Plasma levels of acute phase proteins in patients from the multicenter longitudinal French Cohort in Lung Transplantation (COLT): a pilot study

Abstract

In lung transplantation (Lu-Tx) long-term outcomes still remain poor compared to those of other types of solid organ transplantations. The main problem is the development of chronic lung allograft dysfunction (CLAD). The exact physiopathology of CLAD remains only partially understood. Acute phase proteins (APPs) are not only markers of inflammation but also play a role as systemic modulators of inflammatory processes. We hypothesize that APP plasma concentrations might mirror development and/or susceptibility of CLAD following LuTx. To test this hypothesis, we analysed plasma from 35-lung transplant recipients of whom 25 developed CLAD and 10 remained stable during the follow-up period of 3 to 4.5-years for levels of albumin, alpha1-antitrypsin (AAT), high sensitivity C-reactive protein (CRPH), antithrombin-3, ceruloplasmin (CER), and alpha2-macroglobulin (A2MG) by nephelometry. Clinical data and repeatedly collected plasma samples were obtained from the multicenter longitudinal COLT study (Cohort of Lung Transplantation, NCT00980967). Our results show that within 6 months post LuTx, plasma levels of AAT, A2MG and CER were higher in stable patients relative to those who later developed CLAD. Analysis with a receiver operating characteristics (ROC) model revealed that A2MG, CER and AAT can be considered as putative markers for discriminating stable and CLAD LuTx patients. AUCs were 80.4% (p Our data suggest APPs A2MG, CER and AAT to be useful biomarkers for early identification of LuTx patients at risk to develop CLAD.