Peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen: A single‐center experience
Abstract Background After lung transplantation (LuTX), lower respiratory tract infections (LRTI) and acute cellular rejection (ACR) are associated with changes in peripheral blood and bronchoalveolar lavage fluid mononuclear cell profile (PBMC and BALIC). PBMC is also influenced by immunosuppressive...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-08-01
|
| Series: | Immunity, Inflammation and Disease |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/iid3.673 |
| _version_ | 1811312688567943168 |
|---|---|
| author | Zsuzsanna Jáky‐Kováts Melinda Vámos Zsolt István Komlósi András Bikov Ildikó Madurka Gergő Szűcs Veronika Müller Anikó Bohács |
| author_facet | Zsuzsanna Jáky‐Kováts Melinda Vámos Zsolt István Komlósi András Bikov Ildikó Madurka Gergő Szűcs Veronika Müller Anikó Bohács |
| author_sort | Zsuzsanna Jáky‐Kováts |
| collection | DOAJ |
| description | Abstract Background After lung transplantation (LuTX), lower respiratory tract infections (LRTI) and acute cellular rejection (ACR) are associated with changes in peripheral blood and bronchoalveolar lavage fluid mononuclear cell profile (PBMC and BALIC). PBMC is also influenced by immunosuppressive regimen and its changes with postoperative time. First‐year PBMC and BALIC changes were evaluated in this study with rabbit anti‐thymocyte globulin (ATG) and alemtuzumab (AL) induction therapy. Methods In total, 64 LuTX recipients were included, 53 of them received AL and 11 ATG as induction therapy. PBMC and BALIC were examined routinely and in cases suspicious of infection and/or rejection. A PBMC‐ and BALIC‐based algorithm for infection and rejection prediction was also tested. Results In the AL group, peripheral blood lymphocyte and basophil cell numbers were significantly reduced, while the neutrophil cell number elevation during LRTI was significantly higher compared to the control. Early postoperative measurements showed a lower BALIC lymphocyte count. The algorithm had 17% sensitivity and 94% specificity for ACR in all patients and 33% sensitivity and 95% specificity for ACR with coexisting LRTI. Conclusion BALIC is not significantly influenced by the immunosuppressive regimen. PBMC‐ and BALIC‐based algorithm may improve the differential diagnosis of ACR. |
| first_indexed | 2024-04-13T10:41:16Z |
| format | Article |
| id | doaj.art-2deeff8d153d4d0a850c6557ea82f328 |
| institution | Directory Open Access Journal |
| issn | 2050-4527 |
| language | English |
| last_indexed | 2024-04-13T10:41:16Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Immunity, Inflammation and Disease |
| spelling | doaj.art-2deeff8d153d4d0a850c6557ea82f3282022-12-22T02:49:55ZengWileyImmunity, Inflammation and Disease2050-45272022-08-01108n/an/a10.1002/iid3.673Peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen: A single‐center experienceZsuzsanna Jáky‐Kováts0Melinda Vámos1Zsolt István Komlósi2András Bikov3Ildikó Madurka4Gergő Szűcs5Veronika Müller6Anikó Bohács7Department of Pulmonology, Faculty of Medicine Semmelweis University Budapest HungaryDepartment of Pulmonology, Faculty of Medicine Semmelweis University Budapest HungaryDepartment of Pulmonology, Faculty of Medicine Semmelweis University Budapest HungaryDepartment of Pulmonology, Faculty of Medicine Semmelweis University Budapest HungaryDepartment of Thoracic Surgery, Faculty of Medicine Semmelweis University Budapest HungaryDepartment of Pulmonology, Faculty of Medicine Semmelweis University Budapest HungaryDepartment of Pulmonology, Faculty of Medicine Semmelweis University Budapest HungaryDepartment of Pulmonology, Faculty of Medicine Semmelweis University Budapest HungaryAbstract Background After lung transplantation (LuTX), lower respiratory tract infections (LRTI) and acute cellular rejection (ACR) are associated with changes in