Bronchoalveolar lavage: cell counts, microbiology and protein markers
Evidence level: abstract-only studies; no consensus document opened
Lavage fluid is used in the literature for cell counts, culture, microbiota and candidate protein markers of CLAD.
As of . Primary source: Levy et al. 2019, BAL M30 and M65 (DOI).
Summary
The abstracts read describe several uses of bronchoalveolar lavage (BAL) in research on CLAD. A single-centre study (centre not named in the abstract; authors include Toronto investigators) measured epithelial cell death markers M30 and M65 in BAL and reported that M65 was higher in RAS than in BOS and controls. A KU Leuven case-control study reports higher bronchoalveolar eosinophils and lymphocytes in patients with RAS than in matched controls without CLAD. A Leuven study of pseudomonal colonisation used BAL or sputum cultures. A study of reflux and aspiration (centre not named in the abstract) measured pepsin and bile acids in BAL fluid, and a lavage microbiota study sequenced bacterial DNA from 203 samples. These are research uses reported in abstracts; the abstracts do not establish routine diagnostic thresholds, and this record gives no advice.
Sources and links
Related
Links from this record
- supports: Epithelial cell death markers in bronchoalveolar lavage correlate with chronic lung allograft dysfunction subtypes and survival in lung transplant recipients-a single-center retrospective cohort study
- supports: Clinical predictors for restrictive allograft syndrome: A nested case-control study.
- culture use: Pseudomonal airway colonisation: risk factor for bronchiolitis obliterans syndrome after lung transplantation?
- pepsin and bile acids: Gastro-oesophageal reflux and gastric aspiration in lung transplant patients with or without chronic rejection
- microbiota: Airway Microbiota Determines Innate Cell Inflammatory or Tissue Remodeling Profiles in Lung Transplantation
- related to: Epithelial injury markers
- related to: Microbiome-derived signals
Linked from (derived)
- uses: Bronchoalveolar lavage cytokine-based risk stratification of clinically-stable lung transplant recipients with undefined rejection: Further insights from a follow-up investigation
- uses: Emergence of a senescent and inflammatory pulmonary CD4+ T cell population prior to lung allograft failure
- relates to: Airway pepsinogen A4 identifies lung transplant recipients with microaspiration and predicts chronic lung allograft dysfunction
- uses: Lung microbiome quantification and bacterial density as prognostic markers in lung transplantation
Known gaps in this record
- consensus statement on routine BAL in CLAD diagnosis (not opened)
- centre for several studies is not named in the abstracts
- full text of all sources
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.