Open AccessImmunological diversity in phenotypes of chronic lung allograft dysfunction: a comprehensive immunohistochemical analysis
Author(s) -
Vandermeulen Elly,
Lammertyn Elise,
Verleden Stijn E.,
Ruttens David,
Bellon Hannelore,
Ricciardi Mario,
Somers Jana,
Bracke Ken R.,
Van Den Eynde Kathleen,
Tousseyn Thomas,
Brusselle Guy G.,
Verbeken Erik K.,
Verschakelen Johny,
Emonds MariePaule,
Van Raemdonck Dirk E.,
Verleden Geert M.,
Vos Robin,
Vanaudenaerde Bart M.
Publication year - 2017
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12882
Subject(s) - bronchiolitis obliterans , medicine , immunology , lung transplantation , immune system , myeloid , lung , regulatory b cells , transplantation , pathology , interleukin 10
Summary Chronic rejection after organ transplantation is defined as a humoral‐ and cell‐mediated immune response directed against the allograft. In lung transplantation, chronic rejection is nowadays clinically defined as a cause of chronic lung allograft dysfunction ( CLAD ), consisting of different clinical phenotypes including restrictive allograft syndrome ( RAS ) and bronchiolitis obliterans syndrome ( BOS ). However, the differential role of humoral and cellular immunity is not investigated up to now. Explant lungs of patients with end‐stage BOS ( n = 19) and RAS ( n = 18) were assessed for the presence of lymphoid (B and T cells) and myeloid cells (dendritic cells, eosinophils, mast cells, neutrophils, and macrophages) and compared to nontransplant control lung biopsies ( n = 21). All myeloid cells, with exception of dendritic cells, were increased in RAS versus control (neutrophils, eosinophils, and mast cells: all P < 0.05, macrophages: P < 0.001). Regarding lymphoid cells, B cells and cytotoxic T cells were increased remarkably in RAS versus control ( P < 0.001) and in BOS versus control ( P < 0.01). Interestingly, lymphoid follicles were restricted to RAS ( P < 0.001 versus control and P < 0.05 versus BOS ). Our data suggest an immunological diversity between BOS and RAS , with a more pronounced involvement of the B‐cell response in RAS characterized by a structural organization of lymphoid follicles. This may impact future therapeutic approaches.