Children with absent surfactant protein D in bronchoalveolar lavage have more frequently pneumonia.
Surfactant protein D (SP-D) is an important component of the pulmonary host defense system. We hypothesized that bronchoalveolar lavage (BAL) SP-D levels are lower in children presenting with recurrent bronchitis, providing evidence for a role of SP-D in human respiratory diseases. SP-D levels in BAL were measured in 45 children, who suffered from recurrent bronchitis for an average of 2-3 yr. Clinical outcome was assessed 2 yr after BAL. For comparison, BAL fluids from 15 control children without respiratory symptoms were evaluated. Among the 45 children with recurrent bronchitis, 12 had no SP-D in their BAL at the time of investigation. These SP-D-deficient patients had more frequently pneumonias and their long-term outcome was worse than that of the children with detectable SP-D. No genetic cause could be identified for the SP-D deficiency. Among the children with recurrent bronchitis and SP-D clearly detectable in BAL, those with the diagnosis of allergic asthma had threefold elevated levels compared with controls. In accordance with animal and in vitro data, elevated SP-D concentrations in BAL may represent an up-regulation due to allergic airway inflammation. In contrast, SP-D deficiency due to consumption or failure to up-regulate SP-D may be linked to pulmonary morbidity in children.
Griese
M
M
Children's Hospital, Grosshadern, University of Munich, Munich, Germany. matthias.griese@med.uni-muenchen.de
Steinecker
M
M
Schumacher
S
S
Braun
A
A
Lohse
P
P
Heinrich
S
S
D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology; D011110:Polymorphism, Genetic; D037663:Pulmonary Surfactant-Associated Protein D / Q000032:analysis / Q000172:deficiency* / Q000235:genetics
D037663:Pulmonary Surfactant-Associated Protein D