INVESTIGATING THE PROTEASE/ANTIPROTEASE BALANCE IN BRONCHOALVEOLAR LAVAGE OF LUNG TRANSPLANT RECIPIENTS THROUGH A MULTIFACTORIAL APPROACH

Early and long-term graft and patient survival after lung transplantation continue to be challenged by primary graft dysfunction and by chronic allograft dysfunction or bronchiolitis obliterans syndrome (BOS). While the neutrophilic component is known to play an important role in the pathogenesis and maintenance of this condition, the exact pathogenesis of BOS is still unknown. It has been speculated that it may result from the combination of several noxious triggers which, by causing innate/adaptive immune reactions, lead to immune activation responsible for the induction of the neutrophilic inflammation. This inflammatory phase is ultimately followed by a fibro-proliferative phase of fibrocytes/fibroblasts originating from mesenchymal stromal cells. The current research aimed at the identification of potential biomarkers of BOS that could be useful not only for a better diagnosis of the disease but also for the development of novel drugs that can improve the life quality of patients. The identification of markers that could predict the development and progression of BOS is crucial for preventing the irreversible phase of the disorder with the final goal of improving the survival of lung transplant recipients.