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Low Levels of Exhaled Surfactant Protein A Associated With BOS After Lung Transplantation

Artikel i vetenskaplig tidskrift
Författare Petrea Ericson
Ekaterina Mirgorodskaya
Oscar Hammar
Emilia Viklund
Ann-Charlotte Almstrand
Per Larsson
Gerdt C. Riise
Anna-Carin Olin
Publicerad i Transplantation Direct
Volym 2
Nummer/häfte 9
ISSN 2373-8731
Publiceringsår 2016
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
Core Facilities, Mammalian Protein Expression
Språk en
Länkar 10.1097/txd.0000000000000615
Ämnesord bronchiolitis obliterans syndrome, innate immunity, particles, inflammation, heart
Ämneskategorier Invärtesmedicin

Sammanfattning

Background. There is no clinically available marker for early detection or monitoring of chronic rejection in the form of bronchiolitis obliterans syndrome (BOS), the main long-term complication after lung transplantation. Sampling and analysis of particles in exhaled air is a valid, noninvasive method for monitoring surfactant protein A (SP-A) and albumin in the distal airways. Methods. We asked whether differences in composition of exhaled particles can be detected when comparing stable lung transplant recipients (LTRs) (n = 26) with LTRs who develop BOS (n = 7). A comparison between LTRs and a matching group of healthy controls (n = 33) was also conducted. Using a system developed in-house, particles were collected from exhaled air by the principal of inertial impaction before chemical analysis by immunoassays. Results. Surfactant protein A in exhaled particles and the SP-A/albumin ratio were lower (P = 0.002 and P = 0.0001 respectively) in the BOS group compared to the BOS-free group. LTRs exhaled higher amount of particles (P < 0.0001) and had lower albumin content (P < 0.0001) than healthy controls. Conclusions. We conclude that low levels of SP-A in exhaled particles are associated with increased risk of BOS in LTRs. The possibility that this noninvasive method can be used to predict BOS onset deserves further study with prospective and longitudinal approaches.

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