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. 1988 Jul;132(1):6–11.

Depletion of bronchus-associated lymphoid tissue associated with lung allograft rejection.

R H Hruban 1, W E Beschorner 1, W A Baumgartner 1, S C Achuff 1, T A Traill 1, K A Digennaro 1, B A Reitz 1, G M Hutchins 1
PMCID: PMC1880619  PMID: 3293464

Abstract

Pulmonary infections remain one of the major complications of lung transplantation. The bronchus-associated lymphoid tissue (BALT) forms a local immune system that normally protects the lung from infection. The effects of lung transplantation and lung allograft rejection on the BALT were examined using immunoperoxidase techniques. The BALT was evaluated by quantifying the number of immunoglobulin-bearing plasma cells in the lamina propria of sections of trachea and mainstem bronchus. Sections of donor mainstem bronchus from 2 patients with allograft rejection were compared with sections of native trachea from these same patients, and with sections of mainstem bronchus from 2 transplanted lungs without rejection and 20 controls. Lung allografts from the 2 patients with rejection had a marked depletion of submucosal IgA-bearing and IgG-bearing plasma cells. Two sets of transplanted lungs without evidence of rejection showed only a mild reduction of the BALT. The depletion of BALT associated with allograft rejection may contribute to the increased incidence of pulmonary infections seen in these patients.

