Outcomes following lung transplant remain suboptimal. This is attributable to variable posttransplant recovery of lung function, and inconsistent degrees of lung function loss after peak function is reached. Granzyme B is elevated in the blood and bronchoalveolar lavage (BAL) in acute rejection. We hypothesized that persistent exposure to T cells high in granzyme B would negatively correlate with lung function. We investigated cumulative exposure measured as the area-under-the-curve (AUC) of CD8 + T cell granzyme B hi cells in the first year posttransplant in both BAL and blood in 24 transplant recipients. We assessed the correlation between cumulative 1-year exposure and FEV 1 slope. There was a negative correlation between 1-year exposure and FEV 1 slope within the first year (r = -0.63; P =.001). This relationship persisted even when adjusted for transplant type, gender, age, rejection, and indication for transplantation. In contrast, no relationship was seen with the 1-year AUC and lung function after 1 year posttransplant. In contrast to the BAL granzyme B hi levels, granzyme B hi levels from the blood showed no relationship with lung function. These findings suggest that CD8 + T-celldriven factors are responsible for early improvements in lung function after transplantation.
|Number of pages||7|
|State||Published - Dec 2011|