Transbronchial biopsy: histology and transcript-based classifiers
Evidence level: abstract-only studies (cohorts and transcriptomic studies)
Biopsy histology and gene-expression classifiers are studied for CLAD, with reported associations rather than established diagnostic roles.
As of . Primary source: Parkes et al. 2022 (DOI).
Summary
According to the abstract of Parkes and colleagues (2022), whole-genome mRNA profiling of 498 prospectively collected transbronchial biopsies from the INTERLUNG study, of which 90 were diagnosed as CLAD, showed that CLAD manifested as a parenchymal response to wounding and dedifferentiation, and gene-based classifiers predicted CLAD with an area under the curve of 0.70 without time correction and 0.87 with time correction. The abstract states that histology of these biopsies yields little insight. A Toronto study (Darley 2021) reports that eosinophils on biopsy were associated with higher hazards of CLAD (1.35) and death. A KU Leuven case-control study reports histopathologic lung injury patterns on biopsy as early indicators of later RAS, and a Toronto cohort reports no significant difference in CLAD risk after a first untreated minimal (A1) rejection episode. A 2026 KU Leuven atlas reports that its findings were validated in transbronchial biopsies and describes a 26-gene hub panel. The GEO series for the Parkes study is recorded as a dataset. The abstracts do not describe a validated clinical test, and this record gives no advice.
Sources and links
Related
Links from this record
- abstract read: Transcripts associated with chronic lung allograft dysfunction in transbronchial biopsies of lung transplants
- supports: Eosinophils in transbronchial biopsies: a predictor of chronic lung allograft dysfunction and reduced survival after lung transplantation — a retrospective single‐center cohort study.
- supports: Clinical predictors for restrictive allograft syndrome: A nested case-control study.
- supports: A transcriptomic atlas of chronic lung allograft dysfunction.
- biopsy grading: The impact of first untreated subclinical minimal acute rejection on risk for chronic lung allograft dysfunction or death after lung transplantation.
- dataset: GEO GSE193150: transcripts in transbronchial biopsies (INTERLUNG)
- related to: Airway transcriptomic signatures
Linked from (derived)
- uses: The CD8+ T cell content of transbronchial biopsies from patients with a first episode of clinically stable grade A1 cellular rejection is associated with future chronic lung allograft dysfunction
- uses: Center variability in the prognostic value of a cumulative acute cellular rejection "A-score" for long-term lung transplant outcomes
- relates to: Bronchoalveolar lavage cytokine-based risk stratification of clinically-stable lung transplant recipients with undefined rejection: Further insights from a follow-up investigation
- profiles: GEO GSE125478: molecular assessment of rejection and injury in lung transplant biopsies
- profiles: GEO GSE303535: transcripts defining an NK cell-enriched rejection-like state in transbronchial biopsies
- affects: Biomarker findings are hard to validate and generalise across centres
- affects: CLAD care and measurement vary between centres
Known gaps in this record
- accuracy figures for histology (not in the abstracts)
- independent validation of the classifiers (not in the abstract)
- full text of all sources
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.