Abstract：Objective To observe the levels of pulmonary surfactant proteins A and D (SP-A, SP-D) in bronchoalveolar lavage fluid (BALF) of children with pneumonia, and to explore their relationships with clinical characteristics. Methods Thirty-five children with pneumonia were enrolled in this study. Differential cell counts were obtained by Countstar counting board. The levels of SP-A and SP-D in BALF were detected using ELISA. Results In children with pneumonia, SP-D levels were significantly higher than SP-A levels (Prs=-0.5255, P8 mg/L) were significantly lower than in those with a normal level of C-reactive protein (PPConclusions SP-D levels in BALF are significantly higher than SP-A levels, and have a certain correlation with clinical characteristics in children with pneumonia. As a protective factor, SP-D plays a more important role than SP-A in regulating the immune and inflammatory responses.
WANG Li-Li,ZHENG Shou-Yan,REN Luo et al. Levels of surfactant proteins A and D in bronchoalveolar lavage fluid of children with pneumonia and their relationships with clinical characteristics[J]. CJCP, 2016, 18(5): 386-390.
Nayak A, Dodagatta-Marri E, Tsolaki AG, et al. An insight into the diverse roles of surfactant proteins, SP-A and SP-D in innate and adaptive immunity[J]. Front Immunol, 2012, 3(5): 1-21.
[4]
Hagio T, Kishikawa K, Kawabata K, et al. Inhibition of neutrophil elastase reduces lung injury and bacterial count in hamsters[J]. Pulm Pharmacol Ther, 2008, 21(6): 884-891.
[5]
Tyrrell C, McKechnie SR, Beers MF, et al. Differential alveolar epithelial injury and protein expression in pneumococcal pneumonia[J]. Exp Lung Res, 2012, 38(5): 266-276.
[6]
Güzel A, Karadağ A, Okuyucu A, et al. The evaluation of serum surfactant protein D (SP-D) levels as a biomarker of lung injury in tuberculosis and different lung diseases[J]. Clin Lab, 2014, 60(7):1091-1098.
de Blic J, Midulla F, Barbato A, et al. Bronchoalveolar lavage in children. ERS Task Force on bronchoalveolar lavage in children[J]. Eur Respir J, 2000, 15(1): 217-231.
Han S, Mallampalli RK. The role of surfactant in lung disease and host defense against pulmonary infections[J]. Ann Am Thorac Soc, 2015, 12(5): 765-774.
[12]
Ariki S, Nishitani C, Kuroki Y. Diverse functions of pulmonary collectins in host defense of the lung[J]. J Biomed Biotechnol, 2012, 2012(2): 1-7.
[13]
Garcia Laorden MI, de Castro FR, Sole-Violan J, et al. Influence of genetic variability at the surfactant proteins A and D in community-acquired pneumonia: a prospective, observational, genetic study[J]. Crit Care, 2011, 15(1): 15-27.
[14]
LeVine AM, Whitsett JA, Gwozdz JA, et al. Distinct effects of surfactant protein A or D deficiency during bacterial infection on the lung[J]. J Immunol, 2000, 165(7): 3934-3940.
[15]
Shu LH, Lu Q, Han LY, et al. SP-D, KL-6, and HTI-56 levels in children with mycoplasma pneumoniae pneumonia[J]. Int J Clin Exp Pathol, 2015, 8(9): 11185-11191.
[16]
Douda DN, Jackson R, Grasemann H, et al. Innate immune collectin surfactant protein D simultaneously binds both neutrophil extracellular traps and carbohydrate ligands and promotes bacterial trapping[J]. J Immunol, 2011, 187(4): 1856-1865.
[17]
Ampuero S, Luchsinger V, Tapia L, et al. SP-A1, SP-A2 and SP-D gene polymorphisms in severe acute respiratory syncytial infection in Chilean infants[J]. Infect Genet Evol, 2011, 11(6): 1368-1377.
[18]
Delgado C, Krotzsch E, Jimenez-Alvarez LA, et al. Serum surfactant protein D (SP-D) is a prognostic marker of poor outcome in patients with A/H1N1 virus infection[J]. Lung, 2015, 193(1): 25-30.
[19]
Griese M, Steinecker M, Schumacher S, et al. Children with absent surfactant protein D in bronchoalveolar lavage have more frequently pneumonia[J]. Pediatr Allergy Immunol, 2008, 19(7): 639-647.
[20]
Schleh C, Rothen-Rutishauser BM, Blank F, et al. Surfactant Protein D modulates allergen particle uptake and inflammatory response in a human epithelial airway model[J]. Respir Res, 2012, 13(1): 25-35.
[21]
Forbes LR, Haczku A. SP-D and regulation of the pulmonary innate immune system in allergic airway changes[J]. Clin Exp Allergy, 2010, 40(4): 547-562.
[22]
Liu CF, Rivere M, Huang HJ, et al. Surfactant protein D inhibits mite-induced alveolar macrophage and dendritic cell activations through TLR signalling and DC-SIGN expression[J]. Clin Exp Allergy, 2010, 40(1): 111-122.
Gidaris D, Kanakoudi-Tsakalidou F, Papakosta D, et al. Bronchoalveolar lavage in children with inflammatory and non inflammatory lung disease[J]. Hippokratia, 2010, 14(2): 109-114.
[26]
Liu CF, Chen YL, Shieh CC, et al. Therapeutic effect of surfactant protein D in allergic inflammation of mite-sensitized mice[J]. Clin Exp Allergy, 2005, 35(4): 515-521.
