Department of Medicine, National Jewish Health, Denver, CO, USA.
BMC Pulm Med. 2010 Oct 25;10:53. doi: 10.1186/1471-2466-10-53.
Pulmonary surfactant D (SP-D) has important regulatory functions for innate immunity and has been implicated as a biomarker for chronic obstructive pulmonary disease (COPD). We hypothesized that COPD patients would have reduced bronchoalveolar lavage (BAL) fluid SP-D levels compared to healthy smoking and non-smoking controls.
BAL SP-D and phospholipids were quantified and corrected for dilution in 110 subjects (65 healthy never smokers, 23 smokers with normal spirometry, and 22 smokers with COPD).
BAL SP-D was highest in never smokers (mean 51.9 μg/mL ± 7.1 μg/mL standard error) compared to both smokers with normal spirometry (16.0 μg/mL ± 11.8 μg/mL) and subjects with COPD (19.1 μg/mL ± 12.9 μg/mL; P < 0.0001). Among smokers with COPD, BAL SP-D correlated significantly with FEV1% predicted (R = 0.43; P < 0.05); however, the strongest predictor of BAL SP-D was smoking status. BAL SP-D levels were lowest in current smokers (12.8 μg/mL ± 11.0 μg/mL), intermediate in former smokers (25.2 μg/mL ± 14.2 μg/mL; P < 0.008), and highest in never smokers. BAL phospholipids were also lowest in current smokers (6.5 nmol ± 1.5 nmol), intermediate in former smokers (13.1 nmol ± 2.1 nmol), and highest in never smokers (14.8 nmol ± 1.1 nmol; P < 0.0001).
These data suggest that smokers, and especially current smokers, exhibit significantly reduced BAL SP-D and phospholipids compared to nonsmokers. Our findings may help better explain the mechanism that leads to the rapid progression of disease and increased incidence of infection in smokers.
肺表面活性物质 D（SP-D）对先天免疫具有重要的调节功能，并且被认为是慢性阻塞性肺疾病（COPD）的生物标志物。我们假设与健康的吸烟和非吸烟对照组相比，COPD 患者的支气管肺泡灌洗液（BAL）中的 SP-D 水平会降低。
对 110 名受试者（65 名从未吸烟的健康者，23 名肺功能正常的吸烟者和 22 名 COPD 吸烟者）的 BAL 液 SP-D 和磷脂进行了定量分析，并对稀释进行了校正。
从未吸烟者的 BAL 液 SP-D 最高（平均 51.9μg/ml±7.1μg/ml 标准误差），与肺功能正常的吸烟者（16.0μg/ml±11.8μg/ml）和 COPD 患者（19.1μg/ml±12.9μg/ml）相比均有显著差异（P<0.0001）。在 COPD 吸烟者中，BAL SP-D 与 FEV1%预计值显著相关（R=0.43；P<0.05）；然而，BAL SP-D 的最强预测因素是吸烟状况。当前吸烟者的 BAL SP-D 水平最低（12.8μg/ml±11.0μg/ml），前吸烟者次之（25.2μg/ml±14.2μg/ml；P<0.008），从不吸烟者最高。BAL 磷脂也在当前吸烟者中最低（6.5nmol±1.5nmol），在前吸烟者中中等（13.1nmol±2.1nmol），在从不吸烟者中最高（14.8nmol±1.1nmol；P<0.0001）。
这些数据表明，与不吸烟者相比，吸烟者，尤其是当前吸烟者，BAL SP-D 和磷脂明显减少。我们的发现可能有助于更好地解释导致疾病快速进展和吸烟者感染增加的机制。
