PD-1 Expression in Transbronchial Biopsies of Lung Transplant Recipients is a Possible Early Predictor of Rejection

Overview

Journal Front Immunol

Specialty Allergy & Immunology

Date 2023 Jan 27

PMID 36703976

Authors

Ilaria Righi

Valentina Vaira

Letizia Corinna Morlacchi

Giorgio Alberto Croci

Valeria Rossetti

Francesco Blasi

Stefano Ferrero

Mario Nosotti

Lorenzo Rosso

Mario Clerici

Affiliations

Soon will be listed here.

Abstract

Introduction: Chronic lung allograft dysfunction (CLAD) is the main cause of the reduced survival of lung transplanted (LTx) patients. The possible role of immune checkpoint molecules in establishing tolerance has been scarcely investigated in the setting of lung transplantation.

Methods: We conducted a retrospective, observational pilot study on a consecutive series of transbronchial cryobiopsies (TCB) obtained from 24 patients during LTx follow-up focusing on PD-1, one of the most investigated immune checkpoint molecules.

Results: Results showed that PD-1-expressing T lymphocytes were present in all TCB with a histological diagnosis of acute rejection (AR; 9/9), but not in most (11/15) of the TCB not resulting in a diagnosis of AR (p=0.0006). Notably, the presence of PD-1-expressing T lymphocytes in TCB resulted in a 10-times higher risk of developing chronic lung allograft dysfunction (CLAD), the main cause of the reduced survival of lung transplanted patients, thus being associated with a clearly worst clinical outcome.

Discussion: Results of this pilot study indicate a central role of PD-1 in the development of AR and its evolution towards CLAD and suggest that the evaluation of PD-1-expressing lymphocytes in TCB could offer a prognostic advantage in monitoring the onset of AR in patients who underwent lung transplantation.

Citing Articles

Elevated PD-L1 and PECAM-1 as Diagnostic Biomarkers of Acute Rejection in Lung Transplantation.

Novysedlak R, Balko J, Tavandzis J, Tovazhnianska V, Slavcev A, Vychytilova K Transpl Int. 2024; 37:13796.

PMID: 39640249 PMC: 11617192. DOI: 10.3389/ti.2024.13796.

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