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Selected References

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  1. Baker R. R., Sabanayagam P., Zarins C. K., James A. E., Hutchins G. M., Byers J. M., 3rd, Katarajan T. K., Lee J. M. Functional and morphologic changes after lung allografting in baboons. Surg Gynecol Obstet. 1973 Oct;137(4):650–654. [PubMed] [Google Scholar]
  2. Beschorner W. E., Yardley J. H., Tutschka P. J., Santos G. W. Deficiency of intestinal immunity with graft-vs.-host disease in humans. J Infect Dis. 1981 Jul;144(1):38–46. doi: 10.1093/infdis/144.1.38. [DOI] [PubMed] [Google Scholar]
  3. Bienenstock J., Befus A. D. Mucosal immunology. Immunology. 1980 Oct;41(2):249–270. [PMC free article] [PubMed] [Google Scholar]
  4. Bienenstock J., Johnston N., Perey D. Y. Bronchial lymphoid tissue. I. Morphologic characteristics. Lab Invest. 1973 Jun;28(6):686–692. [PubMed] [Google Scholar]
  5. Bienenstock J., Johnston N., Perey D. Y. Bronchial lymphoid tissue. II. Functional characterisitics. Lab Invest. 1973 Jun;28(6):693–698. [PubMed] [Google Scholar]
  6. Björkander J., Bake B., Oxelius V. A., Hanson L. A. Impaired lung function in patients with IgA deficiency and low levels of IgG2 or IgG3. N Engl J Med. 1985 Sep 19;313(12):720–724. doi: 10.1056/NEJM198509193131203. [DOI] [PubMed] [Google Scholar]
  7. Burke C. M., Glanville A. R., Theodore J., Robin E. D. Lung immunogenicity, rejection, and obliterative bronchiolitis. Chest. 1987 Sep;92(3):547–549. doi: 10.1378/chest.92.3.547. [DOI] [PubMed] [Google Scholar]
  8. Burke C. M., Theodore J., Dawkins K. D., Yousem S. A., Blank N., Billingham M. E., Van Kessel A., Jamieson S. W., Oyer P. E., Baldwin J. C. Post-transplant obliterative bronchiolitis and other late lung sequelae in human heart-lung transplantation. Chest. 1984 Dec;86(6):824–829. doi: 10.1378/chest.86.6.824. [DOI] [PubMed] [Google Scholar]
  9. Byers J. M., 3rd, Sabanayagam P., Baker R. R., Hutchins G. M. Pathologic changes in baboon lung allografts. Comparison of two immunosuppression regimes. Ann Surg. 1973 Dec;178(6):754–760. doi: 10.1097/00000658-197312000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. DeCoteau W. E. The role of secretory IgA in defense of the distal lung. Ann N Y Acad Sci. 1974;221:214–219. doi: 10.1111/j.1749-6632.1974.tb28221.x. [DOI] [PubMed] [Google Scholar]
  11. Fung J. J., Zeevi A., Kaufman C., Paradis I. L., Dauber J. H., Hardesty R. L., Griffith B., Duquesnoy R. J. Interactions between bronchoalveolar lymphocytes and macrophages in heart-lung transplant recipients. Hum Immunol. 1985 Nov;14(3):287–294. doi: 10.1016/0198-8859(85)90236-8. [DOI] [PubMed] [Google Scholar]
  12. Glanville A. R., Baldwin J. C., Burke C. M., Theodore J., Robin E. D. Obliterative bronchiolitis after heart-lung transplantation: apparent arrest by augmented immunosuppression. Ann Intern Med. 1987 Sep;107(3):300–304. doi: 10.7326/0003-4819-107-2-300. [DOI] [PubMed] [Google Scholar]
  13. Green G. M., Jakab G. J., Low R. B., Davis G. S. Defense mechanisms of the respiratory membrane. Am Rev Respir Dis. 1977 Mar;115(3):479–514. doi: 10.1164/arrd.1977.115.3.479. [DOI] [PubMed] [Google Scholar]
  14. Griffith B. P., Hardesty R. L., Trento A., Paradis I. L., Duquesnoy R. J., Zeevi A., Dauber J. H., Dummer J. S., Thompson M. E., Gryzan S. Heart-lung transplantation: lessons learned and future hopes. Ann Thorac Surg. 1987 Jan;43(1):6–16. doi: 10.1016/s0003-4975(10)60157-9. [DOI] [PubMed] [Google Scholar]
  15. Hruban R. H., Beschorner W. E., Gupta P. K., Baumgartner W. A., Achuff S. C., Traill T. A., Reitz B. A., Hutchins G. M. Diagnosis of rejection of lung allografts. N Engl J Med. 1988 Apr 28;318(17):1129–1129. doi: 10.1056/NEJM198804283181716. [DOI] [PubMed] [Google Scholar]
  16. Kaltreider H. B. Expression of immune mechanisms in the lung. Am Rev Respir Dis. 1976 Mar;113(3):347–379. doi: 10.1164/arrd.1976.113.3.347. [DOI] [PubMed] [Google Scholar]
  17. McGregor C. G., Jamieson S. W., Baldwin J. C., Burke C. M., Dawkins K. D., Stinson E. B., Oyer P. E., Billingham M. E., Zusman D. R., Reitz B. A. Combined heart-lung transplantation for end-stage Eisenmenger's syndrome. J Thorac Cardiovasc Surg. 1986 Mar;91(3):443–450. [PubMed] [Google Scholar]
  18. Organ transplantation. Heart and lung. Transplant Proc. 1985 Feb;17(1 Pt 1):199–249. [PubMed] [Google Scholar]
  19. Paradis I. L., Marrari M., Zeevi A., Duquesnoy R. J., Griffith B. P., Hardesty R. L., Dauber J. H. HLA phenotype of lung lavage cells following heart-lung transplantation. J Heart Transplant. 1985 Jul-Aug;4(4):422–425. [PubMed] [Google Scholar]
  20. Prop J., Tazelaar H. D., Billingham M. E. Rejection of combined heart-lung transplants in rats. Function and pathology. Am J Pathol. 1987 Apr;127(1):97–105. [PMC free article] [PubMed] [Google Scholar]
  21. Prop J., Wildevuur C. R., Nieuwenhuis P. Lung allograft rejection in the rat. II. Specific immunological properties of lung grafts. Transplantation. 1985 Aug;40(2):126–131. doi: 10.1097/00007890-198508000-00003. [DOI] [PubMed] [Google Scholar]
  22. Prop J., Wildevuur C. R., Nieuwenhuis P. Lung allograft rejection in the rat. III. Corresponding morphological rejection phases in various rat strain combinations. Transplantation. 1985 Aug;40(2):132–136. doi: 10.1097/00007890-198508000-00004. [DOI] [PubMed] [Google Scholar]
  23. Reynolds H. Y. Lung immunology and its contribution to the immunopathogenesis of certain respiratory diseases. J Allergy Clin Immunol. 1986 Nov;78(5 Pt 1):833–847. doi: 10.1016/0091-6749(86)90227-7. [DOI] [PubMed] [Google Scholar]
  24. Sliman G. A., Beschorner W. E., Baughman K. L., Hutchins G. M., Borkon M. A., Baumgartner W. A. Graft-versus-host-like disease in a heart allograft recipient. A possible autoimmune phenomenon. Transplantation. 1988 Jan;45(1):253–256. doi: 10.1097/00007890-198801000-00057. [DOI] [PubMed] [Google Scholar]
  25. Tomasi T. B., Jr, DeCoteau E. Mucosal antibodies in respiratory and gastrointestinal disease. Adv Intern Med. 1970 Jun;116(535):401–425. [PubMed] [Google Scholar]
  26. Umetsu D. T., Ambrosino D. M., Quinti I., Siber G. R., Geha R. S. Recurrent sinopulmonary infection and impaired antibody response to bacterial capsular polysaccharide antigen in children with selective IgG-subclass deficiency. N Engl J Med. 1985 Nov 14;313(20):1247–1251. doi: 10.1056/NEJM198511143132002. [DOI] [PubMed] [Google Scholar]
  27. Wildevuur C. R., Benfield J. R. A review of 23 human lung transplantations by 20 surgeons. Ann Thorac Surg. 1970 Jun;9(6):489–515. doi: 10.1016/s0003-4975(10)65544-0. [DOI] [PubMed] [Google Scholar]
  28. Yolken R. H., Bishop C. A., Townsend T. R., Bolyard E. A., Bartlett J., Santos G. W., Saral R. Infectious gastroenteritis in bone-marrow-transplant recipients. N Engl J Med. 1982 Apr 29;306(17):1010–1012. doi: 10.1056/NEJM198204293061701. [DOI] [PubMed] [Google Scholar]

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