A study of lung tissue from patients with end-stage bronchiolitis obliterans syndrome (BOS) as a complication of lung transplantation yielded molecular and morphologic insights into the development of chronic rejection. These insights may help develop therapies to optimize long-term outcomes for lung transplantation patients, report investigators in The American Journal of Pathology.
BOS, a common form of chronic lung allograft dysfunction, limits long-term survival after lung transplantation. This study improves our understanding of the formation of obliterative bronchiolitis (OB) lesions in small airways. Identification of early processes leading to BOS and improved understanding of the underlying mechanisms will help us develop tools to manage BOS.
“Lung transplantation can be the last option for some end-stage patients with various underlying lung diseases. Therefore, improving transplantation outcomes may have a significant impact on their survival,” explained lead investigator Gunilla Westergren-Thorsson, PhD, Lung Biology Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden. “Identifying the underlying initial cause of OB lesions in patients undergoing lung transplantation is key to developing therapies to reduce the chance of chronic allograft dysfunction.”
Investigators examined the protein composition in lung tissue from four patients with end-stage BOS as a complication of lung transplantation using laser-capture microdissection and optimized sample preparation protocols for mass spectrometry. Immunohistochemistry and immunofluorescence were used to determine the spatial distribution of commonly identified proteins at the tissue level. Protein signatures were established for 14 OB lesions, which showed variations in their protein content as well as exhibited common features.
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American Journal of Pathology. Study Paper:
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