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After two years treatment there was a significant increase in LS BMD with weekly risedronate compared to placebo.

HMG-B1 than culture negative samples. Due to the confounding effect of infection, our analysis excluded 90 BAL samples with positive cultures. Concentrations of IL-1a were significantly higher in culture negative BAL from BOS patients (median 2.411, range [AJF1] 0.073e19.078 pg/ml) than from Non-BOS patients (median 1.424, range [AJF2] 1.159e17.41 pg/ml; p¼0.001). No significant difference in HMG-B1 concentrations between the two groups was observed (BOS median 58.906, range 0e197.5; Non-BOS median 76.25, range 0e211.563 ng/ml; p¼0.2378). Longitudinal measurements of IL-1a in BOS patients showed significantly higher levels 3 months before or after BOS diagnosis (median 3.935, range 1.122e13.544 pg/ml), compared to >3 months before BOS diagnosis (median 2.015, range 0.073e14.669 pg/ml; p¼0.0153). There was no such difference in HMG-B1 concentrations (p¼0.9164). Conclusions An increase in the alarmin IL-1a, but not HMG-B1, is associated with BOS development. The cellular source of IL-1a requires further evaluation but may be a marker of airway epithelial injury and/or play a mechanistic role in BOS development via its secretion by other cell types. S54POLYMERS Z antitrypsin (Z-AT) polymerises in the liver and is associated with early onset emphysema. Polymers of Z-AT are not only inactivate as antiproteinases, but also act as a pro-inflammatory stimulus. We studied patients with emphysema post lung transplantation, with and without AT deficiency, to examine the relationship between polymers and the presence of infection and inflammation. Bronchoalveolar Lavage Fluid (BALF) was obtained at scheduled surveillance, and when clinically indicated to assess for infection, rejection and airway injury. BALF was assessed by ELISA and immunoblot using a monoclonal antibody to polymeric AT (ATZII). BALF cell pellets were lysed, and HLE activity was used as a measure of BALF neutrophil numbers. 16 patients post-transplant were evaluated, 6 Z-AT patients (15 samples); 9 infective tracheobronchitis, 3 airway stenosis, 1 reflux, 2 normal, and 10 M-AT patients (20 samples); 7 infective tracheobronchitis, 8 rejection, 5 normal. All samples apart from one in the Z-AT group contained polymers; median (IQR) 292 (430e40.2) ng/ml. In one patient BALF was initially negative for polymers, but subsequent samples were positive. Polymers were present in association bacterial infection, colonisation, airway injury and surveillance bronchoscopy of asymptomatic patients. Airway stenosis/inflammation and bacterial tracheobronchitis was associated with a higher amount of polymers (347.35 (SEM657 ng/ml) than Z-AT with normal findings (1426101 ng/ml). Immunoblot confirmed the classical ladders of polymers in Z-AT group, but not in M-AT group. BALF of Z-AT group had a higher free HLE than M-AT; 139(226.5e102.75) ng/ml vs 74(105.25e46) ng/ml, respectively; p#0.001. Free HLE in Z-AT was correlated with polymer concentrations in BALF; r 2 ¼0.63. Total neutrophil numbers were higher in Z-AT compared with M-AT; OD405, 0.5760.07 vs 0.3760.04, respectivel...

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