Bronchiolitis obliterans syndrome (BOS)
The obstructive phenotype of chronic lung allograft dysfunction, in which the small airways are the main site of disease.
As of . Primary source: Verleden et al. 2019, CLAD definition (DOI).
Summary
In the 2019 ISHLT phenotype scheme, as tabulated in an open-access review, BOS is the phenotype with obstructive findings (FEV1/FVC below 0.7) and without the restrictive findings or the parenchymal and pleural computed tomography findings that define RAS. An open-access 2020 review describes BOS as a disease in which small airways are affected by chronic inflammation and obliterative fibrosis while peripheral lung tissue remains relatively intact. The older diagnostic criteria were published in 2002. The wording of the 2019 consensus text itself was not opened for this record.
Sources and links
Related
Links from this record
- defined in: Chronic lung allograft dysfunction: Definition, diagnostic criteria, and approaches to treatment: A consensus report from the Pulmonary Council of the ISHLT
- summarised in: Chronic lung allograft dysfunction post-lung transplantation: The era of bronchiolitis obliterans syndrome and restrictive allograft syndrome
- summarised in: Bronchiolitis obliterans syndrome and restrictive allograft syndrome after lung transplantation: why are there two distinct forms of chronic lung allograft dysfunction?
- earlier criteria: Bronchiolitis obliterans syndrome 2001: an update of the diagnostic criteria
Linked from (derived)
- proposed to be refined by: Molecular endotypes of CLAD (proposed framework)
- contrasted: Chest CT: parenchymal patterns and density in CLAD
- used to define: Spirometry: FEV1 decline from baseline in the ISHLT 2019 CLAD definition
- studied in: Azithromycin
- studied in: Extracorporeal photopheresis (ECP)
- compared in: Retransplantation
- reported association: Acute cellular rejection
- reported association: Airway colonisation: Pseudomonas and fungal infection
- reported association: Cytomegalovirus and respiratory infection
- reported association: Gastro-oesophageal reflux, oesophageal dysmotility and aspiration
- reported association: Primary graft dysfunction
- Azithromycin in Bronchiolitis Obliterans Syndrome
- Extracorporeal Photopheresis for Medicare Recipients of Lung Allografts
- reviews: Acute Rejection and Chronic Lung Allograft Dysfunction: Obstructive and Restrictive Allograft Dysfunction
- compares: Donor-derived cell-free DNA in chronic lung allograft dysfunction phenotypes: a pilot study
- discusses: A transcriptomic atlas of chronic lung allograft dysfunction.
- classifies: Phenotyping CLAD after single lung transplant: Limits and prognostic assessment of the 2019 ISHLT classification system
- discusses: Gastro-oesophageal reflux and gastric aspiration in lung transplant patients with or without chronic rejection
- addresses: European society for organ transplantation clinical practice guideline on prevention and treatment of chronic lung allograft dysfunction
- discusses: IL-17-dependent cellular immunity to collagen type V predisposes to obliterative bronchiolitis in human lung transplants
- discusses: CLAD: translating basic science to clinical practice
- discusses: Impact of Immediate Primary Lung Allograft Dysfunction on Bronchiolitis Obliterans Syndrome.
- discusses: Identification and characterization of inflammatory LILR and fibrotic SPP1 macrophages in chronic lung allograft dysfunction
- describes: Bronchiolitis obliterans syndrome 2001: an update of the diagnostic criteria
- discusses: Antibodies to K-α 1 Tubulin and Collagen V Are Associated With Chronic Rejection After Lung Transplantation
- discusses: Quantitative chest CT for subtyping chronic lung allograft dysfunction and its association with survival.
- discusses: Distinct fibrotic, epithelial and immune transcriptomic programs in phenotypes of chronic lung allograft dysfunction
- compares: Ventilatory capacity in CLAD is driven by dysfunctional airway structure
- compares: Epithelial cell death markers in bronchoalveolar lavage correlate with chronic lung allograft dysfunction subtypes and survival in lung transplant recipients-a single-center retrospective cohort study
- compares: Risk assessment of chronic lung allograft dysfunction phenotypes: Validation and proposed refinement of the 2019 International Society for Heart and Lung Transplantation classification system
- compares: Pulmonary epithelial markers in phenotypes of chronic lung allograft dysfunction
- discusses: An obligatory role for club cells in preventing obliterative bronchiolitis in lung transplants
- discusses: Reprogramming alveolar macrophage responses to TGF-β reveals CCR2+ monocyte activity that promotes bronchiolitis obliterans syndrome
- models features of: Spectrum of chronic lung allograft pathology in a mouse minor-mismatched orthotopic lung transplant model
- discusses: Shared roles of immune and stromal cells in the pathogenesis of human bronchiolitis obliterans syndrome
- defines: An international ISHLT/ATS/ERS clinical practice guideline: diagnosis and management of bronchiolitis obliterans syndrome
- tests treatment in: A European multicentre, randomised controlled trial of pirfenidone in bronchiolitis obliterans syndrome after bilateral lung transplantation
- discusses: Spectrum of chronic lung allograft dysfunction pathology in human lung transplantation.
- compares: Detailed cellular and spatial characterization of chronic lung allograft dysfunction using imaging mass cytometry
- describes: Bronchiolitis obliterans syndrome and restrictive allograft syndrome after lung transplantation: why are there two distinct forms of chronic lung allograft dysfunction?
- discusses: Circulating exosomes with lung self-antigens as a biomarker for chronic lung allograft dysfunction: A retrospective analysis
- discusses: Cytomegalovirus Pneumonitis Is a Risk for Bronchiolitis Obliterans Syndrome in Lung Transplantation.
- discusses: Hyaluronan Contributes to Bronchiolitis Obliterans Syndrome and Stimulates Lung Allograft Rejection through Activation of Innate Immunity
- characterises: Beyond Bronchiolitis Obliterans: In-Depth Histopathologic Characterization of Bronchiolitis Obliterans Syndrome after Lung Transplantation
- studies treatment of: Azithromycin reduces airway neutrophilia and interleukin-8 in patients with bronchiolitis obliterans syndrome
- reports outcomes of: Survival determinants in lung transplant patients with chronic allograft dysfunction
- compares risk factors of: Bronchiolitis obliterans syndrome and restrictive allograft syndrome: do risk factors differ?
- discusses: A new classification system for chronic lung allograft dysfunction
- compares: Impact of CLAD Phenotype on Survival After Lung Retransplantation: A Multicenter Study
- compares with: Restrictive chronic lung allograft dysfunction: Where are we now?
- reviews: Chronic lung allograft dysfunction phenotypes and treatment
- defines: Chronic lung allograft dysfunction: Definition, diagnostic criteria, and approaches to treatment: A consensus report from the Pulmonary Council of the ISHLT
- discusses: Pseudomonal airway colonisation: risk factor for bronchiolitis obliterans syndrome after lung transplantation?
- describes: Chronic lung allograft dysfunction post-lung transplantation: The era of bronchiolitis obliterans syndrome and restrictive allograft syndrome
- profiles: GEO GSE290834: single-cell RNA-seq of explanted human lungs with CLAD-BOS and cGVHD-BOS
- profiles: GEO GSE94557: whole blood gene expression in lung recipients with CLAD
- affects: Clinical CLAD phenotypes are hard to assign reproducibly
- affects: No therapy of proven benefit for established CLAD
Known gaps in this record
- quotation of the 2019 consensus wording (full text not opened)
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.