%0 Journal Article %1 Gregson2013 %A Gregson, Aric L. %A Wang, Xiaoyan %A Weigt, S Sam %A Palchevskiy, Vyacheslav %A Lynch, 3rd, Joseph P %A Ross, David J. %A Kubak, Bernard M. %A Saggar, Rajan %A Fishbein, Michael C. %A Ardehali, Abbas %A Li, Gang %A Elashoff, Robert %A Belperio, John A. %D 2013 %J Am J Respir Crit Care Med %K bos myown pneumonia pseudomonas transplantation %N 5 %P 518-526 %R 10.1164/rccm.201207-1228OC %T Interaction Between Pseudomonas and CXC Chemokines Increases Risk of BOS and Death in Lung Transplantation. %U http://dx.doi.org/10.1164/rccm.201207-1228OC %V 187 %X Rationale Pseudomonas aeruginosa is the most commonly isolated gram negative bacterium after lung transplantation and has been shown to upregulate ELR+ CXC chemokines associated with bronchiolitis obliterans syndrome (BOS), but the effect of pseudomonas on BOS and death has not been well defined. Objectives Determine if the influence of pseudomonas isolation and ELR+ CXC chemokines on the subsequent development of BOS and the occurrence of death is time dependent. Methods A three state model was developed to assess the likelihood of transitioning from lung transplant (State 1) to BOS (State 2), from transplant (State 1) to death (State 3), and from BOS (State 2) to death (State 3). This Cox Semi-Markovian approach determines State survival rates and cause-specific hazards for movement from one State to another. Measurements and Main Results The likelihood of transition from transplant to BOS was increased by acute rejection, CXCL5 and the interaction between pseudomonas and CXCL1. Importantly, the pseudomonas effect in this transition was due entirely to infection rather than colonization. Movement from transplant to death was facilitated by pseudomonas infection and single lung transplant. Transition from BOS to death was effected by the length of time in State 1 and the interactions between any pseudomonas isolation and CXCL5 and aspergillus, either independently or in combination. Conclusions Our model demonstrates that common post-transplantation events drive movement from one post-transplantation State to another and influence outcomes differently dependent upon when after transplantation they occur. Furthermore, pseudomonas and the ELR+ CXC chemokines may interact to negatively influence lung transplant outcomes.

@article{Gregson2013, abstract = {Rationale Pseudomonas aeruginosa is the most commonly isolated gram negative bacterium after lung transplantation and has been shown to upregulate ELR+ CXC chemokines associated with bronchiolitis obliterans syndrome (BOS), but the effect of pseudomonas on BOS and death has not been well defined. Objectives Determine if the influence of pseudomonas isolation and ELR+ CXC chemokines on the subsequent development of BOS and the occurrence of death is time dependent. Methods A three state model was developed to assess the likelihood of transitioning from lung transplant (State 1) to BOS (State 2), from transplant (State 1) to death (State 3), and from BOS (State 2) to death (State 3). This Cox Semi-Markovian approach determines State survival rates and cause-specific hazards for movement from one State to another. Measurements and Main Results The likelihood of transition from transplant to BOS was increased by acute rejection, CXCL5 and the interaction between pseudomonas and CXCL1. Importantly, the pseudomonas effect in this transition was due entirely to infection rather than colonization. Movement from transplant to death was facilitated by pseudomonas infection and single lung transplant. Transition from BOS to death was effected by the length of time in State 1 and the interactions between any pseudomonas isolation and CXCL5 and aspergillus, either independently or in combination. Conclusions Our model demonstrates that common post-transplantation events drive movement from one post-transplantation State to another and influence outcomes differently dependent upon when after transplantation they occur. Furthermore, pseudomonas and the ELR+ CXC chemokines may interact to negatively influence lung transplant outcomes.}, added-at = {2013-03-01T19:23:45.000+0100}, author = {Gregson, Aric L. and Wang, Xiaoyan and Weigt, S Sam and Palchevskiy, Vyacheslav and {Lynch, 3rd}, Joseph P and Ross, David J. and Kubak, Bernard M. and Saggar, Rajan and Fishbein, Michael C. and Ardehali, Abbas and Li, Gang and Elashoff, Robert and Belperio, John A.}, biburl = {https://www.bibsonomy.org/bibtex/2c7b56f7d59fe997ef32cc91fafa2e1ae/aorchid}, description = {my article}, doi = {10.1164/rccm.201207-1228OC}, file = {:allorejection/AmJRespirCritCareMed.187.518.full.pdf:PDF}, groups = {public}, institution = {Medicine, UCLA, Los Angeles, California, United States.}, interhash = {7f0abeda76b039f761bf68d3378d8f4c}, intrahash = {c7b56f7d59fe997ef32cc91fafa2e1ae}, journal = {Am J Respir Crit Care Med}, keywords = {bos myown pneumonia pseudomonas transplantation}, language = {eng}, medline-pst = {aheadofprint}, month = jan, number = 5, pages = {518-526}, pii = {rccm.201207-1228OC}, pmid = {23328531}, timestamp = {2013-03-21T00:45:25.000+0100}, title = {Interaction Between Pseudomonas and CXC Chemokines Increases Risk of BOS and Death in Lung Transplantation.}, url = {http://dx.doi.org/10.1164/rccm.201207-1228OC}, username = {aorchid}, volume = 187, year = 2013 }