Obliterative bronchiolitis

Obliterative bronchiolitis Inflammation of the bronchioles (the small elements of the tracheobronchial tree) characterized by obliteration and/or permanent narrowing of the airways. 

Neuringer IP, Chalermskulrat W, Aris R. Obliterative bronchiolitis or chronic lung allograft rejection a basic science review. J Heart Lung Transplant 2005 24 3-19. 

Hepatotoxicity Penicillamine has been associated with a mild elevation of hepatic enzymes that usually returns to normal even with continuation of the drug. Autoimmune syndromes Autoimmune syndromes that may be caused by penicillamine include polymyositis, diffuse alveolitis and dermatomyositis, Goodpasture s syndrome, myasthenic syndrome, pemphigus, and obliterative bronchiolitis. 

Hertz, M.I., Henke, C.A., Nakhleh, RE. et al. (1992). Obliterative bronchiolitis after lung transplantation A fibroproliferative disorder associated with platelet derived growth factor. Proc. Natl. Acad. Sci. USA 89, 10385-10389. 

Barlow, C.W. Moon, M.R. Green, G.R. Gamberg, P. Theodore, J. Reitz, B.A. Robbins, R.C. Rabbit antilymphocyte globulin versus OKT3 induction therapy after heart-lung and lung transplantation effect on survival, rejection, infection, and obliterative bronchiolitis. Transplant Int. 2001, 14, 234-239. 

Treatment with antibodies to CCRl led to a reduction in both inflammatory cell inflltrates and the development of flbrosis (80). Similar effects have been seen in murine model of obliterative bronchiolitis where the flbrotic response associated with this disorder was attenuated in CCR2 mice (65). This suggests that targeting chemokine receptors may be an efficient way to inhibit pulmonary fibrosis. 

Milne DS, Gascoigne AD, Ashcroft T, Sviland L, Malcolm AJ, Cotris PA. Organizing pneumonia following pulmonary transplantation and the development of obliterative bronchiolitis. Transplantation 1994 57 1757-1762. 

Reichenspurner H, Girgis RE, Robbins RC, et al. Obliterative bronchiolitis after lung and heart-lung transplantation. Ann Thorac Surg 1995 60 1845-1853. 

DiGiovine B, Lynch JP 3d, Martinez FJ, et al. Bronchoalveolar lavage neutrophilia is associated with obliterative bronchiolitis after lung transplantation role of IL-8. J Immunol 1996 157 4194-4202. 

Hertz Ml, Jessurun J, King MB, Savik SK, Murray JJ. Reproduction of the obliterative bronchiolitis lesion after heterotopic transplantation of mouse airways. Am J Pathol 1993 142 1945-1951. 

Neuringer IP, Mannon RB, Coffman TM, et al. Immune cells in a mouse airway model of obliterative bronchiolitis. Am J Respir Cell Mol Biol 1998 19 379-386. 

Keane MP, Gomperts BN, Weigt S, et al. IL-13 is pivotal in the fibro-obliterative process of bronchiolitis obliterans syndrome. J Immunol 2007 178(1) 511-519. 

Hansell DM, Ruhens MB, Padley SP, et al. Obliterative bronchiolitis individual CT signs of small airways disease and functional correlation. Radiology 1997 203 721-726. 

Wang JS, Tseng HH, Lai RS, et al. Sauropus androgynus-constrictive obliterative bronchitis/bronchiolitis histopathological study of penumonectomy and biopsy specimens with emphasis on the inflammatory process and disease progression. Histopathology 2000 37 402 10. 

Miller RR, Muller NL. Neuroendocrine cell hyperplasia and obliterative bronchiolitis in patients with peripheral carcinoid tumors. Am J Surg Pathol 1995 19 653. 

Obliterative Bronchiolitis Foiiowing Lung or Heart-Lung Transplantation... 

Figure 2 (A). Typical FEVi evolution in a patient with late acute BOS. After a very stable period of several years, there is a documented acute rejection episode (arrow), with some improvement of the FEVi after classical treatment, however, quickly followed by a very rapid decline in the FEVi, indicative of fBOS. (B). Natural evolution of FEVi in a patient with slowly progressing BOS and biopsy-proven OB. During the last months of evolution, there appears to be a spontaneous arrest in the FEVi decline. This is compatible with the NRAD phenotype, left untreated and leading to pure OB at the end. (C). Another patient with BOS, who has a spontaneous arrest of the FEVi decline, with a plateau, reached after several months of evolution. Abbreviations. FEVi, forced expiratory volume in one second BOS, bronchiolitis obliterans syndrome fBOS, fibrotic BOS OB, obliterative bronchiolitis NRAD, neutrophilic reversible allograft dysfunction.

Figure 3 (See color insert.) Typical lesion of OB in an open lung biopsy of a lung transplant patient with a progressive decline of the FEVi- The airway is entirely obliterated by a fibrous plug (arrow). Abbreviations OB, obliterative bronchiolitis FEVi, forced expiratory volume in one second. Source Courtesy of Prof. E.K. Verbeken, Leuven, Belgium.

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