Abstract
Background/aim
The aim of this study was to investigate the possible role of surfactant protein D (SP-D) in the pathogenesis and the prognosis of idiopathic pulmonary fibrosis (IPF).
Materials and methods
This study was performed on 10 healthy volunteers (group 1) and 30 patients from the Chest Diseases Department, Kasr El-Aini Hospital, who were divided into three groups: group 2 consisted of 10 patients with IPF receiving steroids; group 3 consisted of 10 patients with IPF not receiving steroids; and group 4 consisted of 10 patients with chronic chest diseases other than IPF and not receiving steroids. All patients underwent full history taking, thorough clinical examination, chest radiography and high-resolution computed tomography of the chest, pulmonary function testing, and estimation of SP-D by enzyme-linked immunosorbent assay.
Results
There was no statistical significance in the mean age of the four included groups. With regard to smoking in patients in groups 2, 3, and 4, there was no statistical significance in the duration or the number of cigarettes smoked per day. There was a significant decrease in FEV1, FVC, and FEV1/FVC in groups 2, 3, and 4 compared with the control group (group 1). SP-D shows a significant increase in groups 2, 3, and 4 compared with the control group, and also shows a significant increase in IPF patients not receiving steroids (group 3) compared with IPF patients receiving steroids (group 2) and patients with chronic chest diseases (group 4). A negative correlation was found between SP-D and FEV1, FVC, and FEV1/FVC. No correlation was found between SP-D, age, the duration of smoking, or the number of cigarettes smoked per day.
Conclusion
The SP-D assay may indicate the rate of decline in the pulmonary function in cases of IPF and in the follow-up of disease progress. It may also assist in making clinical choices for the therapeutic management of patients with IPF.
Article PDF
Similar content being viewed by others
References
American Thoracic Society (ATS)/European Respiratory Society (ERS). American Thoracic Society (ATS)/European Respiratory Society (ERS) International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med 2002; 165:277–304.
Jeffrey AW, Ann DH. 2008. Fishman’s pulmonary diseases and disorders. Vol. 1 and 2, ISBN: 0-07-145739-9 4th ed.
Ikegami M, Clinton NA, Korfhagen TR, Whitsett JA. Surfactant protein D influences surfactant ultrastructure and uptake by alveolar type II cells. Am J Physiol 2005; 288:L552.
Wert SE, Yoshida M, LeVine AM, Ikegami M, Jones T, Ross GF, et al. Increased metalloproteinase activity, oxidant production, and emphysema in surfactant protein D gene-inactivated mice. Proc Natl Acad Sci USA 2000; 97:5972.
Whitsett JA, Weaver TE. Hydrophobic surfactant proteins in lung function and disease. N Engl J Med 2002; 347:2141.
Shimizu H, Hosoda K, Mizumoto M, Kuroki Y, Sato H, Kataoka K, et al. Improved immunoassay for the determination of surfactant protein A (SP-A). Tohoku J Exp Med 1989; 157:269–278.
Honda Y, Kuroki Y, Matsuura E, Nagae H, Takahashi H, Akino T, Abe S. Pulmonary surfactant protein D in sera and bronchoalveolar lavage fluids. Am J Respir Crit Care Med 1995a; 152:1860–1866.
Nagae H, Takahashi H, Kuroki Y, Honda Y, Nagata A, Ogasawara Y, et al. Enzyme-linked immunosorbent assay using F(ab’)2 fragment for the detection of human pulmonary surfactant D in sera. Clin Chim Acta 1997; 266:157–171.
Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plot: a fundamental evaluation tool in clinical medicine. Clin Chem 1993; 39: 561–577.
Thomas AQ, Lane K, Phillips JIII. Heterozygosity for a surfactant protein C gene mutation associated with usual interstitial pneumonitis and cellular nonspecific interstitial pneumonitis in one kindred. Am J Respir Crit Care Med 2002; 165:1322.
Collard HR, King TE, Bartelson BB, Vourlekis JS, Schwarz MI, Brown KK. Changes in clinical and physiological variables predict survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2003; 168:538–542.
Schwartz DA, VanFossen DS, Davis CS, Helmers RA, Dayton CS, Burmeister LF, Hunninghake GW. Determinants of progression in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2005; 149:444–449.
McCormack FX, King TE, Voelker DR, Robinson PC, Mason RJ. Idiopathic pulmonary fibrosis: abnormalities in the bronchoalveolar lavage content of surfactant protein A. Am Rev Respir Dis 1991; 144:160–166.
Honda Y, Kuroki Y, Shijubo N, Fujishima T, Takahashi H, Hosoda K, et al. Aberrant appearance of lung surfactant protein A in sera of patients with idiopathic pulmonary fibrosis and its clinical significance. Respiration 1995b; 62:64–69.
Takahashi H. Am J Respir Crit Care Med 2000; 162:1109–1114.
Takahashi H, Fujishima T, Koba H. Serum surfactant proteins A and D as prognostic factors in idiopathic pulmonary fibrosis and their relationship to disease extent. Am J Respir Crit Care Med 2000; 162:1109–1114.
Barlo NP, van Moorsel CH, Ruven HJ, Zanen P, van-den Bosch JM, Grutters JC. Surfactant protein-D predicts survival in patients with idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis 2009; 26:155–161.
Kinder BW, Brown KK, McCormack FX, Ix JH, Kervitsky A, Schwarz MI, King TE. Serum surfactant protein-A is a strong predictor of early mortality in idiopathic pulmonary fibrosis. Chest 2009; 135:1557–1563.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
El-Miligy, D., Zakaria, M.W., Rashed, L. et al. Serum surfactant protein D as a prognostic factor in idiopathic pulmonary fibrosis. Egypt J Bronchol 9, 64–68 (2015). https://doi.org/10.4103/1687-8426.153654
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/1687-8426.153654