ArticleFrontiers in immunology2025
TSG-6 expression distinguishes rejected and non-rejected human lung transplants: a retrospective study.
Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Lung transplantation (LTx) remains the definitive treatment for select end-stage pulmonary diseases, yet early graft failure due to acute rejection continues to compromise long-term outcomes. Tissue injury and insufficient reparative responses in the immediate post-transplant period contribute to this vulnerability. Tumor Necrosis Factor-Stimulated Gene-6 (TSG-6) is a multifunctional anti-inflammatory and tissue-protective protein known to facilitate resolution of inflammation and extracellular matrix remodeling, but its role in human LTx remains undefined. In this retrospective study, we examined TSG-6 expression in transbronchial biopsies from two matched cohorts of LTx recipients-those with histopathologically confirmed acute rejection (n = 6) and those without rejection (n = 6)-within the first postoperative month. Immunofluorescence analysis revealed significantly elevated TSG-6 expression in non-rejected grafts across two metrics: whole-biopsy staining intensity (Mean 11 ± 1.6 units vs 2.35 ± 0.5, p < 0.01) and percentage of TSG-6-positive cells (~90% vs. ~30%, p < 0.01). Scatter plot visualization confirmed a clear separation between groups, suggesting that elevated TSG-6 expression-both in total tissue and per-cell prevalence-is strongly associated with the absence of acute rejection and may reflect a reparative immune phenotype. Despite the limited sample size, the consistency and magnitude of the effect (Cohen's d ≈ 4.7) underscore the biological relevance of TSG-6 in early graft stability. Our data establish a novel link between increased TSG-6 expression and diminished acute rejection in human lung allografts, suggesting that TSG-6 may actively modulate alloimmune responses and serve as both a marker of graft stability and a candidate for therapeutic intervention.
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