Open AccessSurfactant abnormalities in idiopathic pulmonary fibrosis, hypersensitivity pneumonitis and sarcoidosis
Author(s) -
Günther A.,
Schmidt R.,
Nix F.,
YabutPerez M.,
Guth C.,
Rosseau S.,
Siebert C.,
Grimminger F.,
Morr H.,
Velcovsky H.g.,
Seeger W.
Publication year - 1999
Publication title -
european respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.021
H-Index - 241
eISSN - 1399-3003
pISSN - 0903-1936
DOI - 10.1034/j.1399-3003.1999.14c14.x
Subject(s) - hypersensitivity pneumonitis , sarcoidosis , medicine , pulmonary fibrosis , idiopathic pulmonary fibrosis , pulmonary surfactant , fibrosis , pneumonitis , pathology , dermatology , lung , chemistry , biochemistry
Bronchoalveolar lavage fluids (BALF) from patients with idiopathic pulmonary fibrosis (IPF; n=36), hypersensitivity pneumonitis (HP; n=32) and sarcoidosis (n=44) were investigated for their surfactant properties and compared to healthy control subjects (n=29). The phospholipid (PL) and protein concentration, the PL:protein ratio, PL subclasses, and the surfactant apoproteins (SP)A and SP‐B were quantified in BALF. Large surfactant aggregates (LSA) were measured by means of ultracentrifugation and assayed for surface activity using the pulsating bubble surfactometer. As compared to controls, SP‐A concentrations, LSA content and PL:protein ratios were significantly decreased in all groups, whereas PL and SP‐B concentrations remained unchanged. Changes in the phospholipid profile, with reduced percentages of phosphatidylcholine (not significant) and phosphatidylglycerol and increased fractions of phosphatidylinositol and sphingomyelin (p<0.05), occurred more in IPF than in HP, and not in sarcoidosis. Surface activity was found to be severely impaired in IPF (minimum surface tension (γmin) ~15–20 mN·m ‐1 ), but only modestly affected in HP and sarcoidosis (γmin ~5 mN·m ‐1 ) compared to controls (γmin ~0 mN·m ‐1 ). Reconstitution of pelleted surfactant material with soluble BALF proteins further increased γmin values. In conclusion, moderate changes in biochemical and physical surfactant properties are encountered in hypersensitivity pneumonitis and sarcoidosis, but pronounced disturbances occur in idiopathic pulmonary fibrosis. Eur Respir J 1999; 14: 565–573.