Understanding European cross-border cooperation: a framework for analysis

European integration has had a dual impact on border regions. On the one hand, borders were physically dismantled across most of the EU’s internal territory. On the other hand, they have become a fertile ground for territorial co-operation and institutional innovation. The degree of cross-border co-operation and organization achieved varies considerably from one region to another depending on a combination of various facilitating factors for effective cross-border co-operation, more specifically, economic, political leadership, cultural/identity and state formation, and geographical factors. This article offers a conceptual framework to understand the growth and diversity of cross-border regionalism within the EU context by focusing on the levels of and drives for co-operation

Altered pIgR/IgA mucosal immunity in bronchiolitis obliterans syndrome

Aims: Long-term survival after lung transplantation (LT) is hampered by the occurrence of chronic lung allograft dysfunction (CLAD), manifesting as bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS). CLAD is triggered by several factors, e.g. recurrent infections. As immunoglobulin (Ig) A is crucial to ensure mucosal immunity and limit airway microbial load, we explored whether IgA and its epithelial receptor, the polymeric Ig receptor (pIgR) are impaired in BOS. Methods: Bronchoalveolar lavages (BAL, n=120) from LT recipients included in the Cohort for Lung Transplantation were collected at pre-defined timepoints prior to the diagnosis of functional stability (BOS-free, n=30) or BOS (pre-BOS, n=30), and assessed for secretory (S)-IgA. Bronchiolar epithelium pIgR expression was quantified in transbronchial biopsies from BOS-free (n=20), pre-BOS (n=19) and BOS LT recipients (n=12), as well as in end-stage BOS explants (n=15). Results: S-IgA levels were reduced in BAL from pre-BOS LT recipients versus BOS-free (16.1 vs 33.4 µg/ml, p<0.01). pIgR bronchiolar expression was reduced in transbronchial biopsies from BOS (p<0.05 vs BOS-free and pre-BOS), with further decrease in end-stage BOS explants (p<0.0001 vs BOS-free and pre-BOS). Conclusions: BAL S-IgA and pIgR decreased levels suggest that the pIgR/IgA system is impaired in BOS. This could play a pathogenic role by increasing susceptibility to local infections