Surfactant protein-D predicts survival in patients with idiopathic pulmonary fibrosis.
BACKGROUND
Idiopathic pulmonary fibrosis is a progressive interstitial lung disease with a high mortality rate. As lung transplantation is the only therapeutic option, it is important to predict survival.


OBJECTIVE
This study evaluates the clinical value of surfactant protein-D as a marker of prognosis in patients with idiopathic pulmonary fibrosis.


METHODS
Surfactant protein-D was measured in serum of 72 patients and 305 healthy controls. The optimal cut-off level to define unfavourable prognosis was determined using a ROC analysis. A Cox's proportional Hazards model was used to evaluate variables that were significant predictors of survival.


RESULTS
Serum levels of surfactant protein-D were significantly higher in patients than in controls. ROC analysis showed 460 ng/ml to be the optimal cut-off level to discriminate survivor from non-survivors after 1 year. Patients with high levels (> 460 ng/ml) had a median survival time of 13 months, compared to 67 months in the group with low levels (< 460 ng/ml). Surfactant protein-D showed to be a significant predictor of prognosis, even when corrected for age, sex, smoking, and lung function.


CONCLUSIONS
The measurement of surfactant protein-D in serum of patients with idiopathic pulmonary fibrosis might be a clinically relevant tool to predict survival.
Barlo
N P
NP
Centre for Interstitial Lung Diseases, Department of Pulmonology, St. Antonius Hospital Nieuwegein, The Netherlands.
van Moorsel
C H M
CH
Ruven
H J T
HJ
Zanen
P
P
van den Bosch
J M M
JM
Grutters
J C
JC
D000328:Adult; D000483:Alleles; D015415:Biomarkers / Q000378:metabolism; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D004247:DNA / Q000235:genetics*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000235:genetics / Q000378:metabolism / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011110:Polymorphism, Genetic; D011379:Prognosis; D016016:Proportional Hazards Models; D037663:Pulmonary Surfactant-Associated Protein D / Q000235:genetics / Q000378:metabolism*; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate
D015415:Biomarkers; D037663:Pulmonary Surfactant-Associated Protein D; D004247:DNA