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2016 ; 6
(ä): 26274
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Soluble CD59 is a Novel Biomarker for the Prediction of Obstructive Chronic Lung
Allograft Dysfunction After Lung Transplantation
#MMPMID27215188
Budding K
; van de Graaf EA
; Kardol-Hoefnagel T
; Kwakkel-van Erp JM
; Luijk BD
; Oudijk ED
; van Kessel DA
; Grutters JC
; Hack CE
; Otten HG
Sci Rep
2016[May]; 6
(ä): 26274
PMID27215188
show ga
CD59 is a complement regulatory protein that inhibits membrane attack complex
formation. A soluble form of CD59 (sCD59) is present in various body fluids and
is associated with cellular damage after acute myocardial infarction. Lung
transplantation (LTx) is the final treatment for end-stage lung diseases, however
overall survival is hampered by chronic lung allograft dysfunction development,
which presents itself obstructively as the bronchiolitis obliterans syndrome
(BOS). We hypothesized that, due to cellular damage and activation during chronic
inflammation, sCD59 serum levels can be used as biomarker preceding BOS
development. We analyzed sCD59 serum concentrations in 90 LTx patients, of whom
20 developed BOS. We observed that BOS patients exhibited higher sCD59 serum
concentrations at the time of diagnosis compared to clinically matched non-BOS
patients (p?=?0.018). Furthermore, sCD59 titers were elevated at 6 months
post-LTx (p?=?0.0020), when patients had no BOS-related symptoms.
Survival-analysis showed that LTx patients with sCD59 titers ?400?pg/ml 6 months
post-LTx have a significant (p?0.0001) lower chance of BOS-free survival than
patients with titers ?400?pg/ml, 32% vs. 80% respectively, which was confirmed by
multivariate analysis (hazard ratio 6.2, p?0.0001). We propose that circulating
sCD59 levels constitute a novel biomarker to identify patients at risk for BOS
following LTx.