Title: Exhaled carbon monoxide as a noninvasive marker of airway neutrophilia after lung transplantation
Authors: Vos, Robin ×
Cordemans, Colin
Vanaudenaerde, Bart
De Vleeschauwer, St├ęphanie
Schoonis, Annemie
Van Raemdonck, Dirk
Dupont, Lieven
Verleden, Geert #
Issue Date: May-2009
Publisher: Lippincott Williams & Wilkins
Series Title: Transplantation vol:87 issue:10 pages:1579-83
Abstract: BACKGROUND: Neutrophilic airway inflammation and associated oxidative stress contribute to airway injury and the development of bronchiolitis obliterans syndrome after lung transplantation (LTx). Exhaled carbon monoxide (eCO) reflects heme oxygenase-1 activity in response to oxidative stress. We investigated whether airway neutrophilia and eCO levels are associated in stable LTx recipients. METHODS: In this cross-sectional pilot study, 45 stable LTx recipients were included. During routine follow-up at the outpatient clinic, pulmonary function testings together with eCO measurements before broncho-alveolar lavage (BAL) were performed. BAL cell differentials and interleukin (IL)-8 protein levels were assessed and correlated with eCO. RESULTS: In the studied cohort, eCO levels were increased in patients with elevated (>3%) BAL neutrophilia compared with those with normal BAL neutrophilia (P=0.025). Furthermore, eCO levels significantly correlated with BAL neutrophilia and IL-8 levels in the cohort as a whole (r=0.50; P=0.0005 for total cells, r=0.43; P=0.003 for %cells and r=0.30; P=0.045 for IL-8). This was even more obvious in the LTx recipients with increased (>3%) BAL neutrophilia (r=0.70; P=0.0007 for total cells and r=0.80; P<0.0001 for %cells). For a cutoff of 4 ppm, sensitivity, specificity, positive and negative predictive value of eCO for detecting elevated BAL neutrophilia were 84.0%, 45.0%, 65.6%, and 69.2%, respectively (P=0.049). CONCLUSIONS: Elevated eCO levels in stable LTx recipients may reflect an increased BAL neutrophilia and could, therefore, be used as a noninvasive marker for airway inflammation after LTx.
ISSN: 0041-1337
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Pneumology
Thoracic Surgery
Experimental Cardiac Surgery (-)
× corresponding author
# (joint) last author

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