Pulmonary graft-versus-host disease and chronic lung allograft dysfunction: two sides of the same coin?

Bos, Saskia; Beeckmans, Hanne; Vanstapel, Arno; Sacreas, Annelore; Geudens, Vincent; Willems, Lynn; Schreurs, Ine; Vanaudenaerde, Bart M.; Schoemans, Hélène; Vos, Robin

doi:10.1016/s2213-2600(22)00001-7

Cited by 13 publications

(10 citation statements)

References 81 publications

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“…BOS is also a distinct clinical hallmark of pulmonary chronic graft-versus-host disease (cGvHD) in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients. 36 Recently, the ISHLT CLAD consensus criteria were shown to be also applicable to pulmonary cGVHD and could perhaps be used to better phenotype and study lung disease in cGVHD. 37…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Value of Chest CT Findings at BOS Diagnosis in Lung Transplant Recipients

et al. 2023

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Background. Bronchiolitis obliterans syndrome (BOS) after lung transplantation is characterized by fibrotic small airway remodeling, recognizable on high-resolution computed tomography (HRCT). We studied the prognostic value of key HRCT features at BOS diagnosis after lung transplantation. Methods. The presence and severity of bronchiectasis, mucous plugging, peribronchial thickening, parenchymal anomalies, and air trapping, summarized in a total severity score, were assessed using a simplified Brody II scoring system on HRCT at BOS diagnosis, in a cohort of 106 bilateral lung transplant recipients transplanted between January 2004 and January 2016. Obtained scores were subsequently evaluated regarding post-BOS graft survival, spirometric parameters, and preceding airway infections. Results. A high total Brody II severity score at BOS diagnosis (P = 0.046) and high subscores for mucous plugging (P = 0.0018), peribronchial thickening (P = 0.0004), or parenchymal involvement (P = 0.0121) are related to worse graft survival. A high total Brody II score was associated with a shorter time to BOS onset (P = 0.0058), lower forced expiratory volume in 1 s (P = 0.0006) forced vital capacity (0.0418), more preceding airway infections (P = 0.004), specifically with Pseudomonas aeruginosa (P = 0.002), and increased airway inflammation (P = 0.032). Conclusions. HRCT findings at BOS diagnosis after lung transplantation provide additional information regarding its underlying pathophysiology and for future prognosis of graft survival.

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Section: Discussionmentioning

confidence: 99%

“…BOS is also a distinct clinical hallmark of pulmonary chronic graft-versus-host disease (cGvHD) in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients. 36…”

Section: Relevance For Other Patient Populationsmentioning

confidence: 99%

Prognostic Value of Chest CT Findings at BOS Diagnosis in Lung Transplant Recipients

et al. 2023

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“…How thymic epithelium is distinctively lineage labeled by Foxa2 and Shh, and the tolerance difference should be investigated further. It is also important to note that GvHD is a crucial risk factor for long-term survival following human lung transplantation ( Bos et al, 2022 ). If we transplant the complemented lungs as a graft containing the conditioned host- and donor-derived immune cells to the recipient that provided donor PSC, it may not cause GvHD.…”

Section: Discussionmentioning

confidence: 99%

“…This unique technology has been further developed into intra- and interspecies organ generations such as kidney, pancreas, thymus, and blood vessels ( Hamanaka et al, 2018 ; Kobayashi et al, 2010 ; Usui et al, 2012 ; Yamaguchi et al, 2017 ). However, co-generation of targeted organs and thymus has never been reported, while educating host immune cells for organ transplantation is critical to avoid graft-versus-host disease (GvHD) post-transplantation ( Bos et al, 2022 ). The production of entire organs, including tissue-specific epithelium and mesenchyme, including endothelium, was also tricky because the origin of pulmonary endothelium seems similar to the other organs.…”

Section: Introductionmentioning

confidence: 99%

Conditional blastocyst complementation of a defective Foxa2 lineage efficiently promotes the generation of the whole lung

Miura,

Sarmah,

Tanaka

et al. 2023

eLife

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Millions suffer from incurable lung diseases, and the donor lung shortage hampers organ transplants. Generating the whole organ in conjunction with the thymus is a significant milestone for organ transplantation because the thymus is the central organ to educate immune cells. Using lineage-tracing mice and human pluripotent stem cell (PSC)-derived lung-directed differentiation, we revealed that gastrulating Foxa2 lineage contributed to both lung mesenchyme and epithelium formation. Interestingly, Foxa2 lineage-derived cells in the lung mesenchyme progressively increased and occupied more than half of the mesenchyme niche, including endothelial cells, during lung development. Foxa2 promoter-driven, conditional Fgfr2 gene depletion caused the lung and thymus agenesis phenotype in mice. Wild-type donor mouse PSCs injected into their blastocysts rescued this phenotype by complementing the Fgfr2-defective niche in the lung epithelium and mesenchyme and thymic epithelium. Donor cell is shown to replace the entire lung epithelial and robust mesenchymal niche during lung development, efficiently complementing the nearly entire lung niche. Importantly, those mice survived until adulthood with normal lung function. These results suggest that our Foxa2 lineage-based model is unique for the progressive mobilization of donor cells into both epithelial and mesenchymal lung niches and thymus generation, which can provide critical insights into studying lung transplantation post-transplantation shortly.

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“… BOS: bronchiolitis obliterans syndrome; LuTx: lung transplantation; HSCT: haematopoietic stem cell transplantation; RAS: restrictive allograft syndrome; CT: computed tomography; LONIPC: late-onset non-infectious pulmonary complications; FEV 1 : forced expiratory volume in 1 s; FVC: forced vital capacity; PFT: pulmonary function test; cGvHD: chronic graft versus host disease; TLC: total lung capacity; NIH: National Institutes of Health; DAD: diffuse alveolar damage; AFE: alveolar fibroelastosis; PPFE: pleuroparenchymal fibroelastosis; OB/CB: obliterative bronchiolitis/constrictive bronchiolitis; NSIP: nonspecific interstitial pneumonia; AFOP: acute fibrinous and organising pneumonia; (C)OP: (cryptogenic) organising pneumonia; LIP: lymphoid interstitial pneumonia. Reproduced and modified from [ 15 ] with permission. …”

Section: Infectious and Non-infectious Complications Of Immunosuppres...mentioning

confidence: 99%

ERS International Congress 2023: highlights from the Thoracic Surgery and Lung Transplantation Assembly

Zajacova,

Scaramozzino,

Bellini

et al. 2023

ERJ Open Res

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Five sessions presented at recent European Respiratory Society Congress 2023 were selected by Assembly 8, consisting of thoracic surgeons and lung transplant professionals. Highlights covering management of adult spontaneous pneumothorax, malignant pleural effusion, infectious and immune-mediated complications after lung transplantation, as well as pro & con debate on age limit in lung transplantation and results of ScanCLAD study were summarized by early career members, supervised by the assembly faculty.

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Pulmonary graft-versus-host disease and chronic lung allograft dysfunction: two sides of the same coin?

Cited by 13 publications

References 81 publications

Prognostic Value of Chest CT Findings at BOS Diagnosis in Lung Transplant Recipients

Prognostic Value of Chest CT Findings at BOS Diagnosis in Lung Transplant Recipients

Conditional blastocyst complementation of a defective Foxa2 lineage efficiently promotes the generation of the whole lung

ERS International Congress 2023: highlights from the Thoracic Surgery and Lung Transplantation Assembly

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