Persistent high BAL fluid granulocyte activation marker levels as early indicators of bronchiolitis obliterans after lung transplant. (2000 Jan)
persistent high BAL fluid granulocyte activation marker levels as early indicators of bronchiolitis obliterans after lung transplant . The major cause of mortality in the long term in lung transplant recipients is chronic rejection . This is a fibroproliferative process in the small airways leading to obliterative bronchiolitis and progressive loss of lung function , both constituting the clinical entity bronchiolitis obliterans syndrome ( BOS ) . granulocyte activation has been implicated as one factor behind BOS . granulocyte markers in bronchoalveolar lavage ( BAL ) fluid were prospectively and longitudinally studied in order to identify possible association with BOS . BAL fluid from 266 bronchoscopy procedures performed in twelve single lung , eight bilateral lung and five heart / lung transplant recipients were analysed . The majority ( 19 of 25 ) were studied for a period of 2 yrs after surgery . myeloperoxidase ( MPO ) , eosinophil cationic protein ( ECP ) and interleukin 8 ( IL 8 ) levels were used as indirect markers of activation and attraction of granulocytes . Five patients developed BOS . ninety eight episodes of acute rejection , nine of bacterial infection , 19 of cytomegalovirus pneumonitis , nine of pneumocystis carinii infection , two of aspergillus infection and two of respiratory syncytial virus infection were diagnosed . BOS patients had significantly higher mean levels of MPO , ECP and IL 8 compared to patients without BOS , irrespective of acute rejection status . Over time , the five patients with …

Inflammatory cells and activation markers in BAL during acute rejection and infection in lung transplant recipients : a prospective , … (1997 Oct)
inflammatory cells and activation markers in BAL during acute rejection and infection in lung transplant recipients : a prospective , longitudinal study . acute rejection of the transplanted lung is a clinical problem , since it decreases graft survival and predisposes the patient to chronic rejection and obliterative bronchiolitis ( OB ) . In an earlier study , we had indications that eosinophil cationic protein ( ECP ) from activated eosinophils and hyaluronan ( HYA ) from fibroblasts were associated with acute pulmonary rejection . This prospective longitudinal study was designed to investigate whether molecules from activated inflammatory cells in bronchoalveolar lavage ( BAL ) fluid could serve as clinically useful diagnostic markers for acute rejection . BAL fluid from 138 bronchoscopies performed in 10 single lung , four bilateral lung and five heart lung transplant recipients were analysed . Nine patients were studied for a period of more than 1 yr ( mean 13 . 4 months ) after surgery . differential cell counts were made from the BAL fluid . ECP , myeloperoxidase ( MPO ) , HYA and interleukin 8 ( IL 8 ) were used as indirect markers for activation and attraction of eosinophils , neutrophils and fibroblasts , respectively . fifty four episodes of acute rejection were diagnosed . Two patients developed OB . Nine episodes of bacterial infection , 13 episodes of cytomegalovirus ( CMV ) pneumonitis , three of pneumocystis carinii infection and one of respiratory syncytial virus ( RSV ) infection were …

Bronchiolitis obliterans syndrome in lung transplant recipients is associated with increased neutrophil activity and decreased antioxidant status in the lung. (1998 Nov)
bronchiolitis obliterans syndrome in lung transplant recipients is associated with increased neutrophil activity and decreased antioxidant status in the lung . Long term survival of lung transplant recipients is limited by the advent of obliterative bronchiolitis and irreversible airways obstruction , e . g . bronchiolitis obliterans syndrome ( BOS ) . This study investigated whether inflammatory cells and their activation markers were increased in bronchoalveolar lavage ( BAL ) and transbronchial biopsies ( TBB ) from patients with BOS . levels of antioxidants in BAL fluid were also assessed . BAL fluid and TBB from six single lung , two bilateral lung , and five heart lung transplanted patients with diagnosis of BOS were compared with 13 transplant recipients without BOS . BAL fluid levels of myeloperoxidase ( MPO ) , eosinophil cationic protein ( ECP ) and interleukin ( IL ) 8 were used as markers for the activation and attraction of neutrophils and eosinophils , respectively . immunohistochemical staining of TBB with monoclonal antibodies to MPO and ECP ( EG2 ) was performed . significantly increased BAL percentages of neutrophils and levels of MPO were found in patients with BOS . The findings correlated well with the degree of monoclonal staining for MPO in TBB . BAL levels of ECP and IL 8 were significantly increased in BOS patients . BAL concentrations of the water soluble antioxidants ascorbate , urate and glutathione were generally lower in BOS patients . The results indicate that neutrophil infiltration and activation …

Eosinophil cationic protein in nasal secretion and in serum and myeloperoxidase in serum in respiratory syncytial virus bronchiolitis : relation … (1995 Mar)
eosinophil cationic protein in nasal secretion and in serum and myeloperoxidase in serum in respiratory syncytial virus bronchiolitis : relation to asthma and atopy . eosinophil cationic protein ( ECP ) in nasal secretions was determined in 34 infants with respiratory syncytial virus ( RSV ) bronchiolitis during the acute infection stage and one and six months later . ECP in serum was determined in 19 of these children at the same time . myeloperoxidase ( MPO ) was determined in the same 19 children at the acute infection stage and after one month . All children were followed prospectively for two years after the infection with regard to the development of bronchial obstructive symptoms . asthma , defined as three or more episodes of bronchial obstruction verified by a physician , developed in 18 of children and less severe obstructive symptoms in 29 . A screening test for food IgE antibodies in serum was performed six months and a skin prick test two years after the acute infection . nasal ECP / albumin ratios after six months were significantly higher than during the acute RSV infection . MPO , but not ECP , levels in serum were significantly elevated at the time of acute infection compared with levels after one month . nasal ECP / albumin ratios at the acute infection were compared to a control group of 27 infants with non RSV upper respiratory tract infections and did not differ . It was not possible to predict , …

