Surfactant protein levels in severe respiratory syncytial virus infection
Surfactant protein levels in severe respiratory syncytial virus infection
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DOI：
10.1164/ajrccm.159.4.9709065
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发表时间：
1999-04-01
影响因子：
24.7
通讯作者：
Paton, JY
中科院分区：
文献类型：
--
作者：
Kerr, MH;Paton, JY
呼吸道合胞病毒（RSV）感染是婴儿呼吸道疾病的常见原因。表面活性剂磷脂已显示在严重RSV感染中减少。表面活性蛋白的减少也可能有助于这种疾病的发病机制。我们研究了18例呼吸道合胞病毒感染的机械通气婴儿（中位年龄3.1个月）和16例机械通气手术患者（中位年龄0.4个月）的支气管肺泡灌洗液（BAL）中的每日表面活性蛋白水平。ELISA法测定表面活性蛋白，Lowry法测定总蛋白。与对照样本（中位数9.0 μ g/ml;范围0.5 - 139.6 μ g/ml，p = 0.0368）相比，RSV感染儿童BAL液中的表面活性蛋白A（SP-A）减少（中位数5.6 μ g/ml;范围0.6 - 151.9 μ g/ml）。RSV组的表面活性蛋白B（SP-B）（中位数12.0 ng/ml;范围0 - 60.8 ng/ml）低于对照组（中位数118.1 ng/ml;范围0 - 778.2 ng/ml，p < 0.0000）。RSV组中表面活性蛋白D（SP-D）也降低（中位数130.3 ng/ml;范围0至1，486.0 ng/ml），中位数600.4 ng/ml;范围0至1，869.0 ng/ml，p < 0.0000。RSV组的总蛋白水平较高（中位数0.49 mg/ml;范围0.13 - 2.46 mg/ml vs中位数0.36 mg/ml;范围0.07 - 1.65 mg/ml，p = 0.0079）。SP-A的中值在初始样品中（2.3 μ g/ml）显著低于在最终样品中（6.0 μ g/ml）。然而，没有发现表面活性蛋白浓度和动脉肺泡氧比测量的疾病严重程度之间的显着相关性。我们的结论是，表面活性蛋白浓度的改变存在于严重的RSV感染，并推测这些可能有助于在这种情况下看到的肺功能异常。
Infection with respiratory syncytial virus (RSV) is a common cause of respiratory disease in infancy. Surfactant phospholipids have been shown to be reduced in severe RSV infection. Reduction in surfactant proteins might also contribute to the pathogenesis of this disease. We investigated daily levels of surfactant proteins in bronchoalveolar lavage (BAL) fluid from 18 ventilated infants with RSV infection (median age 3.1 mo) and in a control group of 16 ventilated surgical patients (median age 0.4 mo). Surfactant proteins were measured by ELISA, total protein by the Lowry method. Surfactant protein A (SP-A) was reduced in BAL fluid from children with RSV infection (median 5.6 mu g/ml; range 0.6 to 151.9 mu g/ml) compared with control samples (median 9.0 mu g/ml; range 0.5 to 139.6 mu g/ml, p = 0.0368). Surfactant protein B (SP-B) was lower in the RSV group (median 12.0 ng/ml; range 0 to 60.8 ng/ml) than in control patients (median 118.1 ng/ml; range 0 to 778.2 ng/ml, p < 0.0000). Surfactant protein D (SP-D) was also reduced in the RSV group (median 130.3 ng/ml; range 0 to 1,486.0 ng/ml) versus median 600.4 ng/ml; range 0 to 1,869.0 ng/ml, p < 0.0000. Total protein levels were higher in the RSV group (median 0.49 mg/ml; range 0.13 to 2.46 mg/ml versus median 0.36 mg/ml; range 0.07 to 1.65 mg/ml, p = 0.0079). The median value of SP-A was significantly lower in the initial sample (2.3 mu g/ml) than in the final one (6.0 mu g/ml). However, no significant correlation was found between surfactant protein concentrations and disease severity measured by arterial alveolar oxygen ratio. We conclude that alterations in surfactant protein concentrations are present in severe RSV infection and speculate that these may contribute to the abnormalities of lung function seen in this condition.