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:10/13/2017)... Pekin, IL (PRWEB) , ... October 13, 2017 ... ... Foundation, which established the certification process to promote standards of excellence for the ... iaedp™ Symposium, scheduled for March 22 – 25, 2018 in Orlando, Florida at ...
(Date:10/13/2017)... ... ... Lori R. Somekh, founder of the Law Office of Somekh & Associates ... special needs planning attorneys. “Membership in ElderCounsel helps our office remain up to date ... elder law attorneys nationwide,” said Somekh. , ElderCounsel was founded by ...
(Date:10/13/2017)... RIDGE, N.J. (PRWEB) , ... October 13, 2017 , ... ... annual Holly Day Market. Featuring a collection of specialty vendors and unique items from ... of personalized and quality-focused health and wellness services offered by the VNA. The ...
(Date:10/13/2017)... ... 2017 , ... Yisrayl Hawkins, Pastor and Overseer at The House of Yahweh, ... and least understood books in the Holy Scriptures, Revelation. The Book of Revelation paints ... for centuries. Many have tossed it off as mere rubbish, but Yisrayl Hawkins says ...
(Date:10/13/2017)... ... 13, 2017 , ... “The Journey: From the Mountains to the Mission Field”: ... souls in the Philippines. “The Journey: From the Mountains to the Mission Field” is ... Bible. She has taught all ages and currently teaches a class of ladies at ...
Breaking Medicine News(10 mins):
(Date:9/27/2017)... 27, 2017  Commended for their devotion to personalized service, ... as number one in the South Florida Business Journal,s 50 ... 5000 yearly list, the national specialty pharmacy has found its ... will soon be honored by SFBJ as the 2017 ... Set to receive his award in October, Bardisa said ...
(Date:9/23/2017)... -- Janssen Biotech, Inc. (Janssen) announced today that it ... Food and Drug Administration (FDA) for the Biologics License ... of moderately to severely active rheumatoid arthritis (RA). The ... to further evaluate the safety of sirukumab in the ... "We are disappointed by ...
(Date:9/19/2017)... Sept. 19, 2017   ZirMed Inc ., a recognized ... announced that it has been ranked #1 by its users ... Rankings 2017 User Survey. ZirMed was recognized as the ... hospitals and medical centers over 200 beds and holds one ... technology user survey history. ...
Breaking Medicine Technology: