Acute Lung Allograft Rejection

IV. Chemokines and Chemokine Receptors and Acute Lung Allograft Rejection... 

Similar to acute lung allograft rejection, acute renal allograft rejection is also characterized by an intravascular and interstitial infiltration of mononuclear phagocytes, T cells, and occasional eosinophils. Elevated levels of RANTES/ CCL5 protein have been identified in human renal allografts undergoing acute... 

The beginning of the exploration of chemokines in acute lung allograft rejection has been fruitful. Future use of chemokine and chemokine receptor antagonists may lead to effective treatment and prevention of acute rejection. 

Belperio JA, Burdick MD, Keane MP, et al. The role of the CC chemokine, RANTES, in acute lung allograft rejection. J Immunol 2000 165 461-472. 

Garrity ER, Villanueva J, Bhorade SM, et al. Low rate of acute lung allograft rejection after the use of daclizumah, an interleukin 2 receptor antibody. Transplantation 2001 71 773-777. 

Bowdish, M.F., Barr, M.L., Quardt, S.M., Medina, J., Collins, T., Johnson, M., Tonn, G., Newland, D. et al. (2003) Fvaluation of an oral CXCR3 antagonist in a rat model of acute cardiac allograft rejection. The Journal of Heart and Lung Transplantation, 22, S162. 

Alio- / xenogeneic transplantation graft rejection cyclosporine A, but not tacrolimus, has strong additive effect wilh calcitriol on acute rat lung allograft survival and xenogeneic islets in nonobese diabetic mice [148, 213]... 

Yousem SA, Martin T, Paradis IL, Keenan R, Griffith BP. Can immunohistological analysis of transbronchial biopsy specimens predict responder status in early acute rejection of lung allografts Hum Pathol 1994 25 525-529. 

Moudgil A, Bagga A, Toyoda M, Nicolaidou E, Jordan SC, Ross D. Expression of gamma-IFN mRNA in bronchoalveolar lavage fluid correlates with early acute allograft rejection in lung transplant recipients. Clin Transplant 1999 13 201-207. 

If performed when based on clinical indications, transbronchial biopsy has been reported to reach a sensitivity for the detection of acute rejection of up to 94% (Trulock 1997). The rationale for surveillance biopsy protocols is based upon retrospective evidence that up to one-third of surveillance biopsies demonstrate evidence of allograft rejection (Chakinala et al. 2004) whereas only 40% of histologically confirmed grades II-IV acute rejections are associated with clinical signs or symptoms (Baz et al. 1996). There are reports in the literature however that suggest a much lower yield after 24 months, and some centers do not routinely perform biopsies after this point (Dransfield et al. 2004). In the study of Tamm et al. (1997) the benefit of surveillance biopsies was questioned. In this study, 51 heart-lung transplant recipients who underwent surveillance transbronchial biopsies were compared with 75 pa-... 

Chakinala MM, Trulock EP (2003) Acute allograft rejection after lung transplantation diagnosis and therapy. Chest Surg Clin N Am 13 525-542... 

D Ovidio et al. delivered naked plasmid TGF- pi via endobronchial transfection. They demonstrated selective airway transfection, improved lung graft oxygenation, and reduced rejection scores (102). Suda et al. demonstrated that in vivo intramuscular gene transfer of adenovirus-mediated TGF-pi attenuated acute allograft rejection (96). 

During allograft acute rejection, the production of NO as measured nitrite/nitrate levels, has been demonstrated in several experimental models and inhibition of inducible nitric oxide synthase (rNOS) activity in a rat lung transplant model dramatically improved the survival rate of allografts (Shiraishi etal. 1995, Worrall etal. 1997). Studies carried out on transplant samples from patients with end-stage obliterative bronchioHfis have shown that in... 

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