, Volume 193, Issue 1, pp 25–30 | Cite as

Serum Surfactant Protein D (SP-D) is a Prognostic Marker of Poor Outcome in Patients with A/H1N1 Virus Infection

  • Carlos Delgado
  • Edgar Krötzsch
  • Luis A. Jiménez-Alvarez
  • Gustavo Ramírez-Martínez
  • Jose E. Márquez-García
  • Alfredo Cruz-Lagunas
  • Juan Morán
  • Cármen Hernández
  • Patricia Sierra-Vargas
  • Federico Avila-Moreno
  • Carina Becerril
  • Martha Montaño
  • José L. Bañales-Méndez
  • Joaquín Zúñiga
  • Ivette Buendía-Roldán



Surfactant protein D (SP-D) plays an important role in the innate responses against pathogens and its production is altered in lung disorders.


We studied the circulating levels of SP-D in 37 patients with acute respiratory distress syndrome due to the A/H1N1 virus infection and in 40 healthy controls. Cox logistic regression models were constructed to explore the association of SP-D levels and risk of death.


Mortality rate after a 28-day was 32.42 %. Significant higher levels of SP-D were detected in A/H1N1 patients with fatal outcome (p < 0.05). After adjusting for confounding variables, levels of SP-D ≥250 ng/mL were associated with increased the risk of death (HR = 8.27, 95 % CI 1.1–64.1, p = 0.043).


Our results revealed that higher circulating levels of SP-D are associated with higher mortality risk in critically ill A/H1N1 patients. SP-D might be a predictive factor of poor outcomes in viral pneumonia.


Surfactant protein D (SP-D) A/H1N1 virus Influenza ARDS Mortality Biomarker 



The authors thanks to the patients for their participation in this study. This study was supported by a Grant No. 127002 of the “Fondo Sectorial de Investigación en Salud y Seguridad Social” (FOSISSS) from the National Council of Science and Technology of Mexico (CONACYT).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Carlos Delgado
    • 1
  • Edgar Krötzsch
    • 2
  • Luis A. Jiménez-Alvarez
    • 3
  • Gustavo Ramírez-Martínez
    • 3
  • Jose E. Márquez-García
    • 3
  • Alfredo Cruz-Lagunas
    • 3
  • Juan Morán
    • 3
  • Cármen Hernández
    • 3
  • Patricia Sierra-Vargas
    • 3
  • Federico Avila-Moreno
    • 4
  • Carina Becerril
    • 3
  • Martha Montaño
    • 3
  • José L. Bañales-Méndez
    • 3
    • 5
  • Joaquín Zúñiga
    • 3
  • Ivette Buendía-Roldán
    • 3
    • 6
  1. 1.Surgical Intensive Care Unit, Centro Médico Nacional “20 de Noviembre”ISSSTEMexico CityMexico
  2. 2.Connective Tissue Laboratory, Centro Nacional de Investigación y Atención de QuemadosInstituto Nacional de RehabilitaciónMexico CityMexico
  3. 3.Instituto Nacional de Enfermedades Respiratorias Ismael Cosío VillegasMexico CityMexico
  4. 4.FES-Iztacala, Unidad de Biomedicina, UBIMED, Universidad Nacional Autónoma de MéxicoMexico CityMexico
  5. 5.Instituto Nacional de Cardiología Ignacio ChávezMexico CityMexico
  6. 6.Research UnitInstituto Nacional de Enfermedades RespiratoriasMexico CityMexico

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