Abstract | BACKGROUND: METHODS: In 8 lung transplant patients with gastroesophageal reflux disease, we quantified and compared the pulmonary leukocyte differential and the concentration of inflammatory mediators in the bronchoalveolar lavage fluid (BALF) 4 weeks before LARS, 4 weeks after LARS, and 12 months after lung transplantation. Freedom from bronchiolitis obliterans syndrome (graded 1-3 according to the International Society of Heart and Lung Transplantation guidelines), forced expiratory volume in 1 second trends, and survival were also examined. RESULTS: At 4 weeks after LARS, the percentages of neutrophils and lymphocytes in the BALF were reduced (from 6.6% to 2.8%, P = 0.049, and from 10.4% to 2.4%, P = 0.163, respectively). The percentage of macrophages increased (from 74.8% to 94.6%, P = 0.077). Finally, the BALF concentration of myeloperoxide and interleukin-1β tended to decrease (from 2109 to 1033 U/mg, P = 0.063, and from 4.1 to 0 pg/mg protein, P = 0.031, respectively), and the concentrations of interleukin-13 and interferon-γ tended to increase (from 7.6 to 30.4 pg/mg protein, P = 0.078 and from 0 to 159.5 pg/mg protein, P = 0.031, respectively). These trends were typically similar at 12 months after transplantation. At a mean follow-up of 19.7 months, the survival rate was 75% and the freedom from bronchiolitis obliterans syndrome was 75%. Overall, the forced expiratory volume in 1 second remained stable during the first year after transplantation. CONCLUSIONS: Our preliminary study has demonstrated that LARS can restore the physiologic balance of pulmonary leukocyte populations and that the BALF concentration of pro-inflammatory mediators is altered early after LARS. These results suggest that LARS could modulate the pulmonary inflammatory milieu in lung transplant patients with gastroesophageal reflux disease.
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Authors | P Marco Fisichella, Christopher S Davis, Erin Lowery, Matthew Pittman, James Gagermeier, Robert B Love, Elizabeth J Kovacs |
Journal | The Journal of surgical research
(J Surg Res)
Vol. 177
Issue 2
Pg. e65-73
(Oct 2012)
ISSN: 1095-8673 [Electronic] United States |
PMID | 22537841
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Validation Study)
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Copyright | Copyright © 2012 Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Bronchiolitis Obliterans
(etiology, prevention & control)
- Bronchoalveolar Lavage Fluid
(immunology)
- Female
- Fundoplication
- Gastroesophageal Reflux
(complications, immunology, surgery)
- Graft Rejection
(prevention & control)
- Humans
- Laparoscopy
- Lung Transplantation
(immunology)
- Male
- Middle Aged
- Postoperative Complications
(etiology, prevention & control)
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