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Everolimus Alters the Bronchoalveolar Lavage and Endobronchial Biopsy Immunologic Profile Post‐Human Lung Transplantation
Author(s) -
Snell Gregory I.,
Levvey Bronwyn J.,
Zheng Ling,
Bailey Michael,
Orsida Bernadette,
Law Lucas,
Whitford Helen M.,
Kotsimbos Tom C.,
Williams Trevor J.
Publication year - 2005
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2005.00863.x
Subject(s) - everolimus , medicine , bronchoalveolar lavage , lung transplantation , azathioprine , transplantation , lung , sirolimus , gastroenterology , immunology , pathology , disease
Everolimus has recently shown promise in terms of short‐ and long‐term clinical lung transplant outcomes. This study aims to determine the altered lung allograft cellular and cytokine mileau when everolimus is substituted for azathioprine (AZA). Twenty‐three stable lung transplantation (LTx) recipients were randomized in a double‐blinded study to receive everolimus (13) or AZA (10) plus standard cyclosporine/prednisolone. Bronchoalveolar lavage (BAL) and endobronchial biopsies (EBB) were performed on three occasions (T 0 –T 2 ) to elucidate cellular and cytokine profiles via immunocytochemistry, immunohistology and enzyme‐linked immunosorbent assay (ELISA) techniques. There were no group differences for demographics or clinical events throughout the study nor baseline cellular/cytokine differences. BAL lymphocyte percentage fell in the AZA group by T 2 (p = 0.05). BAL and EBB CD4 measures significantly declined in the everolimus group by T 2 (p < 0.05). EBB neutrophils rose significantly in the AZA group, with a fall in the everolimus group resulting in a significant difference at T 2 (p = 0.01). In conclusion, everolimus has contributed to potentially important differences in BAL and EBB cellular profiles.