Navigation Links
Rejection in Lung Transplants Due to Elevated Pepsin Level

High levels of pepsin, a digestive enzyme that is a marker for gastric aspiration, are associated with acute rejection of a lung transplant , according to researchers in the United Kingdom . This research provides further evidence that lung rejection may be caused by factors other than alloimmunity, the attack the body mounts to protect itself against foreign cells.

We think gastric aspiration [the taking of stomach fluids into the lung] may contribute to an overall injury to the transplanted lung, said Chris Ward, Ph.D., lead author of the study. This pattern of injury may be similar to rejection or increase the risk for further rejection.

The study included 36 lung transplant recipients, 17 subjects with normal lung function but unexplained cough who served as disease controls for the study, and 4 normal, nonsmoking control subjects. The researchers determined pepsin levels in all the subjects using bronchoalveolar lavage (BAL)

Our primary finding was that, compared with control subjects, wrote the researchers, BAL pepsin levels were elevated in stable lung transplant recipients, subjects with acute rejection, and subjects with bronciolitis obliterans [a common manifestation of lung transplant rejecton]. Our secondary finding was that the highest levels of pepsin appeared in the transplant recipients with clinically significant acute rejection (grade A2 or greater).

These findings support the growing recognition that gastroesophageal reflux (GER) is a potential cause for post-transplant lung injury and other airway and lung diseases. Although none of the transplant patients were formally evaluated for GER, nearly all were treated with acid suppression medications, which is standard therapy after lung transplantation.

Despite those medications, known as proton pump inhibitors, the researchers found evidence of gastric aspiration. It is important to recognize that proton pump inhibitors do not prevent reflux per se, but rather act to cut down on acidic reflux, the researchers noted. They also noted, that in addition to the damage that might be done to the new lung by acid reflux, pepsin is not targeted by these drugs and may be a separate cause of lung injury.

The researchers reported that the disease control groupthose with normal lung function, but unexplained coughdid not have pepsin in their lungs, even when 10 of 17 were diagnosed during the study as having gastroesophageal reflux disease (GERD). A diagnosis of GERD does not mean that patients are refluxing out of the esophagus and hence aspirating, they explained. Even if the refluxate reaches the upper airway, it is almost certainly cleared by a hyperactive cough reflex.

In their article, the researchers note ongoing studies being done at Duke University that appear to show lung transplant patients who undergo fundoplication, a surgical procedure that strengthens the valve between the stomach and the esophagus, before the transplant have longer survival rates and delayed onset of bronchiolitis obliterans syndrome than those who do not.

If fundoplication is confirmed as a useful prophylaxis in preventing lung rejection, they write, markers of aspiration may contribute to identifying patients who might derive clinical benefit.




'"/>




Related medicine news :

1. A Urine Test Could Predict Rejection In Transplant Patients
2. Rejection Rate for Liver Transplants Patient Reduced
3. Peer Rejection Leads To Reduced Participation In Classroom Activities
4. Inhaled Cyclosporine Results In Rejection Free Survival among Lung Transplant Patients
5. Low Dose Anti Rejection Protocol Helps Intestinal Transplant Recipients
6. Survey Reveals Rejection of NHS Database Scheme
7. Ontario Supports OHIP’s Rejection of Claim by North York Ma
8. Stem Cell Finding Could Help Reduce Transplant Rejection
9. Stem Cell Transplants May Be Effective For MS Patients
10. Kidney Failure after Non-Kidney Transplants
11. Transplants Help Liver Cancer Patients
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:7/25/2017)... ... July 25, 2017 , ... ... the launch of their partnership to provide the Pharmacist eCare Plan ... platform in the country with the ability to develop the Pharmacist eCare Plan, ...
(Date:7/25/2017)... ... July 25, 2017 , ... Dr. Gina Negrette, a ... more than a decade of experience in psychiatry, treating clients in diverse settings, ... eating disorders, psychotic and manic conditions, as well as those who were fighting ...
(Date:7/24/2017)... (PRWEB) , ... July 24, ... ... Marketing Director,      (407) 916-7235, kklaproth(at)robinsmorton(dot)com , Robins & Morton, ... together to celebrate the structural topping out of the new Destination Medical ...
(Date:7/24/2017)... ... July 24, 2017 , ... Horizon Goodwill Industries, ... opportunity that helps high school girls succeed in STEM programs as well as ... Goodwill will host over 20 high school girls at their corporate headquarters on ...
(Date:7/24/2017)... ... July 24, 2017 , ... Axiad IDS , a leading provider ... partnered with WALLIX to expand its solution to help government contractors more ... a number of ways to address the authentication requirements within NIST SP800-171, but ...
Breaking Medicine News(10 mins):
(Date:7/20/2017)... , July 20, 2017  Prime Therapeutics LLC (Prime) ... Gavras , M.D., following today,s Institute for Clinical and Economic ... on the effectiveness and value of abuse-deterrent formulations (ADF) ... the policy roundtable at the meeting. ... a material cost benefit to the use of abuse-deterrent formulations ...
(Date:7/14/2017)... -- Endo International plc (NASDAQ: ENDP ) will announce ... of its senior management team will host a conference call and ... The dial-in number to access the call is ... the passcode is 45397076. Please dial in 10 minutes prior to ... A replay of the call will be available from August 8, ...
(Date:7/13/2017)...  New York City-based market research firm Kalorama Information notes ... of.  From new products to new costs, to the threat ... completed study, Potential Pipeline Disruptors . Among ... 1.  Age-Driven Growth - True Impact Moment Arriving   ... impact the growing population and, to a more extreme extent, ...
Breaking Medicine Technology: