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1 From the Department of Pulmonary Medicine, Hannover Medical School, Hannover, Germany
2 From the Department of Pathology, Ruhr-Universität Bochum, Bochum, Germany
3 From the Department of Pneumology and Allergy, Ruhrlandklinik Essen, Essen, Germany
4 From the Department of Clinical Chemistry, Fraunhofer Institut für Toxikologie und Aerosolforschung Hannover, Germany
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 µg/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 µg/ml ± 1.7 SEM. Mean SP-A in the control group was 4.0 µg/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.
Key Words: Pulmonary surfactant • surfactant protein A (SP-A) • bronchoalveolar lavage (BAL) • alveolitis • sarcoidosis • hypersensitivity pneumonitis
Submitted on December 16, 1993
Accepted on April 4, 1994
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