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Eur Respir J 2002; 19:439-446
Copyright ©ERS Journals Ltd 2002

Serum surfactant proteins-A and -D as biomarkers in idiopathic pulmonary fibrosis

K.E. Greene1, T.E. King, Jr4, Y. Kuroki5, B. Bucher-Bartelson2, G.W. Hunninghake6, L.S. Newman3, H. Nagae5 and R.J. Mason1

Depts of 1 Medicine, 2 Biostatistics, 3 Occupational Medicine, National Jewish Medical and Research Centre, 4 Dept of Medicine, University of California, San Francisco, USA, 5 Sapporo Medical University, Sapporo, Japan, 6 University of Iowa Medical College, Iowa, USA

CORRESPONDENCE: K.E. Greene, Division of Pulmonary Medicine, National Jewish Medical and Research Centre, 1400 Jackson Street, Denver, CO 80206, USA. Fax: 1 3033981806

Keywords: biomarker, chronic beryllium disease, idiopathic pulmonary fibrosis, sarcoidosis, surfactant proteins, systemic sclerosis

Received: September 14, 2000
Accepted September 16, 2001

This work was supported by NIH No. HL-03724, the Cystic Fibrosis Foundation, NIH No. ES-06538, CDC/NIOSH CCU-81221, NIH No. M01 RR-0051, NIH No. HL-07638, NIH No. HL-60316, NIH No. ES-09607, NIH No. AI-35018, VA Merit, and NIH No. HL-56556.

Idiopathic pulmonary fibrosis (IPF) has a high mortality rate, and current therapies are only marginally effective. A serum biomarker that predicts clinical outcome would be useful to stage disease, indicate prognosis and the need for aggressive therapy, and help stratify patients for clinical trials.

The goals of this study were to determine whether serum levels of surfactant protein-A (SP-A) or surfactant protein-D (SP-D) would distinguish between IPF and other types of interstitial lung disease and whether serum SP-A or SP-D levels predict outcome in patients with IPF.

The authors found that serum SP-A and SP-D levels were significantly elevated in patients with IPF and systemic sclerosis compared to sarcoidosis, beryllium disease and normal controls, and that SP-D correlated with radiographic abnormalities in patients with IPF. In addition, the authors found that both serum SP-A and SP-D levels were highly predictive of survival in patients with IPF.

This is the largest North American data set of surfactant protein measurements in idiopathic pulmonary fibrosis and the first report using multivariate analysis comparing serum surfactant proteins-A and -D to other commonly measured predictors of survival in idiopathic pulmonary fibrosis. Based on these results, the authors propose that serum surfactant proteins may prove to be useful biomarkers in patients with idiopathic pulmonary fibrosis.




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