Kerr M H, Paton J Y
Department of Child Health, University of Glasgow, Royal Hospital for Sick Children, Glasgow, Scotland.
Am J Respir Crit Care Med. 1999 Apr;159(4 Pt 1):1115-8. doi: 10.1164/ajrccm.159.4.9709065.
Infection with respiratory syncytial virus (RSV) is a common cause of respiratory disease in infancy. Surfactant phospholipids have been shown to be reduced in severe RSV infection. Reduction in surfactant proteins might also contribute to the pathogenesis of this disease. We investigated daily levels of surfactant proteins in bronchoalveolar lavage (BAL) fluid from 18 ventilated infants with RSV infection (median age 3.1 mo) and in a control group of 16 ventilated surgical patients (median age 0.4 mo). Surfactant proteins were measured by ELISA, total protein by the Lowry method. Surfactant protein A (SP-A) was reduced in BAL fluid from children with RSV infection (median 5.6 micrograms/ml; range 0.6 to 151.9 micrograms/ml) compared with control samples (median 9.0 micrograms/ml; range 0.5 to 139.6 micrograms/ml, p = 0.0368). Surfactant protein B (SP-B) was lower in the RSV group (median 12.0 ng/ml; range 0 to 60. 8 ng/ml) than in control patients (median 118.1 ng/ml; range 0 to 778.2 ng/ml, p < 0.0000). Surfactant protein D (SP-D) was also reduced in the RSV group (median 130.3 ng/ml; range 0 to 1,486.0 ng/ml) versus median 600.4 ng/ml; range 0 to 1,869.0 ng/ml, p < 0. 0000. Total protein levels were higher in the RSV group (median 0.49 mg/ml; range 0.13 to 2.46 mg/ml versus median 0.36 mg/ml; range 0.07 to 1.65 mg/ml, p = 0.0079). The median value of SP-A was significantly lower in the initial sample (2.3 micrograms/ml) than in the final one (6.0 micrograms/ml). However, no significant correlation was found between surfactant protein concentrations and disease severity measured by arterial alveolar oxygen ratio. We conclude that alterations in surfactant protein concentrations are present in severe RSV infection and speculate that these may contribute to the abnormalities of lung function seen in this condition.
呼吸道合胞病毒（RSV）感染是婴儿期呼吸道疾病的常见病因。在严重的RSV感染中，表面活性物质磷脂已被证明会减少。表面活性物质蛋白的减少也可能导致这种疾病的发病机制。我们调查了18例RSV感染的通气婴儿（中位年龄3.1个月）支气管肺泡灌洗（BAL）液中表面活性物质蛋白的每日水平，并与16例通气手术患者（中位年龄0.4个月）的对照组进行了比较。通过ELISA法测定表面活性物质蛋白，用Lowry法测定总蛋白。与对照样本（中位值9.0微克/毫升；范围0.5至139.6微克/毫升，p = 0.0368）相比，RSV感染儿童的BAL液中表面活性物质蛋白A（SP-A）减少（中位值5.6微克/毫升；范围0.6至151.9微克/毫升）。RSV组的表面活性物质蛋白B（SP-B）低于对照患者（中位值12.0纳克/毫升；范围0至60.8纳克/毫升），而对照组为（中位值118.1纳克/毫升；范围0至778.2纳克/毫升，p < 0.0000）。RSV组的表面活性物质蛋白D（SP-D）也减少（中位值130.3纳克/毫升；范围0至1486.0纳克/毫升），而对照组中位值为600.4纳克/毫升；范围0至1869.0纳克/毫升，p < 0.0000。RSV组的总蛋白水平较高（中位值0.49毫克/毫升；范围0.13至2.46毫克/毫升，而对照组中位值为0.36毫克/毫升；范围0.07至1.65毫克/毫升，p = 0.0079）。初始样本中SP-A的中位值（2.3微克/毫升）显著低于最终样本（6.0微克/毫升）。然而，表面活性物质蛋白浓度与通过动脉肺泡氧比测量的疾病严重程度之间未发现显著相关性。我们得出结论，严重RSV感染中存在表面活性物质蛋白浓度的改变，并推测这些改变可能导致这种情况下出现的肺功能异常。
