Abstract
Lung transplantation remains as a primary treatment for end-stage lung diseases. Although remarkable improvement has been achieved due to the immunosuppressive protocols, long-term survival for lung transplant recipients (LTR) is still limited. In the last few decades, an increasing interest has grown in the study of dysregulation of immune mechanisms underlying allograft failure. In this regard, myeloid-derived suppressor cells (MDSCs) could play an important role in the promotion of graft tolerance due to their immune regulatory function. Here, we describe for the first time circulating subsets MDSCs from LTR at several time points and we evaluate the relationship of MDSCs with sort-term lung transplant outcomes. Although no effect of MDSCs subsets on short-term clinical events was observed, our results determine that Mo-MDSCs frequencies are increased after acute cellular rejection (ACR), suggesting a possible role for Mo-MDSCs in the development of chronic lung allograft dysfunction (CLAD). Therefore, whether MDSCs subsets play a role as biomarkers of chronic rejection remains unknown and requires further investigations. Also, the effects of the different immunosuppressive treatments on these subpopulations remain under research and further studies are needed to establish to what extend MDSCs immune modulation could be responsible for allograft acceptance.
Highlights
Lung transplantation remains the primary treatment option for patients with end stage lung failure
Some studies about myeloid-derived suppressor cells (MDSCs) in human organ transplantation have been reported [6, 12, 13, 18, 24, 25], this is the first study concerning the monitoring of MDSCs in human lung transplant recipients (LTR)
The frequencies of those cells with PMN-MDSCs phenotype decreased in the short-term post transplantation and increased during the follow up, no changes were observed compared to pre-transplant levels
Summary
Lung transplantation remains the primary treatment option for patients with end stage lung failure. Despite the advance in the handling of lung transplant recipients, in contrast to heart, liver and kidney transplantation, 5-year survival in lung transplant recipients (LTR) remains limited [1] by post transplant development of bronchiolitis obliterans syndrome (BOS) which is the prime source of chronic allograft failure [2, 3]. Due to this, predicting the risk of developing chronic lung rejection is one of the most important aims in lung transplantation. MDSCs immunoregulatory role in transplant has been highlighted in previous studies performed in animal models that led to suggest them as potential biomarkers for promoting allograft tolerance [4, 5]. MDSCs were initially described in cancer more than 10 years ago, but their value has been enhanced more recently due to the studies that point their role as important regulators in different clinical settings, such as transplant rejection, infection and autoimmunity [6–10]
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