Purpose Chronic lung allograft dysfunction (CLAD) remains the major barrier to long-term success after lung transplantation. A biomarker in blood that can diagnose CLAD would be of great clinical value. In the current study we have conducted broad proteomics analyzes to detect biomarkers for CLAD Methods Plasma from a cohort of 46 lung transplant recipients (CLAD grade 0: 27 samples, CLAD grade 1 - 3: 19 samples were collected. A panel of 639 proteins were analyzed using a high-component, multiplex immunoassay that enables analysis of protein biomarkers. This high multiplexing is achieved with Proximity Extension Assay (PEA) technology. Each biomarker is addressed by a matched pair of antibodies, coupled to unique, partially complementary oligonucleotides, and measured by quantitative real-time PCR. Results Regression analysis comparing 3 groups CLAD grade 0, CLAD grade 1, and CLAD grade 2-3 showed significant differences in plasma proteins expression levels of 12 different proteins: Low affinity immunoglobulin epsilon Fc receptor (FCER2). Corticoliberin (CRH). Interleukin-20 receptor subunit alpha (IL-20RA). TNF-beta (TNFB). Immunoglobulin superfamily member 3 (IGSF3). Cathepsin L1 (CTSL1). Anterior gradient protein 2 homolog (AGR2). Matrix metalloproteinase-9 (MMP-9). Thymic stromal lymphopoietin (TSLP). Importin subunit alpha-5 (KPNA1). Signaling threshold-regulating transmembrane adapter 1 (SIT1). Ras GTPase-activating protein 1 (RASA1). Conclusion Interestingly a significant decrease was observed in TNFB, KPNA1, IGSF3, CRH, FCER2 levels in recipients with CLAD grade 1, but also in recipients with CLAD grade 2 and 3. IL-20RA was significantly decreased in recipents with CLAD grade 1, but not in recipients with CLAD grade 2 and 3. Proteomic patterns may be a viable way in the search of early biomarkers for BOS
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