peripheral blood and bronchoalveolar lavage fluid mononuclear cell profile (PBMC and BALIC). PBMC is also influenced by immunosuppressive regimen and its changes with postoperative time. First‐year PBMC and BALIC changes were evaluated in this study with rabbit anti‐thymocyte globulin (ATG) and alemtuzumab (AL) induction therapy. Methods In total, 64 LuTX recipients were included, 53 of them received AL and 11 ATG as induction therapy. PBMC and BALIC were examined routinely and in cases suspicious of infection and/or rejection. A PBMC‐ and BALIC‐based algorithm for infection and rejection prediction was also tested. Results In the AL group, peripheral blood lymphocyte and basophil cell numbers were significantly reduced, while the neutrophil cell number elevation during LRTI was significantly higher compared to the control. Early postoperative measurements showed a lower BALIC lymphocyte count. The algorithm had 17% sensitivity and 94% specificity for ACR in all patients and 33% sensitivity and 95% specificity for ACR with coexisting LRTI. Conclusion BALIC is not significantly influenced by the immunosuppressive regimen. PBMC‐ and BALIC‐based algorithm may improve the differential diagnosis of ACR.https://doi.org/10.1002/iid3.673acute cellular rejectionbronchoalveolar lavagedifferential diagnosislung transplantPBMC |
| spellingShingle | Zsuzsanna Jáky‐Kováts Melinda Vámos Zsolt István Komlósi András Bikov Ildikó Madurka Gergő Szűcs Veronika Müller Anikó Bohács Peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen: A single‐center experience Immunity, Inflammation and Disease acute cellular rejection bronchoalveolar lavage differential diagnosis lung transplant PBMC |
| title | Peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen: A single‐center experience |
| title_full | Peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen: A single‐center experience |
| title_fullStr | Peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen: A single‐center experience |
| title_full_unstemmed | Peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen: A single‐center experience |
| title_short | Peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen: A single‐center experience |
| title_sort | peripheral blood and bronchoalveolar leukocyte profile in lung transplant recipients and their changes according to immunosuppressive regimen a single center experience |
| topic | acute cellular rejection bronchoalveolar lavage differential diagnosis lung transplant PBMC |
| url | https://doi.org/10.1002/iid3.673 |
| work_keys_str_mv | AT zsuzsannajakykovats peripheralbloodandbronchoalveolarleukocyteprofileinlungtransplantrecipientsandtheirchangesaccordingtoimmunosuppressiveregimenasinglecenterexperience AT melindavamos peripheralbloodandbronchoalveolarleukocyteprofileinlungtransplantrecipientsandtheirchangesaccordingtoimmunosuppressiveregimenasinglecenterexperience AT zsoltistvankomlosi peripheralbloodandbronchoalveolarleukocyteprofileinlungtransplantrecipientsandtheirchangesaccordingtoimmunosuppressiveregimenasinglecenterexperience AT andrasbikov peripheralbloodandbronchoalveolarleukocyteprofileinlungtransplantrecipientsandtheirchangesaccordingtoimmunosuppressiveregimenasinglecenterexperience AT ildikomadurka peripheralbloodandbronchoalveolarleukocyteprofileinlungtransplantrecipientsandtheirchangesaccordingtoimmunosuppressiveregimenasinglecenterexperience AT gergoszucs peripheralbloodandbronchoalveolarleukocyteprofileinlungtransplantrecipientsandtheirchangesaccordingtoimmunosuppressiveregimenasinglecenterexperience AT veronikamuller peripheralbloodandbronchoalveolarleukocyteprofileinlungtransplantrecipientsandtheirchangesaccordingtoimmunosuppressiveregimenasinglecenterexperience AT anikobohacs peripheralbloodandbronchoalveolarleukocyteprofileinlungtransplantrecipientsandtheirchangesaccordingtoimmunosuppressiveregimenasinglecenterexperience |