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""Outcomes following lung transplant are suboptimal owing to chronic allograft failure termed bronchiolitis obliterans syndrome (BOS). Prior work in both mice and humans has shown that interferon gamma (IFNG)-induced chemokines, including CXCL9 and CXCL10, are elevated in patients with established BOS. We hypothesized that patients who ultimately developed BOS would have elevations in these chemokines before losing lung function. We utilized a high throughput multiplex enzyme-linked immunosorbent assay (ELISA) to measure biomarkers in bronchoalveolar lavage fluid (BALF). We modeled cumulative exposure to seven biomarkers (CXCL9, CXCL10, RANTES, IL1-RA, IL-17, MCP1 and IL-13) by calculating the 1-year area under the curve (AUC) for each biomarker in the BALF of 40 lung transplant patients who had at least four samples obtained in the first year posttransplant. Cumulative elevations in CXCL9 and CXCL10 were associated http://www.selleckchem.com/products/z-vad-fmk.html with a significant risk of subsequent graft failure after transplant http://www.selleckchem.com/products/ly2157299.html (HR 9.37 and 5.52, respectively; p http://www.selleck.cn/products/XL184.html is a viable therapy for select patients with end-stage lung disease. In spite of surgical advances over the past two decades, outcomes in lung transplantation have lagged behind those of other solid organs. In particular, the 5-year survival rate following lung transplantation is 50% (1). The largest hurdle to long-term survival and to continued improved quality of life following lung transplantation is bronchiolitis obliterans (BO), a form of chronic allograft rejection characterized by obliteration of the terminal bronchiole by fibrosis. Many putative factors have been shown to increase the risk of developing BO, including ischemia reperfusion injury, infections, episodes of acute rejection, degree of antigenic mismatch between donor and recipient and aspiration of gastric contents (reviewed in Ref. 2). It is the known association with acute cellular rejection (ACR) early after transplant and the subsequent development of BO that has formed the rationale for periodic surveillance lung biopsy protocols, which are performed by many centers around the world. Biopsies, performed during fiberoptic bronchoscopy procedures, provide samples to be scored for rejection so that patients experiencing early rejection can be aggressively treated and subsequent BO averted. Implicit in protocols that employ surveillance biopsy procedures are two important premises.