Original ArticlesMeasurement of fibroblast proliferative activity in bronchoalveolar lavage fluid in the analysis of obliterative bronchiolitis among lung transplant recipients
Section snippets
Patients
This research study was approved by the Committee on Human Research, University of California, San Francisco. A signed informed consent was obtained from 20 normal volunteers and 6 lung-transplant recipients. Whereas 4 of the lung-transplant recipients eventually developed OB, 2 did not. Clinical characteristics of these patients are summarized in Table I.
Post-transplant evaluation
Following lung transplantation, recipients underwent surveillance evaluations for early diagnosis of rejection and/or infection, every 2
Results
Fibroblast-proliferative activity in the BAL fluid from 14 of the 20 normal volunteers was at or below the negative control level of the assay (Figure 1). In addition, for the 20 volunteer subjects as a group, the median FPA level was 0 with a 75th percentile value of 2%; for the 6 transplant patients the median and 75th percentile values were 11.7% and 9.9%, respectively. The difference between volunteer and transplant-recipient groups was statistically significant (p = 0.002, Wilcoxon rank
Discussion
We previously reported the potential utility of measuring FPA in BAL.18 This current study demonstrates that a sustained increase in the FPA of serial BAL supernatants precedes both histologic OB and BOS, based on the current FEV1 standard. By contrast, factors favoring fibroblast proliferation do not seem to be present in the BAL supernatants obtained from normal subjects.
Further BAL supernatant FPA levels correlate with decrements in FEF25%–75% measured in transplant patients. In the absence
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2004, Respiratory Care Clinics of North AmericaCitation Excerpt :These pathogens are generally recovered with BAL specimens. The composition of BAL fluid has been analyzed in term of cell count, lymphocyte phenotypes, expression of HLA-DR, and fibroblast proliferative activity [35,36]. Although these parameters differ in a variety of lung allograft conditions, their discriminating ability is weak, and their use is currently reserved for research protocols.
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Present address: The Third Department of Internal Medicine, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520 Japan.