Clinical lung and heart/lung transplantationAirway Colonization and Gastric Aspiration After Lung Transplantation: Do Birds of a Feather Flock Together?
Section snippets
Study Population
In this retrospective cross-sectional case–control study, approved by the ethics review board of the University Hospital Gasthuisberg, inflammatory markers (IL-8 protein levels and cell differentials), as well as markers of gastroesophageal reflux (pepsin, bile acids) were evaluated in bronchoalveolar lavage (BAL) fluid of stable double lung transplant (SSLTx) recipients. Patients were selected from a group of 92 out of 125 patients transplanted between January 2000 and December 2005 at our
Study Population
Based on the aforementioned inclusion and exclusion criteria, 24 SSLTx recipients were included in the current study. Patients' characteristics are given in Table 1. Recipients' age, gender, FEV1 at time of BAL sampling after LTx, and therapeutic regimen were comparable between colonized and non-colonized patients (p = not significant [NS]). At the moment of BAL sampling, none of the included patients received azithromycin treatment, as outlined in the inclusion criteria. In this small cohort,
Discussion
In this study we sought to determine whether airway colonization by P aeruginosa and aspiration of gastroduodenal refluxate after LTx are associated. We could confirm that LTx recipients colonized by P aeruginosa had elevated BAL bile acid, but not pepsin, levels compared with non-colonized patients, possibly suggesting that specifically non-acid (bile) reflux may predispose to airway colonization after LTx. Furthermore, bile acid levels, but not pepsin levels, positively correlated with BAL
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Aspiration of conjugated bile acids predicts adverse lung transplant outcomes and correlates with airway lipid and cytokine dysregulation
2021, Journal of Heart and Lung TransplantationBile acid aspiration associated with lung chemical profile linked to other biomarkers of injury after lung transplantation
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2014, Archivos de BronconeumologiaThe effect of gastric juice on interleukin-8 production by cystic fibrosis primary bronchial epithelial cells
2013, Journal of Cystic FibrosisCitation Excerpt :Since aspiration of duodeno-gastric contents was linked to the development of bronchiolitis obliterans syndrome after lung transplantation, several studies have been performed to determine their exact relationship. A clear correlation was found between bile acid levels and IL-8 concentrations and the number of neutrophils in bronchoalveolar lavage fluid of lung transplant patients, suggesting that bile acids are capable of inducing IL-8 expression [9,10]. Our group previously demonstrated that concentrations of bile acids in sputum of CF patients correlate with levels of neutrophil elastase, an inflammatory marker in the lungs [6].
Supported by the Research Foundation of Flanders (FWO; Grants G.0493.04, G.0518.06 and G.0643.08), a research grant from Sandhill Scientific (Denver, CO) and an educational grant from AstraZeneca (Belgium) (to D.S.).
R.V. and K.B. contributed equally contributed to this study.