EXPRESSION OF ADULT T-CELL LEUKEMIA-DERIVED FACTOR IN BRONCHOALVEOLARLAVAGE CELLS AFTER CANINE LUNG TRANSPLANTATION

Lung transplantation is now an accepted therapeutic option for patient s with end-stage lung disease, and an early diagnosis of rejection is essential in the management of these patients. Adult T-cell leukemia-d erived factor (ADF), known as a human homolog of thioredoxin, has been shown to be induced by a variety of stresses. In this study we examin ed ADF expression in lung tissues and bronchoalveolar lavage cells aft er canine lung transplantation to determine whether it could be induce d by allogenic stimulations and could be used to diagnose early reject ion. Allotransplantations were performed in adult mongrel dogs, and im munosuppression was performed from the day of operation to the fifth p ostoperative day. No immunosuppressant was given from the sixth to the tenth postoperative days. Animals were put to death on the tenth post operative day. Bronchoalveolar lavage was performed on the fifth and t enth postoperative days, and the lavage cells and lung tissues were ex amined immunohistochemically with anti-ADP antibody. The grades of rej ection were as follows: grade 1 in two animals, grade 2 in three anima ls, and grade 3 in two animals. The percentages of ADF high-producer c ells in bronchoalveolar lavage cells on the fifth and tenth postoperat ive days were 4.29% +/- 2.65% and 26.6% +/- 3.99%, respectively (p < 0 .01). The percentages of ADF high-producer cells in normal healthy dog s and in those with grade 1, grade 2, and grade 3 rejection were 3.00% +/- 1.64%, 20.5% +/- 9.00%, 25.5% +/- 6.06%, and 34.5% +/- 6.50%, res pectively. The percentage in each rejection group was significantly hi gher than that in normal healthy dogs (p < 0.05). These results sugges t that examination of bronchoalveolar lavage cells with ADF staining m ay be useful in the early diagnosis of rejection.