Skip directly to content

PubMed Lung Transplant

Subscribe to PubMed Lung Transplant feed PubMed Lung Transplant
NCBI: db=pubmed; Term=lung transplant
Updated: 1 hour 12 min ago

Ozone Therapy Protects Against Rejection in a Lung Transplantation Model: A New Treatment?

Sun, 05/28/2017 - 12:45
Related Articles

Ozone Therapy Protects Against Rejection in a Lung Transplantation Model: A New Treatment?

Ann Thorac Surg. 2017 May 24;:

Authors: Santana-Rodríguez N, Llontop P, Clavo B, Fiuza-Pérez MD, Zerecero K, Ayub A, Alshehri K, Yordi NA, Re L, Raad W, Fernández-Pérez L, García-Herrera R, Huang CJ, Bhora FY

Abstract
BACKGROUND: No satisfactory treatment exists for chronic rejection (CR) after lung transplantation (LT). Our objective was to assess whether ozone (O3) treatment could ameliorate CR.
METHODS: Male Sprague-Dawley inbred rats (n = 36) were randomly assigned into four groups: (1) control (n = 6), (2) sham (n = 6), (3) LT (n = 12), and (4) O3-LT (n = 12). Animals underwent left LT. O3 was rectally administered daily for 2 weeks before LT (from 20 to 50 μg) and 3 times/wk (50 μg/dose) up to 3 months. CR; acute rejection; and Hspb27, Prdx, Epas1, Gpx3, Vegfa, Sftpa1, Sftpb, Plvap, Klf2, Cldn5, Thbd, Dsip, Fmo2, and Sepp1 mRNA gene expression were determined.
RESULTS: Severe CR was observed in all animals of LT group, but none of the O3-LT animals showed signs of CR, just a mild acute rejection was observed in 1 animal. A significant decrease of Hspb27, Prdx, Epas1, Gpx3, Vegfa, Sftpa1, Sftpb, Plvap, Klf2, Cldn5, Thbd, Dsip, and Fmo2 gene expression in the O3-LT group was observed CONCLUSIONS: O3 therapy significantly delayed the onset of CR regulating the expression of genes involved in its pathogenesis. No known immunosuppressive therapy has been capable of achieving similar results. From a translational point of view, O3 therapy could become a new adjuvant treatment for CR in patients undergoing LT.

PMID: 28549673 [PubMed - as supplied by publisher]

Combined lung-liver-pancreas transplantation in a recipient with cystic fibrosis.

Sun, 05/28/2017 - 12:45
Related Articles

Combined lung-liver-pancreas transplantation in a recipient with cystic fibrosis.

J Cyst Fibros. 2017 May 23;:

Authors: Barbas AS, Dib MJ, Al-Adra DP, Goldaracena N, Sapisochin G, Waddell TK, Keshavjee S, Selzner N, Chaparro C, Cattral MS

Abstract
Cystic fibrosis (CF) affects multiple organs including the lung, liver, and pancreas. Lung transplant, liver transplant, and combined lung-liver transplant have become well-established therapies for CF patients with end-stage organ failure. Thus far, however, there has been limited experience with pancreas transplantation in CF. In this report, we detail the clinical history, transplant procedure, and post-operative recovery of a patient who underwent combined lung-liver-pancreas transplant for advanced CF.

PMID: 28549610 [PubMed - as supplied by publisher]

Immunosuppression Drug Therapy in Lung Transplantation for Cystic Fibrosis.

Sat, 05/27/2017 - 12:45
Related Articles

Immunosuppression Drug Therapy in Lung Transplantation for Cystic Fibrosis.

Paediatr Drugs. 2017 May 25;:

Authors: Burcham P, Sarzynski L, Khalfoun S, Novak KJ, Miller JC, Tumin D, Hayes D

Abstract
Cystic fibrosis (CF) is a common indication for lung transplantation (LTx) in children and adults with severe and irreversible lung disease. In the setting of LTx in the CF population, immunosuppressive medications are used to prevent allograft rejection despite the majority of these patients being chronically infected with numerous, and often antibiotic-resistant, pathogens. There is limited evidence for the optimal post-LTx immunosuppression regimen in patients with CF, particularly in children. This article provides a review of immunosuppression regimens in the pediatric and adult CF post-LTx population, investigating drug dosing and monitoring, and medication combinations. Currently used immunosuppressive medications and related systemic adverse effects are reviewed. With limitations of data in the pediatric population, future research should address immunosuppression in these children to help guide pediatric drug management as a means to optimize clinical outcomes after LTx.

