High serum concentrations of surfactant protein A in usual interstitial pneumonia compared with non-specific interstitial pneumonia.
BACKGROUND
The pathological diagnosis of interstitial lung diseases (ILD) by surgical lung biopsy is important for clinical decision making. There is a need, however, to use serum markers for differentiating usual interstitial pneumonia (UIP) from other ILD. Surfactant protein (SP)-A, SP-D, KL-6, sialyl SSEA-1 (SLX), and sialyl Lewis(a) (CA19-9) are useful markers for the diagnosis and evaluation of activity of ILD. We have investigated the usefulness of these proteins as markers of UIP.


METHODS
Serum and bronchoalveolar lavage (BAL) fluid levels of the above five markers were measured in 57 patients with various forms of ILD (19 with UIP, 12 with non-specific interstitial pneumonia (NSIP), eight with bronchiolitis obliterans organising pneumonia (BOOP), and 10 with sarcoidosis), eight patients with the control disease (diffuse panbronchiolitis (DPB)), and nine healthy volunteers.


RESULTS
Serum levels of SP-A, SP-D, and KL-6 in patients with UIP and NSIP were significantly higher than in healthy volunteers. In particular, the serum levels of SP-A in patients with UIP were significantly higher than in patients with NSIP (p<0.0001, mean difference -58.3 ng/ml, 95% confidence interval -81.6 to -35.0), and BAL fluid levels of SP-D in patients with UIP were significantly lower than in patients with NSIP (p=0.01, mean difference 322.4 ng/ml, 95% confidence interval 79.3 to 565.5).


CONCLUSIONS
Serum SP-A levels may be clinically useful as a biomarker to differentiate between UIP and NSIP.
Ishii
H
H
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Mukae
H
H
Kadota
J
J
Kaida
H
H
Nagata
T
T
Abe
K
K
Matsukura
S
S
Kohno
S
S
D000328:Adult; D000368:Aged; D000941:Antigens; D000951:Antigens, Neoplasm; D015415:Biomarkers / Q000032:analysis; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D018395:CA-19-9 Antigen / Q000032:analysis; D002452:Cell Count; D005260:Female; D006023:Glycoproteins; D006801:Humans; D016256:Lewis X Antigen / Q000032:analysis; D017563:Lung Diseases, Interstitial / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018396:Mucin-1; D009077:Mucins; D037662:Pulmonary Surfactant-Associated Protein A / Q000032:analysis / Q000097:blood*; D037701:Pulmonary Surfactant-Associated Protein B / Q000032:analysis
D000941:Antigens; D000951:Antigens, Neoplasm; D015415:Biomarkers; D018395:CA-19-9 Antigen; D006023:Glycoproteins; D016256:Lewis X Antigen; C060192:MUC1 protein, human; D018396:Mucin-1; D009077:Mucins; D037662:Pulmonary Surfactant-Associated Protein A; D037701:Pulmonary Surfactant-Associated Protein B