Introduction

Bronchiolitis obliterans syndrome (BOS) is the most common form of CLAD and is characterized by airflow limitation and an obstructive spirometry pattern without parenchymal opacities. The protein signature of BOS lesions concerns extracellular matrix organization and aberrant basement membrane composition. In this pilot study, we investigated the presence of COL4A5 in the serum of patients with BOS.

Methods

41 patients who had undergone LTX were enrolled. Of these, 27 developed BOS and 14 (control group) were considered stable at the time of serum sampling. Of BOS patients, serum samples were analysed at the time of BOS diagnosis and before the clinical diagnosis (pre-BOS). COL4A5 levels were detected through the ELISA kit.

Results

Serum concentrations of COL4A5 were higher in pre-BOS than in stable patients (40.5 ± 13.9 and 24.8 ± 11.4, respectively, p = 0.048). This protein is not influenced by comorbidities, such as acute rejection or infections, or by therapies. Survival analysis also reveals that a higher level of COL4A5 was also associated with less probability of survival. Our data showed a correlation between concentrations of COL4A5 and FEV1 at the time of diagnosis of BOS.

Conclusion

Serum concentrations of COL4A5 can be considered a good prognostic marker due to their association with survival and correlation with functional parameters.

中文翻译：

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肺移植后闭塞性细支气管炎综合征中的 IV 型胶原蛋白 5 链：第一个证据

介绍

闭塞性细支气管炎综合征 (BOS) 是 CLAD 的最常见形式，其特征是气流受限和阻塞性肺量测定模式，无肺实质混浊。BOS 损伤的蛋白质特征涉及细胞外基质组织和异常的基底膜组成。在这项初步研究中，我们调查了 BOS 患者血清中 COL4A5 的存在。

方法

纳入了 41 名接受过 LTX 的患者。其中，27 例出现 BOS，14 例（对照组）在血清取样时被认为稳定。对于 BOS 患者，在 BOS 诊断时和临床诊断前（BOS 前）对血清样本进行分析。通过ELISA试剂盒检测COL4A5水平。

结果

BOS 前患者的 COL4A5 血清浓度高于稳定患者（分别为 40.5 ± 13.9 和 24.8 ± 11.4，p  = 0.048）。这种蛋白质不受急性排斥或感染等合并症或治疗的影响。生存分析还表明，较高水平的 COL4A5 也与较低的生存概率相关。我们的数据显示诊断 BOS 时 COL4A5 和 FEV1 浓度之间存在相关性。

结论

COL4A5 的血清浓度可被认为是良好的预后标志物，因为它们与生存相关且与功能参数相关。