PMID: 28547678 [PubMed - as supplied by publisher]

Acute postoperatory visual loss following bilateral lung transplantation surgery: a case series.

Sat, 05/27/2017 - 12:45
Related Articles

Acute postoperatory visual loss following bilateral lung transplantation surgery: a case series.

Int J Ophthalmol. 2017;10(5):822-825

Authors: Gutierrez-Bonet R, Ruiz-Medrano J, Alarcon-Tomas M, Hijos M, Cifuentes-Canorea P

PMID: 28546945 [PubMed - in process]

Pediatric Lung Transplantation.

Sat, 05/27/2017 - 12:45
Related Articles

Pediatric Lung Transplantation.

Respir Care. 2017 Jun;62(6):776-798

Authors: Sweet SC

Abstract
Pediatric lung transplant is a viable option for treatment of end-stage lung disease in children, with > 100 pediatric lung transplants reported to the Registry of the International Society of Heart and Lung Transplantation each year. Long-term success is limited by availability of donor organs, debilitation as a result of chronic disease, impaired mucus clearance resulting from both surgical and pharmacologic interventions, increased risk for infection resulting from immunosuppression, and most importantly late complications, such as chronic lung allograft dysfunction. Opportunities for investigation and innovation remain in all of these domains: (1) Ex vivo lung perfusion is a promising technology with the potential for increasing the lung donor pool, (2) evolving extracorporeal support strategies coupled with effective rehabilitation will effectively bridge critically ill patients to transplant, and most importantly, (3) research efforts intended to increase our understanding of the underlying mechanisms of chronic lung allograft dysfunction will ultimately lead to the development of effective therapies to prevent or treat the variety of chronic lung allograft dysfunction presentations.

PMID: 28546378 [PubMed - in process]

Respiratory Care Considerations in the Childhood Cancer Patient.

Sat, 05/27/2017 - 12:45
Related Articles

Respiratory Care Considerations in the Childhood Cancer Patient.

Respir Care. 2017 Jun;62(6):765-775

Authors: Elbahlawan L, Rains KJ, Stokes DC

Abstract
This article reviews the common pulmonary complications seen in the pediatric oncology population and our approach to diagnosis, management, and therapy considerations in this specialized population, including patients receiving chemotherapy, radiation, and hematopoietic stem cell transplantation. Although infections cause the most significant complications in this population, non-infectious complications, including acute lung injury from chemotherapy or radiation, idiopathic interstitial pneumonia, diffuse alveolar hemorrhage, bronchiolitis obliterans, and cryptogenic organizing pneumonia, also occur commonly. With improvements in survival of childhood cancer, there are now a growing number of adults who are childhood cancer survivors who may be encountered by therapists in adult hospitals. We also review the growing literature on the emerging late pulmonary findings in these adult childhood cancer survivors.

PMID: 28546377 [PubMed - in process]

Extracorporeal Membrane Oxygenation for Severe Pediatric Respiratory Failure.

Sat, 05/27/2017 - 12:45
Related Articles

Extracorporeal Membrane Oxygenation for Severe Pediatric Respiratory Failure.

Respir Care. 2017 Jun;62(6):732-750

Authors: Lin JC

Abstract
Extracorporeal membrane oxygenation (ECMO) was developed initially in the 1960s to support refractory respiratory failure in addition to the cardiac support inherent in a venoarterial bypass circuit. Early successes occurred predominantly in the neonatal population with subsequent randomized controlled trials and comprehensive reviews concluding therapeutic efficacy for ECMO in neonatal respiratory failure. In contrast, the evidence supporting ECMO for respiratory failure in children is less definitive. However, although pediatric randomized controlled trials have not been completed, sufficient evidence in support of ECMO as a beneficial therapy for pediatric respiratory failure exists. The acceptance of clinical utility and benefit from ECMO for pediatric ARDS and the trend toward increasing venovenous ECMO use have led to its inclusion in the Pediatric Acute Lung Injury Consensus Conference as a strongly agreed upon recommendation for severe pediatric ARDS. However, the Pediatric Acute Lung Injury Consensus Conference recommendations supporting the use of ECMO for pediatric ARDS highlight the lack of evidence-based selection criteria when determining ECMO candidacy in pediatric patients with ARDS. Ultimately, decisions to proceed with ECMO and the concomitant risk of potential life-threatening complications must consider multiple factors that balance potential risks and likelihood of benefit, pre-morbid conditions and impact on potential post-ECMO quality of life, candidacy for lung transplantation, and patient and family goals of care. This review will discuss ECMO for the support of pediatric respiratory failure, ventilator management during ECMO, considerations impacting timing of decannulation, and developing techniques.

