title: Circulating surfactant protein D is decreased in systemic lupus erythematosus.
abstract: OBJECTIVE
  Deficiencies of innate immune molecules like mannan binding lectin (MBL) have been implicated in the pathogenesis of systemic lupus erythematosus (SLE). Surfactant protein D (SP-D) and MBL belong to the same family of innate immune molecules - the collectins, which share important structural and functional properties. We aimed to compare concentrations of serum SP-D in patients with SLE and in healthy controls, and to investigate if SP-D is associated with selected disease indicators. We investigated the possible association of the Met11Thr polymorphism with disease, since this polymorphism is an important determinant for serum level, oligomerization pattern, and function of SP-D.
  
  
  METHODS
  Serum SP-D was measured using a 5-layer ELISA in 70 SLE patients and 1476 healthy subjects. DNA was genotyped for the Met11Thr variant.
  
  
  RESULTS
  Median SP-D level in serum was 911 ng/ml (95% CI 776-1118) in patients and 1068 ng/ml (95% CI 901-1246) in controls (p = 0.0004). Circulating SP-D did not differ significantly in patients with high, intermediate, or low SLE disease activity. Similarly, SP-D did not correlate with C-reactive protein, erythrocyte sedimentation rate, and anti-dsDNA seropositivity. Genetic analysis did not support an association of the Met11Thr genotype with SLE.
  
  
  CONCLUSIONS
  These findings suggest that low SP-D, unrelated to conventional disease indicators, represents an aspect of SLE etiopathogenesis.
authors.affiliation: Medical Biotechnology Center, Institute of Medical Biology, University of Southern Denmark, Odense, Denmark.
authors.forename: Silje Vermedal
authors.initials: SV
authors.lastname: Hoegh
authors.forename: Anne
authors.initials: A
authors.lastname: Voss
authors.forename: Grith Lykke
authors.initials: GL
authors.lastname: Sorensen
authors.forename: Anette
authors.initials: A
authors.lastname: Høj
authors.forename: Christian
authors.initials: C
authors.lastname: Bendixen
authors.forename: Peter
authors.initials: P
authors.lastname: Junker
authors.forename: Uffe
authors.initials: U
authors.lastname: Holmskov
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood* / Q000235:genetics; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D037663:Pulmonary Surfactant-Associated Protein D