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doi:10.1378/chest.06-1257
(Chest. 2007; 131:533-538)
© 2007 American College of Chest Physicians
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Elevation of Interleukin-15 Protein Expression in Bronchoalveolar Fluid in Acute Lung Allograft Rejection*

Sangeeta M. Bhorade, MD, FCCP; Andrew Yu, MD; Wickii T. Vigneswaran, MD, FCCP; Charles G. Alex, MD, FCCP and Edward R. Garrity, MD, FCCP

* From the Departments of Medicine (Drs. Bhorade and Garrity) and Thoracic and Cardiovascular Surgery (Dr. Vigneswaran), University of Chicago, Chicago; Pulmonary/Critical Care Medicine (Dr. Yu), Dupage Medical Group, Lombard; and Department of Medicine (Dr. Alex), Loyola University Medical Center, Maywood, IL.

Correspondence to: Sangeeta M. Bhorade, MD, FCCP, Lung Transplant Program, University of Chicago, 5841 S Maryland Ave, MC0999, Chicago, IL 60637; e-mail: sbhorade{at}medicine.bsd.uchicago.edu

Abstract

Background: Acute rejection remains a major source of morbidity in lung transplantation. Although interleukin (IL)-2 has been the principal T-cell growth factor implicated in acute rejection, IL-2 blockade does not prevent acute rejection completely. Recently, IL-15, a stromal cell-derived cytokine, has been found to share a similar biological function with IL-2. We hypothesized that IL-15 levels may be elevated in acute lung rejection in the presence of IL-2 blockade.

Methods: Acute allograft rejection developed in 21 of 42 lung transplant recipients. BAL fluid (BALF) was analyzed for IL-2 and IL-15 protein expression by standard enzyme-linked immunosorbent assay.

Results: The average (± SD) BALF IL-15 level was higher in lung transplant recipients with acute rejection compared to those without rejection (25 ± 25 pg/mL vs 4.5 ± 1.5 pg/mL, respectively; p < 0.0001). In addition, there appeared to be a bimodal distribution of BALF IL-15 levels in lung transplant recipients with acute rejection. BALF IL-2 levels were not associated with acute rejection. BALF IL-15 levels were not associated with bacterial, fungal, or cytomegalovirus infection.

Conclusion: These data show that BALF IL-15 levels are elevated in acute lung allograft rejection in the presence of IL-2 receptor blockade and may be an important mediator for acute rejection in lung transplantation.

Key Words: acute rejection • allograft • BAL fluid • interleukin-15 • lung transplantation






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