Induced sputum cell profiles in lung transplant recipients with or without chronic rejection: correlation with lung function
K M Beeh, O Kornmann, J Lill, R Buhl
Pulmonary
Department, Internal Medicine, University Hospital, 55131 Mainz,
Germany
Correspondence to: Dr med K M Beeh k.beeh{at}3-med.klinik.uni-mainz.de
Received 29 June 2000; Returned to authors 23 October 2000; Revised version received 2 December 2000; Accepted for publication 8 March 2001
BACKGROUND
Sputum
induction is a non-invasive procedure for measuring inflammatory
processes of the lower respiratory tract. The aim of this study was to
establish sputum cell counts and differentials in patients after lung
transplantation (LTx), with or without chronic transplant rejection.
METHODSSputum
induction was performed in 41 LTx patients (25 single LTx (sLTx), 16 double LTx (dLTx) and 15 healthy non-smoking volunteers. Sputum was
processed according to standard protocols. Total cell count was
calculated as mean (SE) cells × 106/ml sputum and cell
differential (%) was evaluated after staining. Cellular profiles were
correlated with lung function.
RESULTSTotal sputum
cell counts were increased in sLTx (9 (1.9) cells × 106/ml, p=0.01) and dLTx patients (7.2 (1.5) × 106/ml, p=0.01) compared with healthy controls (2.6 (0.6) × 106/ml). There was also a marked sputum neutrophilia in
both patient groups (59 (6)% and 62 (6)%, respectively, p<0.001
v controls). Moreover, in both sLTx and dLTx
patients with chronic transplant rejection there was an increased
number of sputum neutrophils compared with patients with normal graft
function (p<0.05 both comparisons), and neutrophils were inversely
correlated with lung function (forced expiratory volume in one second
(FEV1) % predicted): sLTx,
r=-0.61, p=0.001; dLTx,
r=-0.75, p=0.001, respectively). Sputum
lymphocytes and eosinophils were similar in both groups. No relevant
side effects occurred during sputum induction.
CONCLUSIONSSputum
induction is a safe and non-invasive tool for monitoring lower
respiratory tract inflammation in LTx patients. Both sLTx and dLTx
patients with chronic rejection had increased sputum neutrophils
compared with patients with normal transplant function. These data
support findings of other authors highlighting a possible role for
neutrophils in the pathogenesis of chronic transplant rejection.
Keywords: lung transplantation; sputum; rejection
© 2001 by Thorax
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