Pulmonary epithelial markers in phenotypes of chronic lung allograft dysfunction
Section snippets
Study design and patient selection
This was a single-center, retrospective cohort study approved by the Institutional Research Ethics Board. The study population was drawn from all first, adult, bilateral, LT recipients at Toronto General Hospital who underwent a LT operation between January 1, 2010, and December 31, 2015: this cohort is a subset of a previously-published CLAD cohort.17 All patients with RAS, mixed phenotype and undefined or unclassified with RLO, who had a BAL sample obtained within 6 months after CLAD onset,
Patient cohort characteristics
Of the 506 adult, bilateral, first LT recipients who had a transplant operation between January 1, 2010, and December 31, 2015, 39 were excluded due to insufficient PFT data precluding CLAD diagnosis and 19 because the diagnosis of CLAD was incompletely substantiated or unconfirmed. Fifty-four patients who had a BAL sample obtained within 6 months after CLAD onset (27 BOS, 11 RAS, 7 Mixed, 9 other-RLO) and 23 CLAD-free controls who were alive and CLAD-free for a minimum of 3 years
Discussion
In this study, we evaluated the utility of pulmonary epithelial markers of injury or death in BAL fluid for the diagnosis and phenotyping of CLAD. We used BAL fluid obtained within 6 months after CLAD onset to assess differences in levels of various epithelial markers comparing CLAD vs CLAD-free controls and comparing CLAD phenotypes, BOS vs combined RAS, mixed and other-RLO. We tested an array of epithelial markers selected based on existing literature. We demonstrate elevated BAL levels of
Disclosure statement
TM has received CCSP-related research material from APCBio Innovations, Inc. and collaborates with Trove Therapeutics, Inc. on CCSP-related research. These companies were not involved in the design or analysis of the study. The other authors of this manuscript have no conflicts of interest to disclose.
This research was supported in part by a grant from The Canadian Institutes of Health Research (to TM, #149094), a grant from The Physicians' Services Inc. Foundation (to LL and TM), a Cystic
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Both authors contributed equally to this manuscript.