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:

(Date:6/26/2016)... , ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal ... personalized through a fitness app. The fitness app plans to fix the two major problems ... offer a one size fits all type program , They don’t eliminate all ...
(Date:6/25/2016)... ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on June 21 ... brings up a new, often overlooked aspect of head lice: the parasite’s ability to live ... not a common occurrence, but a necessary one in the event that lice have simply ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... ... athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures as ... City area —Johnson is one of the first doctors to perform the treatment. ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events ... turn to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. ... tools for healthy coping following a traumatic event. , Trauma sufferers tend to feel ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, P.A. announced ... attorneys chosen by their peers for this recognition are considered among the top 2 ... received special honors as members of this year’s Legal Elite Hall of Fame: ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... LAS VEGAS , June 26, 2016 ... movement to value-based care operating models within the health ... that enable greater financial efficiency , Deloitte offers ... address the key business issues impacting efficient cost optimization: ... alignment , These services facilitate better outcomes and ...
(Date:6/24/2016)... CAMBRIDGE, Mass. , June 24, 2016 /PRNewswire/ ... the Spaulding Rehabilitation Network,s Dean Center for ... of Physical Medicine and Rehabilitation, MIT Hacking Medicine, ... Center for Innovation, today announced the five finalists ... Hackathon for Lyme disease.  More than 100 scientists, ...
(Date:6/24/2016)... Dehaier Medical Systems Ltd. (NASDAQ: DHRM ) ... medical devices and wearable sleep respiratory products in ... with Hongyuan Supply Chain Management Co., Ltd. (hereinafter referred ... to develop Dehaier,s new Internet medical technology business. ... Hongyuan Supply Chain,s sales platform to reach Dehaier,s dealers ...
Breaking Medicine Technology: