Abstract：OBJECTIVE: To study the variation and clinical significance of serum levels of surfactant proteins A (SP-A) and D (SP-D) among children with different degrees of bronchiolitis. METHODS: Seventy children with bronchiolitis were divided into acute (n=42) and recovery phase groups (n=28). According to the severity of symptoms, the acute phase group was further divided into severe (n=12) and mild subgroups (n=30). Another 26 children who were hospitalized in the same period due to non-infectious diseases and had not undergone surgery were used as the control group. Competitive enzyme-linked immunosorbent assay was performed to measure serum levels of SP-A and SP-D in each group. RESULTS: The acute phase group had significantly higher serum levels of SP-A and SP-D compared with the recovery phase (P<0.01) and control groups (P<0.01). Compared with the control group, the recovery phase group had elevated levels of SP-A and SP-D (P<0.01). Within the acute phase group, serum levels of SP-A and SP-D in the severe subgroup were significantly higher than in the mild subgroup (P<0.01). CONCLUSIONS: Serum levels of SP-A and SP-D are significantly elevated in children with acute bronchiolitis, and severe cases have higher serum levels of SP-A and SP-D than mild cases. Even after the relief of clinical symptoms, serum levels of SP-A and SP-D remain high. These findings suggest that serum levels of SP-A and SP-D might be useful biomarkers for evaluating the severity of bronchiolitis among children.
YAO Huan-Yin,WANG Wei,ZHANG Pei-Hong et al. Determination and clinical significance of serum surfactant proteins A and D in children with bronchiolitis[J]. CJCP, 2013, 15(11): 987-989.
Barreira ER, Precioso AR, Bousso A. Pulmonary surfactant in respiratory syncytial virus bronchiolitis: The role in pathogenesis and clinical implications[J]. Pediatr Pulmonol, 2011, 46: 415-420.
[5]
Gram K, Yang S, Steiner M, Somani A, Hawgood S, Blazar BR, et al. Simultaneous absence of surfactant proteins A and D increases lung inflammation and injury after allogeneic HSCT in mice[J]. Am J Physiol Lung Cell Mol Physiol, 2009, 296(2): L167-L175.
[6]
Hartshorn KL. Role of surfactant protein A and D (SP-A and SP-D) in human antiviral host defense[J]. Front Biosci, 2010, 1(2): 527-546.
[7]
Duvoix A, Miranda E, Perez J, Sorensen GL, Holmskov U, Trapnell BC, et al. Evaluation of full-length, cleaved and nitrosylated serum surfactant protein D as biomarkers for COPD[J]. COPD, 2011, 8(2): 79-95.
Ishikawa N, Hattori N, Tanaka S, Horimasu Y, Haruta Y, Yokoyama A, et al. Levels of surfactant proteins A and D and KL-6 are elevated in the induced sputum of chronic obstructive pulmonary disease patients: a sequential sputum analysis[J]. Respiration, 2011, 82(1): 10-18.
[10]
Kawasaki Y, Endo K, Suyama K, Sato M, Ito M, Hashimoto K, et al. Serum SP-D levels as a biomarker of lung injury in respiratory syncytial virus bronchiolitis[J]. Pediatr Pulmonol, 2011, 46(1): 18-22.
Kerr MH, Paton JY. Surfactant protein levels in serere respiratory syncytial virus infection[J]. Am J Respir Crit Care Med, 1999, 159(4): 1115-1118．
[13]
El Saleeby CM, Li R, Somes GW, Dahmer MK, Quasney MW, DeVicenzo JP. Surfactant protein A2 polymorphisms and disease severity in a respiratory syncytial virus-infected population[J]. J Pediatr, 2010, 156: 409-414.
