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Heparin-binding protein, lysozyme, and inflammatory cytokines in bronchoalveolar lavage fluid as diagnostic tools for pulmonary infection in lung transplanted patients

Artikel i vetenskaplig tidskrift
Författare A. S. Aspelund
Helena Hammarström
M. Inghammar
H. Larsson
L. Hansson
B. Christensson
L. I. Pahlman
Publicerad i American Journal of Transplantation
Volym 18
Nummer/häfte 2
Sidor 444-452
ISSN 1600-6135
Publiceringsår 2018
Publicerad vid Institutionen för biomedicin, avdelningen för infektionssjukdomar
Sidor 444-452
Språk en
Länkar doi.org/10.1111/ajt.14458
Ämnesord basic (laboratory) research, science, bronchoalveolar lavage (BAL), clinical research, practice, working formulation, acute rejection, recipients, standardization, neutrophils, pneumonia, peptides, diseases, il-10, roles, Surgery, Transplantation
Ämneskategorier Infektionsmedicin, Transplantationskirurgi

Sammanfattning

Pulmonary infection is a common complication after lung transplantation, and early detection is crucial for outcome. However, the condition can be clinically difficult to diagnose and to distinguish from rejection. The aim of this prospective study was to evaluate heparin-binding protein (HBP), lysozyme, and the cytokines interleukin (IL)-1, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF) in bronchoalveolar lavage fluid (BALF) as potential biomarkers for pulmonary infection in lung-transplanted patients. One hundred thirteen BALF samples from 29 lung transplant recipients were collected at routine scheduled bronchoscopies at 3 and 6months, or on clinical indication. Samples were classified into no, possible, probable, or definite infection at the time of sampling. Rejection was defined by biopsy results. HBP, lysozyme, and cytokines were analyzed in BALF and correlated to likelihood of infection and rejection. All biomarkers were significantly increased in BALF during infection, whereas patients with rejection presented low levels that were comparable to noninfection samples. HBP, IL-1, and IL-8 were the best diagnostic markers of infection with area under the receiver-operating characteristic curve values of 0.88, 0.91, and 0.90, respectively. In conclusion, HBP, IL-1, and IL-8 could be useful diagnostic markers of pulmonary infection in lung-transplanted patients. This prospective study on bronchoalveolar fluid from lung transplant recipients suggests that heparin-binding protein, IL-1beta, and IL-8 are useful biomarkers for the detection of pulmonary infection.

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