Increased surfactant protein-A levels in patients with newly diagnosed idiopathic pulmonary fibrosis
Increased surfactant protein-A levels in patients with newly diagnosed idiopathic pulmonary fibrosis
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DOI：
10.1378/chest.125.2.617
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发表时间：
2004-02-01
期刊：
影响因子：
9.6
通讯作者：
Selman, M
中科院分区：
文献类型：
--
作者：
Phelps, DS;Umstead, TM;Selman, M
研究目的：为了测量特发性肺纤维化（IPF）患者的BAL中的表面活性蛋白-A（SP-A）。设计：我们检查了在诊断时和开始治疗之前满足更严格的IPF推荐标准的IPF患者的BAL和肺组织中的SP-A。将26例经活检证实的IPF患者和22例过敏性肺炎（HP）患者与9例正常志愿者进行比较。所有患者均进行肺功能检测，BAL，肺活检前开始treatment.Measurements和结果：我们测量的SP-A在BAL液和肺标本进行SP-A免疫组化。IPF患者的肺组织显示广泛的II型细胞增生，通常含有水平显著升高的免疫反应性SP-A。通过酶联免疫吸附试验，我们发现BAL SP-A比正常值增加了两倍，而总磷脂没有变化。这些数据与SP-A的蛋白质免疫印迹和十二烷基硫酸钠凝胶的Western印迹半定量评估一致。HP患者BAL SP-A增加了三倍。结论：我们的研究结果与先前发表的描述OF中SP-A水平降低的报告之间存在差异的原因尚不清楚。这可能与更严格的诊断标准、BAL前缺乏治疗、患者人群差异或其他方法学差异有关。
Study objectives: To measure surfactant protein-A (SP-A) in the BAL of patients with idiopathic pulmonary fibrosis (IPF).Design: We examined SP-A in BAL and lung tissue of patients with IPF who met the stricter recommended criteria for IPF at the time of diagnosis and prior to the beginning of treatment.Patients: Twenty-six patients with IPF confirmed at biopsy and 22 patients with hypersensitivity pneumonitis (HP) were compared with 9 normal volunteers.Interventions: All patients were subjected to pulmonary function testing, BAL, and lung biopsy prior to the beginning of treatment.Measurements and results: We measured SP-A in BAL fluids and performed SP-A immunohistochemistry on lung specimens. Lung tissues of patients with IPF showed extensive type II cell hyperplasia, usually containing greatly increased levels of immunoreactive SP-A. By enzyme-linked immunosorbent assay, we found a twofold increase over normal values in BAL SP-A without changes in total phospholipids. These data were in agreement with semiquantitative assessments of SP-A by protein immunoblotting and by Western blotting of sodium dodecyl sulfate gels. Patients with HP exhibited a threefold increase of BAL SP-A.Conclusions: The reasons for the difference between our results and previously published reports describing decreased SP-A levels in OF is not clear. It may relate to the stricter criteria for diagnosis, the absence of treatment prior to BAL, differences in the patient population, or to other methodologic differences.