[The first allogenic tracheal transplantation in humans 45 years ago : Procedure, course, and outcome]

In November/December 1978, the first successful tracheal transplantation in humans was performed at the University ENT Clinic in Cologne by the then senior physicians Kurt G. Rose (later chief physician in Dortmund) and Klaus Sesterhenn (later chief physician in Duisburg). Director of the clinic at that time was Prof. Dr. Dr. Fritz Wustrow [10]. The immunological foundations and preliminary work were laid by Sesterhenn in the context of a total of 338 tracheal transplants in Lewis rats in the 1970s (details in the text). The first successful tracheal transplantation was performed on 18 November 1978 in a, then 19-year-old patient who had previously had a motorcycle accident. The donor organ was explanted in the University Hospital Essen and transplanted about 160 min later in the Cologne University ENT Clinic, first into a pocket of the right sternocleidomastoid muscle. The definitive transplantation took place on 06 December 1978. In the article, the circumstances at that time and the perioperative course in the Cologne University ENT Clinic are described by an eyewitness. The former patient is still well and without complications after more than four decades.

Role of CMV chemokine receptor M33 in airway graft rejection in a mouse transplant model

BACKGROUND

Cytomegalovirus (CMV) infection is a risk factor for bronchiolitis obliterans (BO), one form of chronic lung allograft dysfunction (CLAD). The viral chemokine receptor M33 is essential for successful spread of murine CMV to host salivary glands. In the present study we investigated the impact of M33 on chronic airway rejection.

METHODS

MHC I-mismatched tracheas of C·B10-H2^b/LilMcdJ mice were transplanted into BALB/c (H2^d) recipients and infected at different dates with wild type (WT) or M33-deleted (delM33) MCMV representing clinical settings of viral recipient (R)-donor (D)-serostatus: (D-/R+) or (D+/R-). Grafts were recovered for gene expression and histological / immunofluorescence analysis, respectively.

RESULTS

Evaluations showed significantly increased signs of chronic rejection in WT-infected mice compared to uninfected allografts seen in lower epithelium/lamina propria-ratio (ELR) (ELR 0.46 ± 0.07 [WT post] vs. ELR 0.66 ± 0.10 [non-inf.]; p < 0.05). The rejection in delM33-infected groups was significantly reduced vs. WT-infected groups (0.67 ± 0.04 [delM33 post]; vs. WT post p < 0.05). Furthermore, decreased rejection was observed in WT pre-infected compared to post-infected groups (0.56 ± 0.08 [WT pre]; vs. WT post p < 0.05). CD8⁺ T cell infiltration was significantly higher in WT-post compared to the delM33 infected or non-infected allografts.

CONCLUSIONS

These data support the role of the CMV in accelerating CLAD. The deletion of chemokine receptor M33 leads to attenuated rejection.

Tanshinone IIA attenuates epithelial-mesenchymal transition to inhibit the tracheal narrowing

BACKGROUND

This study examines the effects of tanshinone IIA (TIIA) on epithelial-mesenchymal transition (EMT) in tracheal transplantation and the ability of TIIA to inhibit tracheal narrowing after tracheal transplantation. Mechanisms that may be involved in this process are also explored.

METHODS

Human bronchial epithelial cells were treated in vitro with TGF-β1 for 72 h. The cells were pretreated with TIIA (40 μg/mL) or DMSO for 2 h before TGF-β1 stimulation. For the in vivo experiments, tracheas (5-6 rings) from Wistar rats were orthotopically transplanted into Sprague-Dawley rats. The experimental group received multiple infusions of sodium TIIA sulfonate (25 mg/kg, qd, intraperitoneally). The control group received infusions of the same volume of saline. Allografts were harvested at 3, 7, 10, 14, 35, and 90 d after transplantation and were examined for tracheal narrowing. Tracheal tissue samples and human bronchial epithelial cell were then subjected to further tests.

RESULTS

In the in vitro assay, epithelial cadherin expression was decreased after TGF-β1 stimulation, whereas α-smooth muscle actin and vimentin expression levels were increased. The expression levels of ZEB1 and Snail1 were also increased. These changes in expression were partially reversed by treatment with TIIA. In the in vivo assay, TIIA alleviated tracheal stenosis after tracheal allograft transplantation in rats and mitigated EMT by inhibiting the Smad signaling pathway and the expression of the transcription factors ZEB1 and Snail1.

CONCLUSIONS

Our research suggests that TIIA reduces tracheal narrowing after tracheal transplantation by suppressing TGF-β1-dependent EMT.