Respiratory syncytial virus stimulates neutrophil degranulation and chemokine release. (1999 Sep)
respiratory syncytial virus stimulates neutrophil degranulation and chemokine release . neutrophil infiltration of the airways is a common finding in respiratory syncytial virus ( RSV ) bronchiolitis . neutrophil derived chemokines and neutrophil granule contents can cause further inflammation , hyperresponsiveness , and damage of the airways . In this study , peripheral blood neutrophils incubated with RSV ( multiplicity of infection ( MOI ) 10 ) induced IL 8 , macrophage inflammatory protein ( MIP ) 1alpha , MIP 1beta , and myeloperoxidase ( MPO ) release . In contrast , LPS induced only chemokine but not MPO release . RSV induced chemokine and MPO release was noncytotoxic as assessed by trypan blue exclusion . The mechanism of RSV induced chemokine release was shown to be transcription dependent since cytokine mRNA synthesis was increased with RSV stimulation and the process was inhibited by actinomycin D . In addition , the effect of dexamethasone ( dex ) on mediator release was also studied . Dex significantly inhibited chemokine release but did not inhibit MPO release . The mechanism of inhibition of the release of these chemokines is probably posttranscriptional since the mRNA synthesis was not inhibited by dex . We conclude that the release of chemokines ( IL 8 , MIP 1alpha , MIP 1beta ) and granule enzymes ( MPO ) by RSV stimulated neutrophils may contribute to the pulmonary pathology in RSV bronchiolitis . these in vitro findings showing that dex failed to consistently inhibit all the RSV …

Relationship between atopic status and nasal interleukin 10 and 11 levels in infants with respiratory syncytial virus bronchiolitis. (2005 Mar)
relationship between atopic status and nasal interleukin 10 and 11 levels in infants with respiratory syncytial virus bronchiolitis . background : interleukin 10 ( IL 10 ) and IL 11 are known to have anti inflammatory activities , and they have been implicated in the pathogenesis of respiratory syncytial virus ( RSV ) infection . objectives : To determine IL 10 , IL 11 , and myeloperoxidase levels in nasal secretions of infants with acute RSV bronchiolitis and to investigate whether there are any differences in these levels in patients with vs without atopy . methods : We measured IL 10 , IL 11 , and myeloperoxidase levels in nasal secretions of 44 infants ( 20 were atopic ) with acute RSV bronchiolitis . The nasal secretion samples were obtained from patients at hospital admission and were stored immediately at 70 degrees C until analysis . atopy was defined as having at least 1 positive skin prick test reaction to common allergens , a history of atopic dermatitis , or a high serum IgE level compared with age matched controls . results : levels of IL 10 , IL 11 , and myeloperoxidase increased significantly in samples from infants with acute RSV bronchiolitis . levels of IL 10 and IL 11 were significantly lower in patients with vs without atopy ( P . 05 ) . myeloperoxidase levels showed no significant difference in patients with vs without atopy ( P . 18 ) . patients with severe symptoms tended to …

The effect of anti inflammatory properties of mycophenolate mofetil on the development of lung reperfusion injury. (2005 Dec)
The effect of anti inflammatory properties of mycophenolate mofetil on the development of lung reperfusion injury . background : Lung ischemia reperfusion injury ( LIRI ) is associated with an increased incidence of both primary graft failure and obliterative bronchiolitis . The immunosuppressant mycophenolate mofetil ( MMF ) has recently been shown to attenuate inflammatory injury in acute ischemia reperfusion models via a mechanism that is presently unclear . these experiments studied the effects of MMF in a warm , in situ LIRI model , focusing on transcriptional regulation of pro inflammatory mediators . methods : Left lungs of rats were rendered ischemic for 90 minutes and reperfused for up to 4 hours . treated animals received 10 mg / kg of intravenous MMF at 2 hours before ischemia . Left lung injury was quantitated by myeloperoxidase ( MPO ) content , permeability indices and bronchoalveolar lavage ( BAL ) inflammatory cell counts . lungs were analyzed by electrophoretic mobility shift assay ( EMSA ) for transcription factor transactivation and by enzyme linked immunoassay for BAL chemokine protein content . results : MMF significantly reduced lung vascular permeability indices , MPO content and alveolar leukocyte counts at 4 hours of reperfusion . there was significant attenuation of activator protein 1 ( AP 1 ) and early growth response 1 ( EGR 1 ) transactivation , whereas nuclear factor kappab ( NF kappab ) was unaffected . reductions in bronchoalveolar lavage monocyte chemoattractant protein 1 ( MCP 1 ) and cytokine …

Antineutrophil cytoplasmic antibodies in diffuse panbronchiolitis. (1999 Sep)
antineutrophil cytoplasmic antibodies in diffuse panbronchiolitis . background : there are some reports of the coexistence of chronic suppurative lung diseases such as cystic fibrosis and systemic vasculitis . diffuse panbronchiolitis has the same characteristics as chronic recurrent sinopulmonary infection and respiratory bronchiolitis . methods : serum samples from 30 patients with diffuse panbronchiolitis and 57 patients with other pulmonary diseases were tested to find the titer of myeloperoxidase antineutrophil cytoplasmic antibodies ( MPO ANCA ) . results : We found MPO ANCA positivity in 4 patients with diffuse panbronchiolitis but not in those with other pulmonary diseases . conclusions : Our findings show that MPO ANCA is positive in some patients with diffuse panbronchiolitis . careful attention should be paid to the combination of chronic pulmonary infection and various vasculitis .