with pathologic evidence of obliterative bronchiolitis (OB) has emerged as the most important long-term complication of heart-lung transplantation, occurring in 50 percent ofthe patients who left the hospital with normal cardiopulmonary 5 Early observations showed the development of obstructive physiology demonstrated by lung function studies, and the disorder most accurately could be described as unexplained, unclassified obstructive lung disease (UUOLD). As histologic material was reviewed, it became apparent that the major cause of the obstructive physiologic defect was obliterative bronchiolitis. 25 All ten patients showing obstructive physiologic features from whom lung tissue was available demonstrated obliterative bronchiolitis on pathologic analysis. To date, the pathophysiology of posttransplant airway disease is poorly understood. The pathologic features ofpulmonary rejection have been investigated extensively in animal models and consist of perivascular and peribronchial cellular infiltration, alveolar exudation, and terminal necrosis.6’7 However, interpretation of these studies is complicated by the presence of infection and a lack of uniformity in donor-recipient matching, immunosupressant regimens, and experimental protocols. A recent animal study overcame many ofthese problems and described four stages ofacute pulmonary rejection in inbred rats which were not immunosupressed.8 The initial latent phase was sequentially followed by the vascular phase (infiltration of recipient lymphocytes
منابع مشابه
Pathogenesis of obliterative bronchiolitis in rat heterotopic tracheal allografts An experimental approach to chronic lung allograft rejection
متن کامل
The role of autoimmunity in obliterative bronchiolitis after lung transplantation.
First performed in the 1960s with long-term successes achieved in the 1980s, lung transplantation remains the only definitive treatment option for end-stage lung disease. Chronic lung rejection, pathologically classified as obliterative bronchiolitis (OB) with its clinical correlate referred to as bronchiolitis obliterans syndrome, is the limiting factor than keeps 5-yr survival rates for lung ...
متن کاملDevelopment of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation
Orthotopic lung transplantation in rats was first reported by Asimacopoulos and colleagues in 1971 (1). Currently, this method is well accepted and standardized not only for the study of allo-rejection but also between syngeneic strains for examining mechanisms of ischemia-reperfusion injury after lung transplantation. Although the application of the rat and other large animal model (2) contrib...
متن کاملBLT1-mediated T cell trafficking is critical for rejection and obliterative bronchiolitis after lung transplantation
Leukotriene B4 is a lipid mediator that recently has been shown to have potent chemotactic activity for effector T lymphocytes mediated through its receptor, BLT1. Here, we developed a novel murine model of acute lung rejection to demonstrate that BLT1 controls effector CD8+ T cell trafficking into the lung and that disruption of BLT1 signaling in CD8+ T cells reduces lung inflammation and mort...
متن کاملLung allograft loss: naming helps seeing... and vice versa!
The loss of allograft function in the long term (whatever its pattern over time) not only remains the single major cause of death following lung transplantation but has continued largely unabated since the beginning of the modern era in the 1980s [1–3]. As obliterative bronchiolitis (OB) was the most common histopathological finding on biopsy of the failing lung allograft, this feature became t...
متن کامل