Airway epithelium in obliterative airway disease

Lung transplantation is currently the only available treatment for endstage lung disease patients. Despite the success of improved modern lung transplantation with the introduction of new surgical techniques, improved immunosuppressive agents and innovations in managing of acute rejection and infection, the survival rate of recipients is 75% at 1 year and less than 50% at 5 years. (1) One of the most severe complications after lung transplantation is obliterative bronchiolitis (OB) which affect over 40% of the recipients within 5 years during the posttransplantation period.(1). OB is a chronic disease that develops from months and mostly years after lung transplantation (2-4). It is characterized by progressive bronchial inflammation, epithelial injury and luminal fibrosis.(5-7). There is no treatment for human OB and insight into the understandings of its mechanism is still lacking. Presently, all clinical efforts are directed at slowing down the process. These efforts include pre-transplant treatment to the donor lung to reduce inflammatory inducing factors, employment of aggressive peri-transplant administration with antibiotics (3;8-11) and improved immunosuppressive regimens. Only re-transplantation appears to be a curable solution, but is mostly not possible due to the limited availability of donor organs. Clinical investigation of OB in humans is restricted by the limited amount of patient material available for research. This makes the development of new treatments a difficult and time consuming task (12). Thus, a simple animal model that resembles the development of OB in human is a desirable goal