Uhliarova B, Kopincova J, Adamkov M, Svec M, Calkovska A
Department of Physiology, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia.
Department of Otorhinolaryngology, FD Roosevelt Faculty Hospital, Banska Bystrica, Slovakia.
Clin Otolaryngol. 2016 Jun;41(3):249-58. doi: 10.1111/coa.12508. Epub 2016 Feb 7.
Surfactant proteins (SP) A and D play a critical role in the innate defence of respiratory mucosa. Although numerous studies have focused on the importance of surfactant in the lower airways, relatively little is known about its role in the upper respiratory system.
The prospective study was conducted with 61 subjects divided into patients with chronic rhinosinusitis with nasal polyps (CRSwNP), with chronic rhinosinusitis without nasal polyps (CRSsNP) and healthy controls. SP-A and SP-D were detected in nasal lavage fluid (NALF) by ELISA and in nasal mucosa by immunohistochemical staining. Severity of the diseases assessed by preoperative CT score, presence of comorbidity (allergy and bronchial asthma) and bacterial culture from the middle nasal meatus was evaluated.
In nasal mucosa, SPs were localised in ciliated cells of the surface epithelium and serous acini of the submucosal glands. Stronger expression of SPs in submucosal glands was observed in CRSwNP and CRSsNP groups in comparison with controls. In patients with CRSsNP and more severe form of the disease, higher levels of SP-A and SP-D in NALF and stronger immunoreactivity of these proteins in nasal mucosa were detected. Identification of pathogenic bacteria was associated with higher levels of SP-A and SP-D in NALF and nasal mucosa in patients with CRSsNP and control group. Presence of allergy was associated with stronger expression of SP-A in submucosal glands in all CRS patients and with decreased levels of both SPs in NALF in CRSsNP patients.
Surfactant proteins A and D play an important role in innate host defence of upper respiratory tract. Different expression of these proteins in patients with chronic rhinosinusitis indicates possible novel target of therapy in these patients.
表面活性蛋白（SP）A和D在呼吸道黏膜的固有防御中起关键作用。尽管众多研究聚焦于表面活性剂在下呼吸道的重要性，但其在上呼吸道系统中的作用却知之甚少。
对61名受试者进行前瞻性研究，将其分为伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）患者、不伴鼻息肉的慢性鼻-鼻窦炎（CRSsNP）患者和健康对照组。通过酶联免疫吸附测定（ELISA）检测鼻灌洗液（NALF）中的SP-A和SP-D，并通过免疫组织化学染色检测鼻黏膜中的SP-A和SP-D。通过术前CT评分评估疾病严重程度，评估合并症（过敏和支气管哮喘）的存在情况以及中鼻道的细菌培养结果。
在鼻黏膜中，表面活性蛋白定位于表面上皮的纤毛细胞和黏膜下腺的浆液性腺泡中。与对照组相比，CRSwNP组和CRSsNP组黏膜下腺中表面活性蛋白的表达更强。在CRSsNP患者及病情更严重的患者中，检测到NALF中SP-A和SP-D水平更高，且这些蛋白在鼻黏膜中的免疫反应性更强。在CRSsNP患者和对照组中，病原菌的鉴定与NALF和鼻黏膜中较高水平的SP-A和SP-D相关。过敏的存在与所有CRS患者黏膜下腺中SP-A的更强表达相关，且与CRSsNP患者NALF中两种表面活性蛋白水平降低相关。
表面活性蛋白A和D在上呼吸道的固有宿主防御中起重要作用。这些蛋白在慢性鼻-鼻窦炎患者中的不同表达表明，这可能是这些患者新的治疗靶点。
