DOI: https://doi.org/10.22263/2312-4156.2019.6.43
Zhuravleva L.N., Novikova V.I.
The assessment of the concentration of surfactant protein D in the blood serum and tracheobronchial secretion in respiratory distress syndrome and congenital pneumonia in premature newborns
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2019;18(6):43-49.
Abstract.
One of the major causes of morbidity in newborns is the respiratory tract pathology. Among the premature infants, the leading cause is given to pneumonia and respiratory distress syndrome (RDS).
Objectives. To assess the concentration of surfactant protein D (SP-D) in the secretion of the tracheobronchial tree and in the blood serum of children with congenital pneumonia and respiratory distress syndrome.
Material and methods. We observed 45 newborns with respiratory disorders (27 children with congenital pneumonia and 18 children with respiratory distress syndrome), the comparison group consisted of 20 «almost healthy» newborns without any tracheobronchial pathology.
Results. The concentration of SP-D in the group of «almost healthy» premature newborns made up 1.97 ng / ml (25-75 IQR 1.3-2.14 ng / ml). The concentration of SP-D in the serum of patients with congenital pneumonia was 35.78 ng / ml (25-75 IQR 25.57-41.63 ng / ml) during 1-2 days, and thereafter on the 10th-14th day it was also significantly higher (p<0.001) in comparison with premature infants without respiratory diseases and children with RDS (p<0.001). We found a positive correlation between the severity of pneumonia and the increase in serum SP-D levels on the 1st - the 2nd day of life in patients with an unfavorable outcome of pneumonia (r=0.62, p<0.001). We also determined that the blood serum SP-D level of 21.8 ng / ml in preterm infants may be used as a diagnostic criterion for the prognostically unfavorable course of congenital pneumonia.
Key words: newborns, respiratory distress syndrome, pneumonia, immune status, surfactant protein D, premature infants.
References
1. Lyamina SV, Kruglov SV, Vedenikin TYu. A new strategy for managing the immune response in lung diseases is the role of surfactant protein D as a bivalent macrophage reprogramming factor. Fundam Issled. 2011;(1):90-8. (In Russ.)
2. Crouch E. C. Structure, biologic properties and expression of surfactant protein D. Biochim Biophys Acta. 1998 Nov;1408(2-3):278-89. doi: http://dx.doi.org/10.1016/s0925-4439(98)00073-8
3. Atochina-Vasserman EN, Beers MF, Kadire H, Tomer Y, Inch A, Scott P, et al. Selective inhibition of iNOS activity in vivo reverses inflammatory abnormalities in SP-D deficient mice. J Immunol. 2007 Dec;179(12):8090-7. doi: http://dx.doi.org/10.4049/jimmunol.179.12.8090
4. Fisher JH, Larson J, Cool C, Dow SW. Lymphocyte activation in the lungs of SP-D null mice. Am J Respir Cell Mol Biol. 2002 Jul;27(1):24-33. doi: http://dx.doi.org/10.1165/ajrcmb.27.1.4563
5. Vasserman EN, Lyamina SV, Shimshelashvili ShL, Abramova EV, Nazarov VA, Kruglov SV, i dr. SP-D controls the balance of Th1 and Th2 cytokines and has signs of endogenous macrophage reprogramming factor. Fundam Issled. 2010;(6):28-36. (In Russ.)
6. Sin DD, Pahlavan PS, Man SF. Surfactant protein D: a lung specific biomarker in COPD? Ther Adv Respir Dis 2008 Apr;2(2):65-74. doi: http://dx.doi.org/10.1177/1753465808088903
7. Sorensen GL, Husby S, Holmskov U. Surfactant protein A and surfactant protein D variation in pulmonary disease. Immunobiology. 2007;212(4-5):381-416.
8. Mackay RM, Grainge CL, Lau LC, Barber C, Clark HW, Howarth PH. Airway surfactant protein D (SP-D) deficiency in adults with severe asthma. Chest. 2016 May;149(5):1165-72. doi: http://dx.doi.org/10.1016/j.chest.2015.11.012
9. Nayak A, Dodagatta-Marri E, Tsolaki AG, Kishore U. An insight into the diverse roles of surfactant proteins, SP-A and SP-D in innate and adaptive immunity. Front Immunol. 2012 Jun;3:131. doi: http://dx.doi.org/10.3389/fimmu.2012.00131
10. Yamaguchi R, Sakamoto A, Yamamoto T, Ishimaru Y, Narahara S, Sugiuchi H, et al. Surfactant protein D inhibits interleukin-12p40 production by macrophages through the SIRP alpha/ROCK/ERK signaling pathway. Am J Med Sci. 2017 Jun;353(6):559-567. doi: http://dx.doi.org/10.1016/j.amjms.2017.03.013
11. Glasser J, Mallampalli RK. Surfactants and its role in the pathology of pulmonary infection. Microbes Infect. 2012 Jan;14(1):17-25. doi: http://dx.doi.org/10.1016/j.micinf.2011.08.019
12. Lyamina SV, Vedenikin TYu, Malyshev IYu. A modern approach to the analysis of the immune response in lung diseases: surfactant protein D and its role [Elektronnyi resurs]. Sovremen Problemy Nauki Obrazovaniia: elektron nauch zhurn. 2011;(4). Rezhim dostupa: https://science-education.ru/ru/article/view?id=4717. Data dostupa: 25.11.2019. (In Russ.)
Information about authors:
Zhuravleva L.N. – Candidate of Medical Sciences, associate professor of the Chair of Pediatrics, Vitebsk State Order of Peoples’ Friendship Medical University;
Novikova V.I. – Doctor of Medical Sciences, professor, head of the Chair of Pediatrics of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.
Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Pediatrics. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Lyudmila N. Zhuravleva.
