Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection

Background. Bronchus-associated lymphoid tissue (BALT) has been associated with lung allograft rejection in rat transplant models. In human transplant recipients, BALT has not been linked to clinically significant rejection. We hypothesize that the immunohistochemical composition of BALT varies with...

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Main Authors: K. V. Shenoy, C. Solomides, F. Cordova, T. J. Rogers, D. Ciccolella, G. J. Criner
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Journal of Transplantation
Online Access:http://dx.doi.org/10.1155/2012/928081
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author K. V. Shenoy
C. Solomides
F. Cordova
T. J. Rogers
D. Ciccolella
G. J. Criner
author_facet K. V. Shenoy
C. Solomides
F. Cordova
T. J. Rogers
D. Ciccolella
G. J. Criner
author_sort K. V. Shenoy
collection DOAJ
description Background. Bronchus-associated lymphoid tissue (BALT) has been associated with lung allograft rejection in rat transplant models. In human transplant recipients, BALT has not been linked to clinically significant rejection. We hypothesize that the immunohistochemical composition of BALT varies with the presence of acute lung allograft rejection. Methods. We retrospectively examined 40 human lung allograft recipients transplanted from 3/1/1999 to 6/1/2008. Patients were grouped by frequency and severity of acute rejection based on International Society of Heart Lung Transplant (ISHLT) criteria. Transbronchial biopsies were reviewed for BALT by a blinded pathologist. BALT if present was immunohistochemically stained to determine T-and B-cell subpopulations. Results. BALT presence was associated with an increased frequency of acute rejection episodes in the first year after transplantation. Patients with a lower CD4/CD8 ratio had an increased rejection rate; however, BALT size or densities of T-cell and B-cell subpopulations did not correlate with rejection rate. Conclusion. The presence of BALT is associated with an increased frequency of rejection one year after transplant. The lower the CD4/CD8 ratio, the more acute rejection episodes occur in the first year after transplantation. The immunohistochemical composition of BALT may predict patients prone to frequent episodes of acute cellular rejection.
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spelling doaj-art-51499d2fa08743fe928bbf9ccb5797272025-02-03T05:59:17ZengWileyJournal of Transplantation2090-00072090-00152012-01-01201210.1155/2012/928081928081Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft RejectionK. V. Shenoy0C. Solomides1F. Cordova2T. J. Rogers3D. Ciccolella4G. J. Criner5Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USADivision of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USADivision of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USADivision of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USADivision of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USADivision of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USABackground. Bronchus-associated lymphoid tissue (BALT) has been associated with lung allograft rejection in rat transplant models. In human transplant recipients, BALT has not been linked to clinically significant rejection. We hypothesize that the immunohistochemical composition of BALT varies with the presence of acute lung allograft rejection. Methods. We retrospectively examined 40 human lung allograft recipients transplanted from 3/1/1999 to 6/1/2008. Patients were grouped by frequency and severity of acute rejection based on International Society of Heart Lung Transplant (ISHLT) criteria. Transbronchial biopsies were reviewed for BALT by a blinded pathologist. BALT if present was immunohistochemically stained to determine T-and B-cell subpopulations. Results. BALT presence was associated with an increased frequency of acute rejection episodes in the first year after transplantation. Patients with a lower CD4/CD8 ratio had an increased rejection rate; however, BALT size or densities of T-cell and B-cell subpopulations did not correlate with rejection rate. Conclusion. The presence of BALT is associated with an increased frequency of rejection one year after transplant. The lower the CD4/CD8 ratio, the more acute rejection episodes occur in the first year after transplantation. The immunohistochemical composition of BALT may predict patients prone to frequent episodes of acute cellular rejection.http://dx.doi.org/10.1155/2012/928081
spellingShingle K. V. Shenoy
C. Solomides
F. Cordova
T. J. Rogers
D. Ciccolella
G. J. Criner
Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection
Journal of Transplantation
title Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection
title_full Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection
title_fullStr Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection
title_full_unstemmed Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection
title_short Low CD4/CD8 Ratio in Bronchus-Associated Lymphoid Tissue Is Associated with Lung Allograft Rejection
title_sort low cd4 cd8 ratio in bronchus associated lymphoid tissue is associated with lung allograft rejection
url http://dx.doi.org/10.1155/2012/928081
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