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Carbon monoxide: Poison gas or anti-inflammatory drug?

Could become part of future treatment regimen for organ transplant patients.

ANN ARBOR, Mich. Carbon monoxide, a poisonous gas that kills thousands of Americans every year, could turn out to be a life-saver for patients recovering from organ transplants, strokes or heart attacks, according to new research from the University of Michigan Cardiovascular Center.

In a recent study, U-M scientists found that inhaling small amounts of carbon monoxide for several weeks after transplant surgery prevented the development of a lethal inflammatory reaction in experimental mice receiving transplanted trachea, or windpipes.

If carbon monoxide therapy works as well in human patients as it does in mice, it could prevent an inflammatory response, called obliterative bronchiolitis, which develops in nearly 50 percent of all patients who receive a lung transplant from an unrelated donor. OB is the most common complication following a lung transplant in humans and the most deadly. It occurs when the patient's immune system rejects the transplanted lung and sends an army of T cells to attack and destroy the foreign tissue.

"No one is sure exactly how it happens, but the small airways in the lung swell and become progressively smaller until the patient cannot breathe," says David J. Pinsky, M.D., the J. Griswold Ruth, M.D. & Margery Hopkins Ruth Professor of Internal Medicine and chief of cardiovascular medicine in the U-M Medical School, who directed the research. "Currently, we have no effective treatments for OB. Unless the patient receives a new lung transplant, the outcome is generally fatal."

Results of the U-M study were published July 18 in the most recent issue of the Journal of Experimental Medicine (JEM).

Pinsky's research team focuses on the relationship between carbon monoxide and nitric oxide two poisonous gases produced by different types of cells in the body. U-M research findings suggest that a patient's c
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