Emphysematous changes and lower levels of plasma irisin are associated with bronchiolitis obliterans syndrome after bilateral living-donor lobar lung transplantation
Emphysematous changes and lower levels of plasma irisin are associated with bronchiolitis obliterans syndrome after bilateral living-donor lobar lung transplantation
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DOI：
10.1007/s00595-021-02339-w
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发表时间：
2021-07
期刊：
影响因子：
2.5
通讯作者：
T. Shiotani;S. Sugimoto;H. Yamamoto;K. Miyoshi;S. Otani;K. Suzawa;H. Yamamoto;M. Okazaki;M. Yamane;S. Toyooka
中科院分区：
文献类型：
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作者：
T. Shiotani;S. Sugimoto;H. Yamamoto;K. Miyoshi;S. Otani;K. Suzawa;H. Yamamoto;M. Okazaki;M. Yamane;S. Toyooka
目的鸢尾素水平的降低可能与肺气肿的发生有关。同样，活体供体大叶肺移植（LDLLT）后慢性肺同种异体移植功能障碍（CLAD）患者也可能发生肺气肿变化。我们研究了双侧LDLLT和尸体肺移植（CLT）后肺气肿变化的严重程度以及鸢尾素水平与CLAD的关系。方法回顾性研究59例接受双侧LDLLT （n= 31）或CLT （n= 28）的患者，分为非clad组（n= 41）、LDLLT- clad组（n= 11）和CLT- clad组（n= 7）。我们比较了两组患者肺气肿变化的严重程度、骨骼肌质量和血浆鸢尾素水平。结果ldllt -覆层组和clt -覆层组的肺气肿变化明显加重（p= 0.046和0.036），特别是闭塞性细支气管炎综合征（BOS）患者的肺气肿变化明显加重（p= 0.046和0.036）。尽管各组骨骼肌质量相似，但LDLLT- clad组血浆中鸢尾素水平明显低于非clad组（p= 0.022），尤其是LDLLT后发生BOS的患者。结论肺气肿变化和血浆鸢尾素水平降低与双侧LDLLT后的CLAD相关，尤其是BOS患者。
PurposeDecreased irisin levels may be associated with the development of emphysema. Similarly, emphysematous changes may develop in patients with chronic lung allograft dysfunction (CLAD) after living-donor lobar lung transplantation (LDLLT). We investigated the severity of emphysematous changes and the relationship between irisin levels and CLAD after bilateral LDLLT and cadaveric lung transplantation (CLT).MethodsThe subjects of this retrospective study were 59 recipients of bilateral LDLLT (n= 31) or CLT (n= 28), divided into a non-CLAD group (n= 41), a LDLLT-CLAD group (n= 11), and a CLT-CLAD group (n= 7). We compared the severity of emphysematous changes, the skeletal muscle mass, and the plasma irisin levels among the groups.ResultsThe emphysematous changes were significantly more severe in the LDLLT-CLAD and CLT-CLAD groups (p= 0.046 and 0.036), especially in patients with bronchiolitis obliterans syndrome (BOS), than in the non-CLAD group. Although the skeletal muscle mass was similar in all the groups, the plasma irisin levels were significantly lower in the LDLLT-CLAD group (p= 0.022), especially in the patients with BOS after LDLLT, than in the non-CLAD group.ConclusionEmphysematous changes and lower levels of plasma irisin were associated with CLAD, especially in patients with BOS, after bilateral LDLLT.