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This Article Full Text Full Text (PDF) All Versions of this Article: 34/1/95    most recent 09031936.00156508v1 Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Lomas, D. A. PubMed PubMed Citation Articles by Lomas, D. A.

Serum surfactant protein D is steroid sensitive and associated with exacerbations of COPD

¹ Dept of Medicine, University of Cambridge, Cambridge Institute for Medical Research, Cambridge, UK, ² The Channing Laboratory and Pulmonary and Critical Care Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, ³ GlaxoSmithKline, Research Triangle Park, NC, and ⁴ GlaxoSmithKline, King of Prussia, PA, USA.

CORRESPONDENCE: D. A. Lomas, Dept of Medicine, University of Cambridge, Cambridge Institute for Medical Research, Wellcome Trust/MRC Building, Hills Road, Cambridge, CB2 0XY, UK. E-mail: dal16{at}cam.ac.uk

Keywords: Biomarker, bronchitis, emphysema, exacerbation, inflammation, prednisolone

Received: October 15, 2008
Accepted January 2, 2009

Surfactant protein (SP)-D is a lung-derived protein that has been proposed as a biomarker for inflammatory lung disease.

Serum SP-D was evaluated as a biomarker for components of chronic obstructive pulmonary disease (COPD) in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) cohort and its response assessed to the administration of the anti-inflammatory agent prednisolone.

The median level of serum SP-D was significantly elevated in 1,888 individuals with COPD compared to 296 current and former smokers without airflow obstruction (121.1 and 114.3 ng·mL^–1, respectively; p = 0.021) and 201 nonsmokers (82.2 ng·ml^–1; p<0.001). There was no correlation with the severity of COPD. Individuals with COPD who had a serum SP-D concentration that was greater than the 95th percentile of nonsmokers (175.4 ng·mL^–1) showed an increased risk of exacerbations over the following 12 months (adjusted OR 1.30; 95% CI 1.03–1.63). Treatment with 20 mg·day^–1 prednisolone for 4 weeks resulted in a fall in serum SP-D levels (126.0 to 82.1 ng·mL^–1; p<0.001) but no significant change in post-bronchodilator forced expiratory volume in 1 s.

Serum SP-D concentration is raised in smokers and may be useful in identifying individuals who are at increased risk of exacerbations of COPD. It may represent an intermediate measure for the development of novel anti-inflammatory agents.