Serum Surfactant Protein D as a Prognostic Factor in Idiopathic Pulmonary Fibrosis Patients

Document Type : Original Article

Authors

1 Medical Biochemistry Department, Faculty of Medicine, October 6 University

2 Medical Biochemistry Department, Faculty of Medicine, Cairo University

3 Chest Diseases Department, Faculty of Medicine, Cairo University

Abstract

Idiopathic pulmonary fibrosis (IPF) carries a 50% 5-years survival rate. The
pathogenesis of IPF is characterized by chronic inflammation, fibroblast proliferation
and extracellular matrix production with chronic scarring and honeycomb formation.
This fibroproliferative response is uniformly accompanied by type II cell hyperplasia.
Surfactant proteins–D (SP-D), is produced and secreted by type II cells. It can be
detected in serum and is elevated in patients with certain inflammatory lung diseases.
Measurement of this protein might be a useful marker for early detection of IPF and
its prognosis. The present work was conducted on 30 patients, and 10 healthy
volunteers obtained from chest Department, Faculty of Medicine, Cairo University,
and were categorized into four groups as follows: Group 1: Included ten healthy
volunteers as control group, Group 2: Consists of ten patients with idiopathic
pulmonary fibrosis (IPF) received steroid therapy for one month, Group 3: Ten
patients with idiopathic pulmonary fibrosis (IPF) not receiving steroid therapy and
Group 4: Included ten patients with chronic chest disease without idiopathic
pulmonary fibrosis. All groups were subjected to history taking, pulmonary function
test and estimation of serum surfactant D (SP-D level) by ELISA. The results of the
present study showed significant decrease in the pulmonary function tests represented
by forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)
(FEV1/FVC%) in the three diseased groups compared to control. Mean level of SP-D
in serum showed a highly significant increase in the three diseased groups compared
to control. The mean level of serum SP-D is significantly higher in group 3 compared
to group 2. Furthermore, significant negative correlation was found between SP-D
serum level and FEV1 and FEV1/FVC in all IPF patients. From these results it could
be concluded that the SP-D assay may be of value in estimating the rate of decline in
pulmonary function in cases of IPF as well as in the follow up of disease progress. It
may also assist in making clinical choices for therapeutic management of these
patients.

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