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Respir Physiol Neurobiol. 2014 Apr 1;194:54-61. doi: 10.1016/j.resp.2014.01.018. Epub 2014 Feb 1.

Mechanisms for reduced pulmonary diffusing capacity in haematopoietic stem-cell transplantation recipients.

Author information

  • 1Fisiopatologia Respiratoria, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, Genoa, Italy. Electronic address: giovanni.barisione@hsanmartino.it.
  • 2Ematologia 2, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, Genoa, Italy.
  • 3Dipartimento di Medicina Interna e Specialità Mediche, Università di Genova, Genoa, Italy.
  • 4Dipartimento di Medicina Sperimentale, Università di Genova, Genoa, Italy.
  • 5Radiologia, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, Genoa, Italy.
  • 6Allergologia e Fisiopatologia Respiratoria, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy.

Abstract

Lung diffusing capacity for CO (DLCO) is compromised in haematopoietic stem-cell transplantation (HSCT) recipients. We derived alveolar-capillary membrane conductance (DM,CO) and pulmonary capillary volume (VC) from DLCO and diffusing capacity for NO (DLNO). Forty patients were studied before and 6 weeks after HSCT. Before HSCT, DLNO and DLCO were significantly lower than in 30 healthy controls. DM,CO was ∼40% lower in patients than in controls (p<0.001), whereas VC did not differ significantly. After HSCT, DLNO and DM,CO further decreased, the latter by ∼22% from before HSCT (p<0.01) while VC did not change significantly. Lung density, serum CRP and reactive oxygen metabolites were significantly increased, with the latter being correlated (R2=0.71, p<0.001) with the decrement in DLNO. We conclude that DLNO and, to a lesser extent, DLCO are compromised before HSCT mainly due to a DM,CO reduction. A further reduction of DM,CO without VC loss occurs after HSCT, possibly related to development of oedema, or interstitial fibrosis, or both.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01735526.

Copyright © 2014 Elsevier B.V. All rights reserved.

KEYWORDS:

Alveolar–capillary membrane conductance; Carbon monoxide; Lung density; Nitric oxide; Pulmonary capillary volume; Reactive oxygen metabolites

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