Title: Azithromycin and the treatment of lymphocytic airway inflammation after lung transplantation
Authors: Vos, Robin ×
Verleden, Stijn
Ruttens, David
Vandermeulen, Elly
Bellon, Hannelore
Neyrinck, Arne
Van Raemdonck, Dirk
Yserbyt, Jonas
Dupont, Lieven
Verbeken, Erik
Moelants, Elke
Mortier, Anneleen
Proost, Paul
Schols, Dominique
Cox, Benoit
Verleden, Geert
Vanaudenaerde, Bart #
Issue Date: Dec-2014
Publisher: Munksgaard International Publishers
Series Title: American Journal of Transplantation vol:14 issue:12 pages:2736-48
Article number: 10.1111/ajt.12942
Abstract: Lymphocytic airway inflammation is a major risk factor for chronic lung allograft dysfunction, for which there is no established treatment. We investigated whether azithromycin could control lymphocytic airway inflammation and improve allograft function. Fifteen lung transplant recipients demonstrating acute allograft dysfunction due to isolated lymphocytic airway inflammation were prospectively treated with azithromycin for at least 6 months (NCT01109160). Spirometry (FVC, FEV1 , FEF25-75 , Tiffeneau index) and FeNO were assessed before and up to 12 months after initiation of azithromycin. Radiologic features, local inflammation assessed on airway biopsy (rejection score, IL-17(+)  cells/mm(2) lamina propria) and broncho-alveolar lavage fluid (total and differential cell counts, chemokine and cytokine levels); as well as systemic C-reactive protein levels were compared between baseline and after 3 months of treatment. Airflow improved and FeNO decreased to baseline levels after 1 month of azithromycin and were sustained thereafter. After 3 months of treatment, radiologic abnormalities, submucosal cellular inflammation, lavage protein levels of IL-1β, IL-8/CXCL-8, IP-10/CXCL-10, RANTES/CCL5, MIP1-α/CCL3, MIP-1β/CCL4, Eotaxin, PDGF-BB, total cell count, neutrophils and eosinophils, as well as plasma C-reactive protein levels all significantly decreased compared to baseline (p < 0.05). Administration of azithromycin was associated with suppression of posttransplant lymphocytic airway inflammation and clinical improvement in lung allograft function.
ISSN: 1600-6135
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Pneumology
Anesthesiology and Algology
Thoracic Surgery
Laboratory of Molecular Immunology (Rega Institute)
Laboratory of Virology and Chemotherapy (Rega Institute)
Translational Cell & Tissue Research
Stem Cell Biology and Embryology (+)
× corresponding author
# (joint) last author

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