{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:04:03Z","timestamp":1788537843605,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100092"],"award-info":[{"award-number":["82100092"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006407","name":"Natural Science Foundation of Henan Province","doi-asserted-by":"publisher","award":["222300420334"],"award-info":[{"award-number":["222300420334"]}],"id":[{"id":"10.13039\/501100006407","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006407","name":"Natural Science Foundation of Henan Province","doi-asserted-by":"publisher","award":["232300420255"],"award-info":[{"award-number":["232300420255"]}],"id":[{"id":"10.13039\/501100006407","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20200341"],"award-info":[{"award-number":["LHGJ20200341"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20200380"],"award-info":[{"award-number":["LHGJ20200380"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010950","name":"Science and Technology Department, Henan Province","doi-asserted-by":"publisher","award":["SBGJ202102106"],"award-info":[{"award-number":["SBGJ202102106"]}],"id":[{"id":"10.13039\/501100010950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The development of bronchiolitis obliterans syndrome (BOS) following allogeneic hematopoietic stem cell transplantation (allo-HCT) remains an unresolved clinical problem. However, developing a risk stratification tool for BOS risk is challenging as numerous factors contribute to its development. Moreover, allo-HCT may lead to a decrease in respiratory mucosal surface defense function, resulting in recurrent inflammation and fibrosis. Previous studies have shown that immunoglobulin G (IgG) and IgA levels significantly decrease after lung transplantation and are associated with BOS. Therefore, we hypothesized that immunoglobulin levels of patients may also decrease after allo-HCT, and may even be risk factor for the development of BOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, a total of 134 patients were enrolled. According to the presence of BOS, these patients were divided into BOS and non-BOS groups. Clinical information and immunoglobulin levels were analyzed between the two groups. Immunoglobulin levels of patients before and after transplantation were compared. Binary logistic regression and Cox regression were used to identify variables with independent prognostic significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ABO incompatible, human leukocyte antigen (HLA) mismatch, lung infection within 100 days post-transplantation, cytomegalovirus (CMV) serology positivity, and pre-transplant IgA immunoglobulin deficiency were risk factors for BOS after allo-HCT. Following transplantation, IgA and IgM levels significantly decreased, and many patients had levels below the reference values. In addition, the serum IgA levels prior to transplantation were lower in the BOS group than the non-BOS group. In multivariate models, pre-transplant IgA deficiency was a risk factor for BOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following allo-HCT, IgA and IgM levels decreased, and numerous patients had levels below the reference values. In multivariate models, pre-transplant IgA deficiency was identified as a risk factor for BOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1692881","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T05:30:07Z","timestamp":1767591007000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Immunoglobulin levels of children with bronchiolitis obliterans syndrome after hematopoietic cell transplantation"],"prefix":"10.3389","volume":"12","author":[{"given":"Yinyan","family":"Yue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suqin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1455009","DOI":"10.3389\/fimmu.2024.1455009","article-title":"Immune dysregulation as a driver of bronchiolitis obliterans.","volume":"15","author":"Deng","year":"2024","journal-title":"Front Immunol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1136\/thx.2004.031005","article-title":"Challenges in pulmonary fibrosis. 2: bronchiolocentric fibrosis.","volume":"62","author":"Cordier","year":"2007","journal-title":"Thorax"},{"key":"B3","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1164\/rccm.200310-1359OC","article-title":"Respiratory viral infections are a distinct risk for bronchiolitis obliterans syndrome and death.","volume":"170","author":"Khalifah","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2695","DOI":"10.1111\/ajt.13798","article-title":"HLA matching at the eplet level protects against chronic lung allograft dysfunction.","volume":"16","author":"Walton","year":"2016","journal-title":"Am J Transplant"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1038\/s41409-024-02422-z","article-title":"Evaluation of risk for bronchiolitis obliterans syndrome after allogeneic hematopoietic cell transplantation with myeloablative conditioning regimens.","volume":"59","author":"Duque-Afonso","year":"2024","journal-title":"Bone Marrow Transplant"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1126\/science.1104816","article-title":"Host-bacterial mutualism in the human intestine.","volume":"307","author":"B\u00e4ckhed","year":"2005","journal-title":"Science"},{"key":"B7","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1111\/j.1399-3046.2008.01067.x","article-title":"Hypogammaglobulinemia: incidence, risk factors, and outcomes following pediatric lung transplantation.","volume":"13","author":"Robertson","year":"2009","journal-title":"Pediatr Transplant"},{"key":"B8","first-page":"9883768","article-title":"Bronchiolitis obliterans syndrome: incidence, natural history, prognosis, and risk factors.","volume":"17","author":"Heng","year":"1998","journal-title":"J Heart Lung Transplant."},{"key":"B9","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.bbmt.2014.12.001.","article-title":"National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: i. 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