Early Administration of FTY720 Prevents Chronic Airway as Well as Vascular Destruction in Experimental Rat Lung Transplantation

• Published in: Transplantation proceedings 2013-03, Vol.45 (2), p.783-786
• Main Authors: Hirt, S.W, von Suesskind-Schwendi, M, Puehler, T, Schmid, C, Lehle, K
• Format: Article
• Language: English
• Subjects: Acute Disease; Animals; Bronchiolitis Obliterans - immunology; Bronchiolitis Obliterans - pathology; Bronchiolitis Obliterans - prevention & control; Chronic Disease; Drug Administration Schedule; Fingolimod Hydrochloride; Graft Rejection - immunology; Graft Rejection - pathology; Graft Rejection - prevention & control; Immunosuppressive Agents - administration & dosage; Lung - blood supply; Lung - drug effects; Lung - immunology; Lung - pathology; Lung Transplantation - adverse effects; Lung Transplantation - immunology; Lymphocytes - drug effects; Lymphocytes - immunology; Male; Propylene Glycols - administration & dosage; Rats; Rats, Inbred F344; Rats, Inbred WKY; Sclerosis; Sphingosine - administration & dosage; Sphingosine - analogs & derivatives; Surgery; Time Factors; Vascular Diseases - immunology; Vascular Diseases - pathology; Vascular Diseases - prevention & control
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.03.066

Abstract Background Chronic rejection (CR) in terms of bronchiolitis obliterans (BO) and vascular sclerosis (VS) still represents the major obstacle for pulmonary graft survival in the medium and long term course after lung transplantation (LTX). Aside from nonspecific stimuli, early acute rejection (AR) seems to be causative especially in cases of a late diagnosis or inadequate treatment. This study investigated the effects of FTY720, a new immunosuppressant that promotes lymphocyte sequestration into lymph nodes and Peyer's patches, on the development of CR after experimental LTX. Methods A total of 50 rats underwent allogenic (F344-to-WKY) and syngenic (WKY-to-WKY) left LTX. Group 1 animals had no treatment. Group 2 animals were administered FTY720 (3 mg/kg body weight per day) at the maximum time of AR (day 14) and continued up to day 100 after LTX. Group 3 animals were treated with the same dosage of FTY720 from day 0 to 100. The grades of AR and CR were classified according to the criteria of the International Society for Heart and Lung Transplantation. Results Within 14 days after allogenic LTX, all nontreated rats developed early AR followed by severe CR with VS and BO. Similar data were observed for FTY720 treatment of existing AR (group 2). Only early administration of FTY720 (at the time of LTX) significantly reduced the proportion of animals with severe acute vascular rejection ( P < .001). However, all of these allografts showed high-grade acute airway inflammation. After long-term application, the chronic inflammatory response was absent; none of the allografts developed BO and VS. Conclusion Only application of FTY720 immediately after LTX prevented lymphocyte recirculation and lung injury.