Noah Terry L, Murphy Paula C, Alink Jorien J, Leigh Margaret W, Hull William M, Stahlman Mildred T, Whitsett Jeffrey A
Department of Pediatrics, University of North Carolina, Chapel Hill, USA.
Am J Respir Crit Care Med. 2003 Sep 15;168(6):685-91. doi: 10.1164/rccm.200301-005OC. Epub 2003 Jun 26.
The pulmonary collectins surfactant protein (SP)-A and SP-D play important roles in innate lung defense, enhancing opsonization of microbes and limiting lung inflammatory responses. To quantify relationships among collectins, bacteria, and inflammation in early cystic fibrosis (CF) airway secretions, bronchoalveolar lavage fluids (BALFs) were collected from children undergoing clinically indicated bronchoscopy. Quantitative bacteriology, differential cell counts, and ELISA for SP-A and SP-D were assessed. Significantly increased numbers of neutrophils relative to bacteria were noted in BALF from CF compared with non-CF subjects. Although SP-A levels tended to be lower in CF compared with non-CF, this was only significant in the presence of bacterial infection. Among CF patients, SP-A concentrations in BALF were inversely related to inflammation, bacterial colony-forming units per milliliter, and age. SP-D levels were significantly decreased in CF patients, and SP-D was rarely detectable in the presence of infection. Among CF patients, SP-D correlated inversely with inflammation and bacterial colony-forming units per milliliter, and there was decreased immunostaining of BALF cells for SP-D in CF. Immunohistochemistry of CF autopsy lung sections for SP-A and SP-D confirmed their paucity at sites of infection and inflammation. We conclude that relative collectin deficiency occurs early in CF airways and is inversely related to inflammation in CF airways.
肺凝集素表面活性蛋白（SP）-A和SP-D在肺部天然防御中发挥重要作用，可增强微生物的调理作用并限制肺部炎症反应。为了量化早期囊性纤维化（CF）气道分泌物中凝集素、细菌和炎症之间的关系，我们从接受临床指征支气管镜检查的儿童中收集了支气管肺泡灌洗液（BALF）。评估了定量细菌学、细胞分类计数以及SP-A和SP-D的酶联免疫吸附测定（ELISA）。与非CF受试者相比，CF患者BALF中中性粒细胞数量相对于细菌显著增加。虽然与非CF患者相比，CF患者的SP-A水平往往较低，但这仅在存在细菌感染时具有显著性差异。在CF患者中，BALF中的SP-A浓度与炎症、每毫升细菌集落形成单位以及年龄呈负相关。CF患者的SP-D水平显著降低，并且在存在感染时很少能检测到SP-D。在CF患者中，SP-D与炎症和每毫升细菌集落形成单位呈负相关，并且CF患者BALF细胞中SP-D的免疫染色减少。CF尸检肺组织切片中SP-A和SP-D的免疫组织化学证实它们在感染和炎症部位缺乏。我们得出结论，凝集素相对缺乏在CF气道中出现较早，并且与CF气道中的炎症呈负相关。
