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Review
. 2017 Aug 7;18(1):151.
doi: 10.1186/s12931-017-0634-6.

Plasma and bronchoalveolar lavage samples in acute lung allograft rejection: the potential role of cytokines as diagnostic markers

Nicole E Speck  1 , Macé M Schuurmans  1 , Christian Benden  1 , Cécile A Robinson  1 , Lars C Huber  2
Affiliations
Review

Plasma and bronchoalveolar lavage samples in acute lung allograft rejection: the potential role of cytokines as diagnostic markers

Nicole E Speck et al. Respir Res. .

Abstract

The role of differential cytology patterns in peripheral blood and bronchoalveolar lavage samples is increasingly investigated as a potential adjunct to diagnose acute and chronic allograft dysfunction after lung transplantation. While these profiles might facilitate the diagnosis of acute cellular rejection, low sensitivity and specificity of these patterns limit direct translation in a clinical setting. In this context, the identification of other biomarkers is needed. This review article gives an overview of cytokine profiles of plasma and bronchoalveolar lavage samples during acute cellular rejection. The value of these cytokines in supporting the diagnosis of acute cellular rejection is discussed. Current findings on the topic are highlighted and experimental settings for future research projects are identified.

Keywords: Blood; Bronchoalveolar lavage; Cytokine; Diagnosis; Graft rejection; Lung transplantation; Plasma.

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Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Proposal of an integrative algorithm. This descriptive algorithm is designed to estimate probabilities for ACR or other causes of ALAD in lung transplant recipients presenting with clinical findings or a drop in lung function (FEV1 > 10%). The integration of microbiology data, differential cytology [11] and cytokine expression levels from peripheral blood and BAL samples might assist in decision-making to increase or decrease the likelihood for ACR in the context of the clinical presentation. In the absence of standardized BAL techniques and detection methods, BAL cytokine expression levels and cut-offs have to interpreted wth caution and should be confirmed in larger studies. Since results from studies with very different designs have been included, direct translation in a clinical setting is not feasible and the use of this algorithm does not obviate the need for biopsy to confirm or exclude histology-proven ACR. * Numbers vary between different studies. ** Absence of microbiological evidence for infection
See this image and copyright information in PMC

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