Donor smoking is associated with pulmonary edema, inflammation and epithelial dysfunction in ex vivo human donor lungs.
Donor smoking is associated with pulmonary edema, inflammation and epithelial dysfunction in ex vivo human donor lungs.
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DOI：
10.1111/ajt.12853
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
California Transplant Donor Network
中科院分区：
文献类型：
--
作者：
Ware LB;Lee JW;Wickersham N;Nguyen J;Matthay MA;Calfee CS;California Transplant Donor Network
尽管吸烟者供肺的接受者的临床结果较差，但其潜在机制尚不清楚。我们测试了从 298 名器官捐献者身上回收的离体肺中供体吸烟与肺水肿程度（通过肺重量估计）、肺泡液清除率（通过空腔滴注 5% 白蛋白测量）以及肺上皮损伤和炎症生物标志物（支气管肺泡灌洗表面活性蛋白-D 和 IL-8）之间的关联。与不吸烟者相比，当前吸烟者 (n=127) 的肺水肿程度较高（中位数 408g，IQR 364-500 vs. 385g，IQR 340 - 460，p=0.009）。目前吸烟者与非吸烟者相比，研究入组时的氧合情况较差（中位 PaO2/FiO2 214 mmHg，IQR 126-323 vs. 266 mmHg，IQR 154-370，p=0.02）。当前暴露量最高（≥20包年）的吸烟者的肺泡液清除率显着较低，这表明香烟烟雾对肺泡上皮液转运功能的影响可能与剂量相关。吸烟者的 BAL IL-8 显着升高，而表面活性蛋白-D 则较低。这些发现表明，长期接触香烟烟雾对器官捐献者的炎症、气体交换、肺上皮功能和肺液平衡有重要影响，从而可能影响肺移植受者的肺功能。
Although recipients of donor lungs from smokers have worse clinical outcomes, the underlying mechanisms are unknown. We tested the association between donor smoking and the degree of pulmonary edema (as estimated by lung weight), the rate of alveolar fluid clearance (measured by airspace instillation of 5% albumin) and biomarkers of lung epithelial injury and inflammation (bronchoalveolar lavage surfactant protein-D and IL-8) in ex vivo lungs recovered from 298 organ donors. The extent of pulmonary edema was higher in current smokers (n=127) compared to non-smokers (median 408g, IQR 364-500 vs. 385g, IQR 340 - 460, p=0.009). Oxygenation at study enrollment was worse in current smokers versus non-smokers (median PaO2/FiO2 214 mmHg, IQR 126-323 vs. 266 mmHg, IQR 154-370, p=0.02). Current smokers with the highest exposure (≥20 pack-years) had significantly lower rates of alveolar fluid clearance, suggesting that the effects of cigarette smoke on alveolar epithelial fluid transport function may be dose related. BAL IL-8 was significantly higher in smokers while surfactant protein-D was lower. These findings indicate that chronic exposure to cigarette smoke has important effects on inflammation, gas exchange, lung epithelial function and lung fluid balance in the organ donor that could influence lung function in the lung transplant recipient.
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影响因子：
9.6
作者：
Briot R;Frank JA;Uchida T;Lee JW;Calfee CS;Matthay MA
通讯作者：
Matthay MA
影响因子：
2.3
作者：
Fernández, JA;Gruber, A;Griffin, JH
通讯作者：
Griffin, JH
DOI：
10.1152/ajplung.00358.2013
发表时间：
2014-05-01
影响因子：
4.9
作者：
McAuley, D. F.;Curley, G. F.;Lee, J. W.
通讯作者：
Lee, J. W.
DOI：
10.1164/ajrccm.150.3.8087340
发表时间：
1994-09-01
影响因子：
24.7
作者：
MCCREA, KA;ENSOR, JE;HASDAY, JD
通讯作者：
HASDAY, JD
影响因子：
168.9
作者：
Bonser, Robert S.;Taylor, Rhiannon;Neuberger, James
通讯作者：
Neuberger, James