PMID: 28546375 [PubMed - in process]

Our unquenched thirst to improve prediction of heart failure risk: From jugular venous distention to microRNAs.

Sat, 05/27/2017 - 12:45
Related Articles

Our unquenched thirst to improve prediction of heart failure risk: From jugular venous distention to microRNAs.

J Heart Lung Transplant. 2017 Jun;36(6):607-608

Authors: Papoutsidakis N, Ahmad T, Jacoby D

PMID: 28545617 [PubMed - in process]

LTB4 and montelukast in transplantation-related bronchiolitis obliterans in rats.

Sat, 05/27/2017 - 12:45
Related Articles

LTB4 and montelukast in transplantation-related bronchiolitis obliterans in rats.

J Cardiothorac Surg. 2017 May 25;12(1):43

Authors: Tu ZL, Zhou ZY, Xu HC, Cao JL, Ye P, Wang LM, Lv W, Hu J

Abstract
BACKGROUND: Lung transplantation is the only effective treatment for end-stage lung diseases. Bronchiolitis obliterans, which is known as non-infectious chronic lung allograft dysfunction (CLAD) in the new classification, is the greatest threat to long-term survival after lung transplantation. This study investigated the role of leukotriene B4 (LTB4) and montelukast in transplantation-related bronchiolitis obliterans and discussed the pathophysiological significance of LTB4 in chronic rejection.
METHODS: Rats were randomly divided into an experimental group (montelukast), a positive control group (dexamethasone), and a blank control group (normal saline solution; NS). Each piece of trachea removed from a F344 rat was transplanted into a Lewis rat through a 5-mm incision at the episternum by subcutaneous embedding. The recipients were treated with gastric lavage with 3 mg/kg · d montelukast suspension, 1 mg/kg · d dexamethasone, and 1 mL/kg · d NS, respectively, in each group. On Day 28, peripheral blood was drawn to measure the white blood cell counts and plasma LTB4 levels. The donor specimens were stained by H-E and Masson, and their organizational structure and extent of fibrosis were visually assessed. The measurement data were compared using one-way analysis of variance, and the categorical data were compared using the chi-square test. A P value of less than 0.05 was considered to indicate statistical significance.
RESULTS: The white blood cell counts of the montelukast, dexamethasone, and NS groups were (16.0 ± 4.2) × 10(9)/L, (19.5 ± 11.6) × 10(9)/L, and (25.8 ± 3.6) × 10(9)/L; no statistical significance was found (P = 0.101). The concentrations of LTB4 were 2230 ± 592 pg/mL, 1961 ± 922 pg/mL, and 3764 ± 1169 pg/mL, and statistical significance was found between the NS group and each of the others (P = 0.009). The percentages of tracheal occlusion were 73.6% ± 13.8%, 23.4% ± 3.2%, and 89.9% ± 11.3%, and statistical significance was found among the three groups (P = 0.000).
CONCLUSIONS: The study established a model to simulate bronchiolitis obliterans after clinical lung transplantation. Oral administration of montelukast reduced plasma LTB4 levels in rats and played a preventive role against tracheal fibrosis after transplantation. This suggests that LTB4 may be involved in bronchiolitis obliterans after pulmonary transplantation. This study indicates a new direction for research into the prevention and treatment of bronchiolitis obliterans after lung transplantation.

PMID: 28545478 [PubMed - in process]

Echocardiography accurately predicts pulmonary hypertension in patients with advanced lung disease.

Sat, 05/27/2017 - 12:45
Related Articles

Echocardiography accurately predicts pulmonary hypertension in patients with advanced lung disease.

Crit Care. 2017 May 25;21(1):115

Authors: Cottini S, Benden C, Huber LC, Arrigo M

PMID: 28545472 [PubMed - in process]

Good for the lung but bad for the liver? Garlic-induced hepatotoxicity following liver transplantation.

Fri, 05/26/2017 - 12:45
Related Articles

Good for the lung but bad for the liver? Garlic-induced hepatotoxicity following liver transplantation.

J Clin Pharm Ther. 2017 May 25;:

Authors: Shaikh SA, Tischer S, Choi EK, Fontana RJ

Abstract
WHAT IS KNOWN AND OBJECTIVE: Limited data exist surrounding the metabolism and safety of garlic supplements.
CASE DESCRIPTION: A patient with a history of hepatopulmonary syndrome (HPS) and orthotopic liver transplantation was admitted to our surgery transplant service with severe hypoxaemia. The patient was started on high-dose Garlicin Cardio(®) (Allium sativum) for HPS and soon after had elevated liver function tests. Garlicin Cardio(®) was discontinued and liver enzymes normalized. A liver biopsy revealed mild periportal cholestatic reaction suggesting potential drug-induced aetiology.
WHAT IS NEW AND CONCLUSION: This is the first description of liver injury secondary to garlic supplementation. Therefore, this garlic supplement should be listed as a potential cause of acute drug-induced liver injury.

PMID: 28543822 [PubMed - as supplied by publisher]

Metagenomic sequencing complements routine diagnostics in identifying viral pathogens in lung transplant recipients with unknown etiology of respiratory infection.

Fri, 05/26/2017 - 12:45
Related Articles

Metagenomic sequencing complements routine diagnostics in identifying viral pathogens in lung transplant recipients with unknown etiology of respiratory infection.

PLoS One. 2017;12(5):e0177340

Authors: Lewandowska DW, Schreiber PW, Schuurmans MM, Ruehe B, Zagordi O, Bayard C, Greiner M, Geissberger FD, Capaul R, Zbinden A, Böni J, Benden C, Mueller NJ, Trkola A, Huber M

Abstract
BACKGROUND: Lung transplant patients are a vulnerable group of immunosuppressed patients that are prone to frequent respiratory infections. We studied 60 episodes of respiratory symptoms in 71 lung transplant patients. Almost half of these episodes were of unknown infectious etiology despite extensive routine diagnostic testing.
METHODS: We re-analyzed respiratory samples of all episodes with undetermined etiology in order to detect potential viral pathogens missed/not accounted for in routine diagnostics. Respiratory samples were enriched for viruses by filtration and nuclease digestion, whole nucleic acids extracted and randomly amplified before high throughput metagenomic virus sequencing. Viruses were identified by a bioinformatic pipeline and confirmed and quantified using specific real-time PCR.
RESULTS: In completion of routine diagnostics, we identified and confirmed a viral etiology of infection by our metagenomic approach in four patients (three Rhinovirus A, one Rhinovirus B infection) despite initial negative results in specific multiplex PCR. Notably, the majority of samples were also positive for Torque teno virus (TTV) and Human Herpesvirus 7 (HHV-7). While TTV viral loads increased with immunosuppression in both throat swabs and blood samples, HHV-7 remained at low levels throughout the observation period and was restricted to the respiratory tract.
CONCLUSION: This study highlights the potential of metagenomic sequencing for virus diagnostics in cases with previously unknown etiology of infection and in complex diagnostic situations such as in immunocompromised hosts.

PMID: 28542207 [PubMed - in process]

Lung or Heart-Lung Transplant in Pulmonary Arterial Hypertension: What Is the Impact of Systemic Sclerosis?

Fri, 05/26/2017 - 12:45
Related Articles

Lung or Heart-Lung Transplant in Pulmonary Arterial Hypertension: What Is the Impact of Systemic Sclerosis?

Exp Clin Transplant. 2017 May 22;:

Authors: Gadre SK, Minai OA, Wang XF, Zhang Q, Budev M, Tonelli AR

Abstract
OBJECTIVES: Little is known about recipient characteristics and outcomes of patients with pulmonary arterial hypertension undergoing lung transplant, particularly those with systemic sclerosis-associated disease. Here, we describe the characteristics and outcomes of patients with pulmonary arterial hypertension undergoing lung transplant, focusing on systemic sclerosis-associated disease.
MATERIALS AND METHODS: This retrospective study included pulmonary arterial hypertension patients undergoing lung or heart-lung transplant between July 1992 and August 2013 at a single center.
RESULTS: We evaluated 51 patients with pulmonary arterial hypertension (37.3% males; mean age of 45.3 ± 11.9 y). Of 51 patients, 9 (17.6%) had systemic sclerosis-associated pulmonary arterial hypertension. Pulmonary arterial hypertension patients without systemic sclerosis-associated disease had higher mean pulmonary arterial pressure (P = .002), higher pulmonary vascular resistance (P = .008), and were more likely to have severe right ventricular systolic dysfunction (P = .006) than individuals with the disease. Mean hospital stay posttransplant was similar in the 2 groups (42.2 ± 43.3 vs 43.1 ± 19.4 d; P = .20). Higher pretransplant creatinine clearance (P = .0005), forced vital capacity (P = .01), and absence of vasopressor/inotrope use (P = .03) were associated with shorter hospital stay. Mortality for pulmonary arterial hypertension patients with versus without systemic sclerosis-associated disease was 0% versus 13% at 1 year, 29% versus 24% at 2 years, and 86% versus 53% at 5 years. Female sex (hazard ratio, 0.23; 95% confidence interval, 0.08-0.68) and less severe tricuspid regurgitation (hazard ratio, 0.31; 95% confidence interval, 0.11-0.89) were independently associated with long-term survival.
CONCLUSIONS: Pulmonary arterial hypertension patients with versus without systemic sclerosis-associated disease have comparable short-term and 2-year outcomes after lung or heart-lung transplant. Female sex and less severe tricuspid regurgitation were independently associated with better long-term survival. These outcomes did not vary when adjusted for the year of transplant.

PMID: 28540841 [PubMed - as supplied by publisher]

Physical activity level significantly affects the survival of patients with end-stage lung disease on a waiting list for lung transplantation.

Fri, 05/26/2017 - 12:45
Related Articles

Physical activity level significantly affects the survival of patients with end-stage lung disease on a waiting list for lung transplantation.

Surg Today. 2017 May 24;:

Authors: Komatsu T, Oshima A, Chen-Yoshikawa TF, Harashima SI, Aoyama A, Inagaki N, Date H

Abstract
PURPOSE: Our objective was to investigate the factors predicting the survival of patients on the waiting list for lung transplantation (LT) during the waiting period, with a special emphasis on the physical activity level.
METHODS: The study included 70 patients with end-stage pulmonary disease who were on the waiting list for LT at Kyoto University Hospital. We examined the association between the baseline characteristics, including the body mass index and body composition, serum albumin, serum C-reactive protein (CRP), steroid administration, physical activity level (calculated by the food frequency questionnaire) and survival during the waiting period using Kaplan-Meier curves and Cox proportional hazard regression models.
RESULTS: A physical activity level of ≤1.2 was correlated with significantly decreased survival (1-year survival: 68 vs. 90.9%, p = 0.0089), with a hazard ratio (HR) of 2.24 (95% confidence interval (CI) 1.22-4.19, p = 0.0001). Hypo-albumin (HR 2.024, 95% CI 1.339-6.009, p = 0.004), a high level of CRP (HR 2.551, CI 1.229-4.892, p = 0.02), and the administration of steroids (HR 2.258, CI 1.907-5.032, p = 0.024) were also significant predictors of survival.
CONCLUSIONS: Low levels of physical activity during the waiting period for LT led to decreased survival times among LT candidates.

PMID: 28540430 [PubMed - as supplied by publisher]

Experiences of supportive care when waiting for a lung re-transplantation.

Fri, 05/26/2017 - 12:45
Related Articles

Experiences of supportive care when waiting for a lung re-transplantation.

SAGE Open Med. 2017;5:2050312117697151

Authors: Ivarsson B, Ingemansson R, Sjöberg T

Abstract
OBJECTIVES: Lung transplant patients and their next of kin share the experiences of illness but little is known in the face of a lung re-transplantation. To describe patients' and next of kin's experiences of supportive care while awaiting lung re-transplantation and the objective was to highlight a small group with special circumstances and needs.
METHODS: Using qualitative content analysis, seven adult patients and seven next of kin were consecutively selected from a regional lung transplantation centre and individually interviewed shortly after decision about lung re-transplantation.
RESULTS: The experiences of supportive care were captured in one main category: 'once again haunted by death' and three sub-categories: 'when life turns and death once again snorts down your neck', 'the importance of information', and 'perceptions of support'. A complex interaction between the experience of waiting, and communication patterns, emotional states, and social support was shown.
CONCLUSION: This study provides insights into the complex interaction between the experience of waiting for a second lung transplant and communication patterns, emotional states, social support and social roles between patients, next of kin, healthcare professionals, and the health and social welfare system. There is a need for developing supportive care programme to achieve the best possible care.

PMID: 28540044 [PubMed - in process]

Pulmonary Transplant Salvage Using Ultrasound-Assisted Thrombolysis of Subacute Occlusive Main Pulmonary Artery Embolus.

Fri, 05/26/2017 - 12:45
Related Articles

Pulmonary Transplant Salvage Using Ultrasound-Assisted Thrombolysis of Subacute Occlusive Main Pulmonary Artery Embolus.

Innovations (Phila). 2017 May 19;:

Authors: Spratt JR, Shrestha P, Loor G, Patil JM, Hertz MI, Pettersson GB, Rosenberg MS

Abstract
A 53-year-old woman who underwent bilateral lung transplantation 14 months before presented with 2 to 3 weeks of severe exertional dyspnea. Workup revealed a complete embolic occlusion of her left main pulmonary artery related to a femoral deep venous thrombosis. The occlusion did not respond to systemic anticoagulation, and a trial of catheter-directed thrombolysis was pursued. Flow to the left lower lobe was restored after 2 days of thromobolytic therapy. The patient is alive and well at more than 1 year of follow-up.

PMID: 28538271 [PubMed - as supplied by publisher]

BK virus as a mediator of graft dysfunction following kidney transplantation.

Fri, 05/26/2017 - 12:45
Related Articles

BK virus as a mediator of graft dysfunction following kidney transplantation.

Curr Opin Organ Transplant. 2017 May 22;:

Authors: Yi SG, Knight RJ, Lunsford KE

Abstract
PURPOSE OF REVIEW: BK virus is a significant risk factor for kidney allograft dysfunction and loss among renal transplant recipients. Currently, there is no proven effective treatment except for the reduction of immunosuppression. In this review, we discuss diagnostic challenges and current treatment options for BK in kidney transplant recipients.
RECENT FINDINGS: Antiviral and antibiotic therapies have been employed for BK viraemia with variable efficacy. In addition, novel therapeutic regimens such as adoptive transfer of targeted T cells have been described as possible treatment options for recipients with BK nephropathy. BK can also be seen in the native kidneys of pancreas, heart, lung and liver transplant recipients, suggesting that BK screening measures should be employed to other solid organ transplant recipients.
SUMMARY: Early screening for BK combined with reduction of immunosuppression remains the mainstay of treatment for BK viraemia. New therapeutic advances demonstrate promise in vitro; however, the in-vivo efficacy will be demonstrated by future studies.

PMID: 28538243 [PubMed - as supplied by publisher]

Pathology of Chronic Hypersensitivity Pneumonitis: What Is It? What Are the Diagnostic Criteria? Why Do We Care?

Fri, 05/26/2017 - 12:45
Related Articles

Pathology of Chronic Hypersensitivity Pneumonitis: What Is It? What Are the Diagnostic Criteria? Why Do We Care?

Arch Pathol Lab Med. 2017 May 24;:

