Lung Innate Lymphoid Cell Composition Is Altered in Primary Graft Dysfunction

Area of Science:

• Immunology
• Transplantation Science
• Pulmonary Medicine

Background:

• Primary graft dysfunction (PGD) is a major complication following lung transplantation.
• The immunologic underpinnings of PGD remain incompletely understood.
• Innate lymphoid cells (ILCs) are key regulators of inflammation and tissue repair.

Purpose of the Study:

• To investigate the association between donor-derived ILC subset alterations and PGD.
• To examine PGD in lung transplant recipients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD).

Main Methods:

• Single-center cohort study analyzing pre- and post-reperfusion donor lung biopsies.
• Flow cytometry used to phenotype ILC subsets in 18 lung transplant recipients.
• Assessment of ILC subset changes related to reperfusion and PGD development.

Main Results:

• Allograft reperfusion decreased natural killer cell frequencies and tended to reduce overall ILCs.
• PGD development (38.9% of patients) correlated with a selective reduction in ILC2 subsets post-reperfusion.
• Non-PGD patients showed higher pre-reperfusion ILC1 and post-reperfusion ILC2 frequencies.

Conclusions:

• Donor ILC subset composition changes significantly after lung allograft reperfusion.
• Alterations in ILC subsets, particularly ILC2 reduction, are associated with PGD.
• These findings suggest a role for ILCs in modulating lung injury post-transplantation.