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Surfactant protein D as a marker for pulmonary complications in pediatric patients with sickle cell disease: Relation
Azza A Tantawy1, Amira A Adly1, Fatma S E Ebeid1
1Faculty of Medicine, Pediatrics Department, Ain Shams University, Cairo, Egypt.
Insights
Surfactant protein D (SP-D) is elevated in children with sickle cell disease (SCD), indicating potential lung damage. Higher SP-D levels correlate with worse lung function and interstitial lung disease severity in SCD patients.
Area of Science:
- Pulmonary Medicine
- Biomarker Discovery
- Pediatric Hematology
Background:
- Surfactant protein D (SP-D) is a key component of the innate immune system in the lungs.
- SP-D is recognized as a potential indicator of lung integrity and disease progression.
- Sickle cell disease (SCD) is associated with significant pulmonary complications.
Purpose of the Study:
- To determine surfactant protein D (SP-D) levels in children and adolescents with SCD.
- To assess the relationship between SP-D levels and pulmonary complications in SCD.
- To evaluate the association of SP-D with lung function parameters in SCD patients.
Main Methods:
- Serum SP-D levels were measured in 50 SCD patients and 30 healthy controls.
- High-resolution computerized tomography (HRCT) was used to assess lung structure.
- Pulmonary function tests (PFTs), including FVC, FEV1, FEV1/FVC%, and FEF25-75%, were performed.
Main Results:
- SP-D levels were significantly higher in SCD patients compared to controls, especially in those with sickle cell anemia.
- SP-D levels correlated positively with disease severity, interstitial lung disease, HbS, and serum ferritin.
- SP-D levels negatively correlated with hydroxyurea treatment duration and pulmonary function parameters.
- A SP-D cutoff of 720 ng/mL demonstrated 82% sensitivity and 88% specificity for detecting abnormal pulmonary function in SCD.
Conclusions:
- SP-D is a potential biomarker for assessing lung integrity in pediatric SCD patients.
- Elevated SP-D levels are associated with pulmonary complications and impaired lung function in SCD.
- SP-D may serve as a valuable tool for screening SCD patients at risk for pulmonary issues.
Background:
Surfactant protein D (SP-D) is considered a candidate biomarker for lung integrity and for disease progression.
Aim:
We determined the level of SP-D in children and adolescents with SCD and assessed its possible relation to pulmonary complications and lung function.
Methods:
Serum SP-D levels were assessed in 50 SCD patients compared with 30 healthy controls. High-resolution computerized tomography (HRCT) of the chest was done. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1 ), FEV1 /FVC% and forced expiratory flow rate during 25-75% of expiration (FEF25-75%) were determined.
Results:
SP-D was significantly higher in SCD patients than controls, particularly patients with sickle cell anemia than those with sickle β-thalassemia. SP-D levels were significantly associated with increasing severity of interstitial lung disease. The highest SP-D levels were observed among patients with restrictive lung disease followed by mixed type then obstructive lung disease. SP-D was positively correlated to HbS and serum ferritin while negatively correlated to duration of hydroxyurea treatment and parameters of pulmonary functions. ROC curve analysis revealed that SP-D cutoff value 720 ng/mL could significantly detect the presence of abnormal pulmonary function among SCD patients with 82% sensitivity and 88% specificity. Logistic regression analysis showed that SP-D is an independent factor related to abnormal pulmonary function in SCD.
Conclusions:
SP-D may be a promising biomarker for screening of SCD patients for risk of later pulmonary complications.
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