Gastrointestinal microbiota contributes to the development of murine transfusion-related acute lung injury

Research output: Contribution to journalArticle


Transfusion-related acute lung injury (TRALI) is a syndrome of respiratory distress upon blood transfusion and is the leading cause of transfusion-related fatalities. Whether the gut microbiota plays any role in the development of TRALI is currently unknown. We observed that untreated barrier-free (BF) mice suffered from severe antibody-mediated acute lung injury, whereas the more sterile housed specific pathogen-free (SPF) mice and gut flora-depleted BF mice were both protected from lung injury. The prevention of TRALI in the SPF mice and gut flora-depleted BF mice was associated with decreased plasma macrophage inflammatory protein-2 levels as well as decreased pulmonary neutrophil accumulation. DNA sequencing of amplicons of the 16S ribosomal RNA gene revealed a varying gastrointestinal bacterial composition between BF and SPF mice. BF fecal matter transferred into SPF mice significantly restored TRALI susceptibility in SPF mice. These data reveal a link between the gut flora composition and the development of antibody-mediated TRALI in mice. Assessment of gut microbial composition may help in TRALI risk assessment before transfusion.


  • Rick Kapur
  • Michael Kim
  • Johan Rebetz
  • Björn Hallström
  • Jonas T Björkman
  • Alisa Takabe-French
  • Noel Kim
  • Jonathan Liu
  • Shanjeevan Shanmugabhavananthan
  • Stefan Milosevic
  • Mark J McVey
  • Edwin R Speck
  • John W Semple
External organisations
  • Saint Michael's Hospital
  • Skåne University Hospital
  • University of Toronto
  • Canadian Blood Services
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology
Original languageEnglish
Pages (from-to)1651-1663
JournalBlood Advances
Issue number13
Publication statusPublished - 2018 Jul 10
Publication categoryResearch