Kobayashi Hideo, Kanoh Soichiro, Motoyoshi Kazuo
Division of Pulmonary Medicine, Department of Medicine, National Defense Medical College, Tokorozawa, Japan.
Biomarkers. 2008 Jun;13(4):385-92. doi: 10.1080/13547500801903651.
Serum surfactant protein (SP)-A offers a useful clinical marker for interstitial lung disease (ILD). However, SP-A is occasionally elevated in non-ILD pulmonary patients. The present study was conducted to investigate factors that affect serum SP- A levels in respiratory medicine. Serum SP-A, serum SP-D, serum Klebs von den Lungen (KL)-6 and pulmonary function tests were evaluated in 929 patients (current smokers, n=255; ex-smokers, n=242; never-smokers, n=432) without ILD or pulmonary alveolar proteinosis. Serum SP-A was significantly higher in current smokers than in never- or ex-smokers (p<0.01 and p<0.05, respectively). Serum SP- A was significantly higher in chronic obstructive pulmonary disease (COPD) and pulmonary thromboembolism than in other diseases (p<0.01). Serum SP-A correlated positively with amount of smoking (p<0.01) and negatively with forced expiratory volume in 1 s/forced vital capacity (p<0.05). Serum SP-D and KL-6 were unaffected by smoking. Smoking should be taken into account when evaluating serum SP-A levels, and different baseline levels of serum SP-A should be established for smokers and non-smokers. Serum SP-A may also represent a useful marker for predicting COPD in the preclinical stage.
血清表面活性蛋白（SP）-A是间质性肺疾病（ILD）的一项有用的临床标志物。然而，在非ILD肺部疾病患者中，SP-A偶尔也会升高。本研究旨在调查呼吸内科中影响血清SP-A水平的因素。对929例无ILD或肺泡蛋白沉积症的患者（现吸烟者，n = 255；既往吸烟者，n = 242；从不吸烟者，n = 432）进行了血清SP-A、血清SP-D、血清克雷伯斯冯登肺（KL）-6及肺功能测试评估。现吸烟者的血清SP-A显著高于从不吸烟者或既往吸烟者（分别为p < 0.01和p < 0.05）。慢性阻塞性肺疾病（COPD）和肺血栓栓塞患者的血清SP-A显著高于其他疾病患者（p < 0.01）。血清SP-A与吸烟量呈正相关（p < 0.01），与1秒用力呼气量/用力肺活量呈负相关（p < 0.05）。血清SP-D和KL-6不受吸烟影响。评估血清SP-A水平时应考虑吸烟因素，并且应为吸烟者和非吸烟者建立不同的血清SP-A基线水平。血清SP-A也可能是临床前期预测COPD的一项有用标志物。
