Department of Medical Sciences, Surgery and Neurosciences, Respiratory Disease and Lung Transplant Unit, Siena University, 53100, Siena, Italy.
Unit of Respiratory Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100, Sassari, Italy.
Lung. 2023 Aug;201(4):363-369. doi: 10.1007/s00408-023-00632-8. Epub 2023 Jul 4.
Bronchiolitis obliterans syndrome (BOS) is the most common form of CLAD and is characterized by airflow limitation and an obstructive spirometry pattern without parenchymal opacities. The protein signature of BOS lesions concerns extracellular matrix organization and aberrant basement membrane composition. In this pilot study, we investigated the presence of COL4A5 in the serum of patients with BOS.
41 patients who had undergone LTX were enrolled. Of these, 27 developed BOS and 14 (control group) were considered stable at the time of serum sampling. Of BOS patients, serum samples were analysed at the time of BOS diagnosis and before the clinical diagnosis (pre-BOS). COL4A5 levels were detected through the ELISA kit.
Serum concentrations of COL4A5 were higher in pre-BOS than in stable patients (40.5 ± 13.9 and 24.8 ± 11.4, respectively, p = 0.048). This protein is not influenced by comorbidities, such as acute rejection or infections, or by therapies. Survival analysis also reveals that a higher level of COL4A5 was also associated with less probability of survival. Our data showed a correlation between concentrations of COL4A5 and FEV1 at the time of diagnosis of BOS.
Serum concentrations of COL4A5 can be considered a good prognostic marker due to their association with survival and correlation with functional parameters.
闭塞性细支气管炎综合征（BOS）是 CLAD 最常见的形式，其特征是气流受限和阻塞性肺活量测定模式，无实质混浊。BOS 病变的蛋白质特征与细胞外基质组织和异常基底膜组成有关。在这项初步研究中，我们研究了 BOS 患者血清中 COL4A5 的存在情况。
共纳入 41 例接受 LTX 的患者。其中，27 例发生 BOS，14 例（对照组）在血清取样时被认为稳定。在 BOS 患者中，在 BOS 诊断时和临床诊断前（pre-BOS）分析了血清样本。通过 ELISA 试剂盒检测 COL4A5 水平。
pre-BOS 患者的血清 COL4A5 浓度高于稳定患者（分别为 40.5±13.9 和 24.8±11.4，p=0.048）。该蛋白不受急性排斥反应或感染等合并症或治疗的影响。生存分析还表明，较高的 COL4A5 水平与存活概率较低相关。我们的数据显示，COL4A5 浓度与 BOS 诊断时的 FEV1 之间存在相关性。
由于与生存相关且与功能参数相关，COL4A5 的血清浓度可被视为良好的预后标志物。
