Protein Signatures of Remodeled Airways in Transplanted Lungs with Bronchiolitis Obliterans Syndrome Obtained Using Laser-Capture Microdissection

Catharina Müller, Oskar Rosmark, Emma Åhrman, Hans Brunnström, Katharina Wassilew, Annika Nybom, Barbora Michaliková, Hillevi Larsson, Leif T Eriksson, Hans H Schultz, Michael Perch, Johan Malmström, Jenny Wigén, Martin Iversen, Gunilla Westergren-Thorsson


Bronchiolitis obliterans syndrome, a common form of chronic lung allograft dysfunction, is the major limitation to long-term survival after lung transplantation. The histologic correlate is progressive, fibrotic occlusion of small airways, obliterative bronchiolitis lesions, which ultimately lead to organ failure. The molecular composition of these lesions is unknown. In this sutdy, the protein composition of the lesions in explanted lungs from four end-stage bronchiolitis obliterans syndrome patients was analyzed using laser-capture microdissection and optimized sample preparation protocols for mass spectrometry. Immunohistochemistry and immunofluorescence were used to determine the spatial distribution of commonly identified proteins on the tissue level, and protein signatures for 14 obliterative bronchiolitis lesions were established. A set of 39 proteins, identified in >75% of lesions, included distinct structural proteins (collagen types IV and VI) and cellular components (actins, vimentin, and tryptase). Each respective lesion exhibited a unique composition of proteins (on average, n = 66 proteins), thereby mirroring the morphologic variation of the lesions. Antibody-based staining confirmed these mass spectrometry-based findings. The 14 analyzed obliterative bronchiolitis lesions showed variations in their protein content, but also common features. This study provides molecular and morphologic insights into the development of chronic rejection after lung transplantation. The protein patterns in the lesions were correlated to pathways of extracellular matrix organization, tissue development, and wound healing processes.

Original languageEnglish
JournalAmerican Journal of Pathology
Issue number8
Pages (from-to)1398-1411
Number of pages14
Publication statusPublished - Aug 2021


  • Airway Remodeling
  • Bronchiolitis Obliterans/metabolism
  • Humans
  • Laser Capture Microdissection
  • Lung/pathology
  • Lung Transplantation
  • Proteome
  • Transplants/metabolism


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