ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2024
Small airway brush gene expression predicts chronic lung allograft dysfunction and mortality.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Utility of donor-derived cell-free DNA testing after lung transplantation in the precision medicine era.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2026Review
- Airway molecular signatures in antibody-mediated lung transplant rejection.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- Immune gene correlation networks differentiate both chronic lung allograft dysfunction and survival.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- Acute lung allograft dysfunction predicts lung allograft failure: Construct validity of the 2026 International Society for Heart and Lung Transplantation spirometric definition.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2026Observational
- Post-lung transplant surveillance in 2026: current practice, variability, and the need for standardization.Transplant international : official journal of the European Society for Organ Transplantation · 2026Review
- Integrated cross-organ transcriptomic analysis uncovers conserved gene signatures predictive of allograft rejection.PloS one · 2026Article
- Increase in Alveolar Septal Width Is a Histological Predictor of Chronic Lung Allograft Dysfunction and Survival in Lung Transplant Recipients-A Longitudinal Study.Journal of clinical medicine · 2025Article
- Persistent and progressive acute lung allograft dysfunction is linked to cell compositional and transcriptional changes in small airways.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2025Article
- Addressing Knowledge Gaps in the Early Detection of Bronchiolitis Obliterans Syndrome after Hematopoietic Cell Transplantation: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Proteomic Analysis of Transbronchial Biopsies to Discover Novel Biomarkers for Early Identification of Chronic Lung Allograft Dysfunction.Transplantation direct · 2025Article
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
backgroundChronic lung allograft dysfunction (CLAD) limits survival following lung transplant, but substantial lung damage occurs before diagnosis by traditional methods. We hypothesized that small airway gene expression patterns could identify CLAD risk before spirometric diagnosis and predict subsequent graft failure.
methodsCandidate genes from 4 rejection-associated transcript sets were assessed for associations with CLAD or graft failure in a derivation cohort of 156 small airway brushes from 45 CLAD cases and 37 time-matched controls with >1-year stable lung function. Candidate genes not associated with CLAD and time to graft failure were excluded, yielding the Airway Inflammation 2 (AI2) gene set. Area under the receiver operating curve (AUC) for CLAD and competing risks of death or graft failure were assessed in an independent validation cohort of 37 CLAD cases and 37 controls.
resultsThirty-two candidate genes were associated with CLAD and graft failure, comprising the AI2 score, which clustered into 3 subcomponents. The AI2 score identified CLAD before its onset, in early and late post-CLAD brushes, as well as in the validation cohort (AUC 0.69-0.88). The AI2 score association with CLAD was independent of positive microbiology, CLAD stage, or CLAD subtype. However, transcripts most associated with CLAD evolved over time from CLAD onset. The AI2 score predicted time to graft failure and retransplant-free survival in both cohorts (p ≤ 0.03).
conclusionsThis airway inflammation gene score is associated with CLAD development, graft failure, and death. Future studies defining the molecular heterogeneity of airway inflammation could lead to endotype-targeted therapies.
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