Authors: Churg A, Bilawich A, Wright JL

Abstract
CONTEXT: - Chronic hypersensitivity pneumonitis (CHP) has emerged from obscurity during the past 15 years and is now recognized as a very common form of fibrosing interstitial pneumonia but one that is frequently misdiagnosed both clinically and on surgical lung biopsy as usual interstitial pneumonia/idiopathic pulmonary fibrosis (UIP/IPF) or fibrotic nonspecific interstitial pneumonia.
OBJECTIVE: - To review the pathologic features of CHP.
DATA SOURCES: - Clinical, pathology, and radiology literature were used.
CONCLUSIONS: - Upper lobe-predominant fibrosis and/or air-trapping on computed tomography scan are features of CHP but not UIP/IPF; however, radiologic separation is possible in only about 50% of cases. Morphologically, CHP sometimes mimics UIP/IPF, but CHP often shows isolated foci of peribronchiolar (centrilobular) fibrosis, frequently associated with fibroblast foci, and in CHP, fibrosis may bridge from the centrilobular region to another bronchiole, an interlobular septum, or the pleura ("bridging fibrosis"). This set of findings is uncommon in UIP/IPF. In addition, CHP may produce a picture of fibrotic nonspecific interstitial pneumonia. Although giant cells/granulomas are usually present in subacute hypersensitivity pneumonitis, they are much less frequently found in CHP, and their absence does not contradict the diagnosis. This diagnostic separation is clinically important because CHP is treated differently than UIP/IPF is (immunosuppressive agents versus antifibrotic agents); further, there are some data to suggest that removing the patient from antigen exposure improves outcome, and there is evidence that patients with CHP have a much survival prognosis after lung transplantation than do patients with UIP/IPF. In most cases, accurate diagnosis of CHP requires consultation among clinicians, radiologists, and pathologists.

PMID: 28537805 [PubMed - as supplied by publisher]

Induction of resident memory T cells enhances the efficacy of cancer vaccine.

Fri, 05/26/2017 - 12:45
Related Articles

Induction of resident memory T cells enhances the efficacy of cancer vaccine.

Nat Commun. 2017 May 24;8:15221

Authors: Nizard M, Roussel H, Diniz MO, Karaki S, Tran T, Voron T, Dransart E, Sandoval F, Riquet M, Rance B, Marcheteau E, Fabre E, Mandavit M, Terme M, Blanc C, Escudie JB, Gibault L, Barthes FLP, Granier C, Ferreira LCS, Badoual C, Johannes L, Tartour E

Abstract
Tissue-resident memory T cells (Trm) represent a new subset of long-lived memory T cells that remain in tissue and do not recirculate. Although they are considered as early immune effectors in infectious diseases, their role in cancer immunosurveillance remains unknown. In a preclinical model of head and neck cancer, we show that intranasal vaccination with a mucosal vector, the B subunit of Shiga toxin, induces local Trm and inhibits tumour growth. As Trm do not recirculate, we demonstrate their crucial role in the efficacy of cancer vaccine with parabiosis experiments. Blockade of TFGβ decreases the induction of Trm after mucosal vaccine immunization, resulting in the lower efficacy of cancer vaccine. In order to extrapolate this role of Trm in humans, we show that the number of Trm correlates with a better overall survival in lung cancer in multivariate analysis. The induction of Trm may represent a new surrogate biomarker for the efficacy of cancer vaccine. This study also argues for the development of vaccine strategies designed to elicit them.

PMID: 28537262 [PubMed - in process]

Viroimmunotherapy of Thoracic Cancers.

Fri, 05/26/2017 - 12:45
Related Articles

Viroimmunotherapy of Thoracic Cancers.

Biomedicines. 2017 Jan 04;5(1):

Authors: Dash AS, Patel MR

Abstract
Thoracic cancers, including non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), and malignant pleural mesothelioma (MM), cause the highest rate of cancer mortality worldwide. Most of these deaths are as a result of NSCLC; however, prognoses for the other two diseases remain as some of the poorest of any cancers. Recent advances in immunotherapy, specifically immune checkpoint inhibitors, have begun to help a small population of patients with advanced lung cancer. People who respond to these immune therapies generally have a durable response and many see dramatic decreases in their disease. However, response to immune therapies remains relatively low. Therefore, intense research is now underway to rationally develop combination therapies to expand the range of patients who will respond to and benefit from immune therapy. One promising approach is with oncolytic viruses. These oncolytic viruses (OVs) have been found to be selective for or have been engineered to preferentially infect and kill cancer cells. In pre-clinical models of different thoracic cancers, it has been found that these viruses can induce immunogenic cell death, increase the number of immune mediators brought into the tumor microenvironment and broaden the neoantigen-specific T cell response. We will review here the literature regarding the application of virotherapy toward augmenting immune responses in thoracic cancers.

PMID: 28536345 [PubMed - in process]

Pages