TY - JOUR
T1 - Quantity and structure of surfactant proteins vary among patients with alveolar proteinosis
AU - Doyle, I. R.
AU - Davidson, K. G.
AU - Barr, H. A.
AU - Nicholas, T. E.
AU - Payne, K.
AU - Pfitzner, J.
PY - 1998
Y1 - 1998
N2 - Alveolar proteinosis (AP) is an idiopathic condition characterized by excess alveolar surfactant. Although the surfactant proteins (SP) are known to be aberrant, little is known of their variation between patients or their abundance relative to the lipids. We have examined surfactant composition in lavage fluid from 16 normal subjects and 13 patients with AP, one of whom was lavaged on 11 occasions over ~ 13 mo. In this patient we have examined composition on each occasion and in each sequential lavage aliquot. Composition was constant between right and left lung, but it differed markedly between patients. The cholesterol/disaturated phospholid ratios (CHOL/DSP) were invariably elevated, on average by ~ 7-fold, whereas the SP- A/DSP and SP-B/DSP ratios were generally elevated, in some cases by as much as ~ 40- and ~ 100-fold, respectively. Although AP lavage generally contained more non-thiol-dependent SP-A aggregates and low Mr isoforms, the two-dimensional immunochemical staining patterns varied between patients and right and left lung. In the patient lavaged on multiple occasions, the SP- A/DSP and SP-B/DSP ratios progressively decreased as the patient's condition resolved. Because the SP-B/SP-A ratio was normal in all cases, we suggest that structural changes to the proteins occurred secondarily and that caution must be used in comparing functional data derived using SP-A obtained from patients with AP.
AB - Alveolar proteinosis (AP) is an idiopathic condition characterized by excess alveolar surfactant. Although the surfactant proteins (SP) are known to be aberrant, little is known of their variation between patients or their abundance relative to the lipids. We have examined surfactant composition in lavage fluid from 16 normal subjects and 13 patients with AP, one of whom was lavaged on 11 occasions over ~ 13 mo. In this patient we have examined composition on each occasion and in each sequential lavage aliquot. Composition was constant between right and left lung, but it differed markedly between patients. The cholesterol/disaturated phospholid ratios (CHOL/DSP) were invariably elevated, on average by ~ 7-fold, whereas the SP- A/DSP and SP-B/DSP ratios were generally elevated, in some cases by as much as ~ 40- and ~ 100-fold, respectively. Although AP lavage generally contained more non-thiol-dependent SP-A aggregates and low Mr isoforms, the two-dimensional immunochemical staining patterns varied between patients and right and left lung. In the patient lavaged on multiple occasions, the SP- A/DSP and SP-B/DSP ratios progressively decreased as the patient's condition resolved. Because the SP-B/SP-A ratio was normal in all cases, we suggest that structural changes to the proteins occurred secondarily and that caution must be used in comparing functional data derived using SP-A obtained from patients with AP.
UR - http://www.scopus.com/inward/record.url?scp=0031889084&partnerID=8YFLogxK
U2 - 10.1164/ajrccm.157.2.9701090
DO - 10.1164/ajrccm.157.2.9701090
M3 - Article
C2 - 9476887
AN - SCOPUS:0031889084
SN - 1073-449X
VL - 157
SP - 658
EP - 664
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 2
ER -