Abstract
Bronchoalveolar lavage fluid (BALF) offers a potential means to diagnose
acute rejection and could provide insight into the immune mechanisms
responsible for lung allograft rejection. Transbronchial biopsies
from 29 bronchoscopic procedures were assessed for rejection. Concurrent
BALF lymphocyte subsets were examined by flow cytometry, including
CD4 and CD8 T cells and their activation status by CD38 expression,
natural killer (NK), NK-like T (NT), B, regulatory T, and invariant
receptor NK-T cells. Percentages of CD4 were reduced, and CD8 and
activation of CD4 T cells correlated with rejection. There were trends
for increased NT, reduced NK, and increased B cell percentages with
rejection, suggesting potential roles of these cells. Among regulatory
cells, the percentages of regulatory T cells decreased and CD4/CD8
invariant NK-T cells increased during rejection, suggesting a proinflammatory
profile. A unique BALF lymphocyte profile was associated with rejection
and may provide insight into the pathogenesis of allograft rejection.
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