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dc.contributor.author Willetts, Lian
dc.contributor.author Parker, Kimberly
dc.contributor.author Wesselius, Lewis J
dc.contributor.author Protheroe, Cheryl A
dc.contributor.author Jaben, Elizabeth
dc.contributor.author Graziano, P
dc.contributor.author Moqbel, Redwan
dc.contributor.author Leslie, Kevin O
dc.contributor.author Lee, Nancy A
dc.contributor.author Lee, James J
dc.date.accessioned 2015-02-03T21:57:56Z
dc.date.available 2015-02-03T21:57:56Z
dc.date.issued 2011-08-26
dc.identifier.citation Respiratory Research. 2011 Aug 26;12(1):116
dc.identifier.uri http://hdl.handle.net/1993/30259
dc.description.abstract Abstract Background Acute lung injury (ALI) is a serious respiratory disorder for which therapy is primarily supportive once infection is excluded. Surgical lung biopsy may rule out other diagnoses, but has not been generally useful for therapy decisions or prognosis in this setting. Importantly, tissue and peripheral blood eosinophilia, the hallmarks of steroid-responsive acute eosinophilic pneumonia, are not commonly linked with ALI. We hypothesized that occult eosinophilic pneumonia may explain better outcomes for some patients with ALI. Methods Immunohistochemistry using a novel monoclonal antibody recognizing eosinophil peroxidase ( EPX-mAb ) was used to assess intrapulmonary eosinophil accumulation/degranulation. Lung biopsies from ALI patients (n = 20) were identified following review of a pathology database; 45% of which (i.e., 9/20) displayed classical diffuse alveolar damage (ALI-DAD). Controls were obtained from uninvolved tissue in patients undergoing lobectomy for lung cancer (n = 10). Serial biopsy sections were stained with hematoxylin and eosin ( H&E ) and subjected to EPX-mAb immunohistochemistry. Results EPX-mAb immunohistochemistry provided a >40-fold increased sensitivity to detect eosinophils in the lung relative to H&E stained sections. This increased sensitivity led to the identification of higher numbers of eosinophils in ALI patients compared with controls; differences using H&E staining alone were not significant. Clinical assessments showed that lung infiltrating eosinophil numbers were higher in ALI patients that survived hospitalization compared with non-survivors. A similar conclusion was reached quantifying eosinophil degranulation in each biopsy. Conclusion The enhanced sensitivity of EPX-mAb immunohistochemistry uniquely identified eosinophil accumulation/degranulation in patients with ALI relative to controls. More importantly, this method was a prognostic indicator of patient survival. These observations suggest that EPX-mAb immunohistochemistry may represent a diagnostic biomarker identifying a subset of ALI patients with improved clinical outcomes.
dc.title Immunodetection of occult eosinophils in lung tissue biopsies may help predict survival in acute lung injury
dc.type Journal Article
dc.language.rfc3066 en
dc.description.version Peer Reviewed
dc.rights.holder Lian Willetts et al.; licensee BioMed Central Ltd.
dc.date.updated 2015-02-03T16:40:46Z
dc.identifier.doi http://dx.doi.org/10.1186/1465-9921-12-116


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