Hamm H, Lührs J, Guzman y Rotaeche J, Costabel U, Fabel H, Bartsch W
Department of Pulmonary Medicine, Hannover Medical School, Germany.
Chest. 1994 Dec;106(6):1766-70. doi: 10.1378/chest.106.6.1766.
Interstitial lung diseases often are accompanied by histopathologic evidence of alveolar type 2 cell alterations. In the alveolar milieu, the surfactant-specific protein A (SP-A) is a secretory product of alveolar type 2 cells. Therefore, we measured SP-A levels in bronchoalveolar lavage (BAL) fluids from patients with untreated sarcoidosis (n = 35) and hypersensitivity pneumonitis (HP [n = 10]) and compared the results with those from 21 healthy control subjects. In sarcoidosis patients, SP-A was markedly higher than in control subjects with a mean of 8.0 micrograms/ml of recovered BAL fluid +/- 0.7 SEM (p < 0.0001 compared with control subjects). In HP, SP-A values were comparable with those in sarcoidosis with a mean of 9.0 micrograms/ml +/- 1.7 SEM. Mean SP-A in the control group was 4.0 micrograms/ml +/- 0.3 SEM. These results suggest that SP-A secretion is stimulated in sarcoidosis and HP. Further studies seem justified to investigate the role of the surfactant system in interstitial lung diseases as well as the potential clinical usefulness of SP-A measurements in BAL.
间质性肺疾病常伴有肺泡Ⅱ型细胞改变的组织病理学证据。在肺泡环境中，表面活性物质特异性蛋白A（SP-A）是肺泡Ⅱ型细胞的分泌产物。因此，我们检测了未经治疗的结节病患者（n = 35）和过敏性肺炎（HP [n = 10]）患者支气管肺泡灌洗（BAL）液中的SP-A水平，并将结果与21名健康对照者进行比较。在结节病患者中，SP-A明显高于对照者，回收的BAL液平均为8.0微克/毫升±0.7 SEM（与对照者相比，p < 0.0001）。在HP中，SP-A值与结节病患者相当，平均为9.0微克/毫升±1.7 SEM。对照组的平均SP-A为4.0微克/毫升±0.3 SEM。这些结果表明，结节病和HP中SP-A的分泌受到刺激。进一步研究似乎有必要探讨表面活性物质系统在间质性肺疾病中的作用以及BAL中SP-A检测的潜在临床应用价值。
