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Surfactant protein D in serum from patients with allergic bronchopulmonary aspergillosis
Abstract:
Surfactant protein D (SP-D) interacts with Aspergillus fumigatus and is strongly increased in the lavage from animals with acute allergic reactions to the fungus, suggesting a central role for SP-D. As the course of cystic fibrosis (CF) is often complicated by an allergic bronchopulmonary aspergillosis (ABPA), the authors hypothesised that SP-D may also be increased in serum during an ABPA, potentially assisting in its diagnosis and follow-up. In 22 patients with CF (11 with ABPA, 11 matched without ABPA) and 19 control patients without a pulmonary disease, SP-D concentrations in serum were assessed by an enzyme immunoassay. Serum SP-D in CF patients (130 +/- 16 ng x mL(-1) (mean +/- SEM)) was significantly higher than in the controls without lung disease (66 +/- 8 ng x mL(-1)). During the whole ABPA-episode, SP-D level did not change significantly, despite large changes of total serum immunoglobulin E. There was a clear negative correlation between SP-D concentration and overall lung function, i.e. forced expiratory volume in one second and forced vital capacity. Serum level of surfactant protein D may be of value to follow pulmonary function and lung injury in cystic fibrosis patients. Surfactant protein D serum levels are not helpful for the diagnosis and follow-up of an allergic bronchopulmonary aspergillosis episode, contrary to what was expected from animal experiments.
Insights
Surfactant protein D (SP-D) is elevated in cystic fibrosis (CF) patients and correlates with lung function decline. However, serum SP-D levels do not aid in diagnosing or monitoring allergic bronchopulmonary aspergillosis (ABPA) in CF patients.
Area of Science:
- Pulmonary Medicine
- Immunology
- Biochemistry
Background:
- Surfactant protein D (SP-D) plays a role in immune responses to Aspergillus fumigatus.
- Allergic bronchopulmonary aspergillosis (ABPA) is a common complication in cystic fibrosis (CF).
- Previous animal studies suggest SP-D may be involved in ABPA.
Purpose of the Study:
- To investigate serum SP-D concentrations in CF patients with and without ABPA.
- To assess the potential of serum SP-D as a diagnostic or monitoring biomarker for ABPA in CF.
- To explore the relationship between serum SP-D levels and lung function in CF patients.
Main Methods:
- Serum SP-D levels were measured using enzyme immunoassay in 22 CF patients (11 with ABPA, 11 without) and 19 controls.
- Lung function was assessed by forced expiratory volume in one second (FEV1) and forced vital capacity (FVC).
- Serum SP-D levels were compared between groups and correlated with lung function parameters.
Main Results:
- Serum SP-D levels were significantly higher in CF patients compared to controls.
- Serum SP-D levels did not change significantly during ABPA episodes.
- A negative correlation was observed between serum SP-D concentration and lung function (FEV1 and FVC).
Conclusions:
- Serum SP-D levels may serve as a marker for lung injury and to monitor pulmonary function in CF patients.
- Serum SP-D is not a reliable biomarker for the diagnosis or follow-up of ABPA episodes in CF.
- Findings contrast with expectations from animal studies regarding SP-D's role in ABPA diagnosis.
