Airway neutrophilia in stable and bronchiolitis obliterans syndrome

Thorax 2000;55:53–59

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Airway neutrophilia in stable and bronchiolitis obliterans syndrome patients following lung transplantation Ling Zheng, E Haydn Walters, Chris Ward, Ning Wang, Bernadette Orsida, Helen Whitford, Trevor J Williams, Tom Kotsimbos, Gregory I Snell

Department of Respiratory Medicine, Alfred Hospital and Monash Medical School, Prahran 3181, Melbourne, Australia L Zheng E H Walters C Ward N Wang B Orsida H Whitford T J Williams T Kotsimbos G I Snell Correspondence to: Dr G Snell Received 22 March 1999 Returned to authors 2 June 1999 Revised manuscript received 29 July 1999 Accepted for publication 4 October 1999

Abstract Background—The bronchiolitis obliterans syndrome (BOS) remains the major constraint on the long term success of lung transplantation. Neutrophils have been associated with fibrosing lung conditions and have been noted to be increased in the bronchoalveolar lavage (BAL) fluid of patients with BOS. Methods—This study was undertaken to examine neutrophil accumulation in the BAL fluid, airway wall and lung parenchyma, as well as levels of interleukin (IL)-8 in the BAL fluid, in normal controls and lung transplant recipients with and without BOS. Bronchoscopic examination included endobronchial biopsy (EBB), BAL fluid, and transbronchial biopsy (TBB) sampling. Tissue neutrophils were identified by neutrophil elastase staining on 3 µm paraYn biopsy sections and quantified by computerised image analyser. IL-8 levels were measured in unconcentrated BAL fluid by ELISA. Results—Compared with controls, airway wall neutrophilia was increased in both stable lung transplant recipients and those with BOS (p