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MINERVA MEDICA

A Journal on Internal Medicine


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Minerva Medica 2017 Nov 21

DOI: 10.23736/S0026-4806.17.05285-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Serum surfactant protein D and exhaled nitric oxide as biomarkers of early lung damage in systemic sclerosis

Alida BENFANTE, Riccardo MESSINA, Alessandra PATERNÒ, Nicola SCICHILONE

Dipartimento Biomedico di Medicina Interna e Specialistica, University of Palermo, Palermo, Italy


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BACKGROUND: Interstitial lung disease (ILD) complicates the course of systemic sclerosis (SSc), representing the main cause of death in these patients. The identification of parameters that can predict the early onset and progression of ILD in SSc represents an unmet need in clinical practice. The study was designed to explore whether the surfactant proteins (SP) A and D may be used as noninvasive tools for the early identification of ILD in SSc. Alveolar exhaled nitric oxide (NO) was investigated as a surrogate marker of distal inflammation.
METHODS: Unselected consecutive subjects newly diagnosed with scleroderma and subjects free of respiratory and systemic diseases were recruited. All patients underwent clinical, lung functional, radiological and biological assessments.
RESULTS: 15 individuals affected by SSc (M/F: 3/12), and 10 healthy subjects (M/F: 3/7) participated to the study. The serum SP-D values were 115.3±81.36 ng/ml in SSc subjects and 32±11.9 ng/ml in healthy controls (p=0.004). The concentrations of serum SP-A were not statistically different between groups. Serum SP-D inversely correlated with FEV1% predicted (rs=-0.29; p=0.004), FVC% predicted (rs=-0.20; p=0.02) and DLCO% predicted (rs=-0.36; p=0.001). Alveolar NO concentrations were significantly different between SSc and control subjects (6.5±2.9 ppb vs 2.2±1.3 ppb, respectively; p=0.001), and positively associated with the levels of serum SP-D (r=0.60, p=0.03).
CONCLUSIONS: These findings suggest that, in patients with scleroderma, SP-D and exhaled alveolar NO could represent novel non-invasive markers of early detection and activity of lung involvement.


KEY WORDS: Biomarker - Interstitial lung disease - Exhaled nitric oxide - Surfactant protein - Systemic sclerosis - Lung function

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Publication History

Article first published online: November 21, 2017
Manuscript accepted: November 8, 2017
Manuscript received: June 3, 2017

Cite this article as

Benfante A, Messina R, Paternò A, Scichilone N. Serum surfactant protein D and exhaled nitric oxide as biomarkers of early lung damage in systemic sclerosis. Minerva Med 2017 Nov 21. DOI: 10.23736/S0026-4806.17.05285-5

Corresponding author e-mail

nicola.scichilone@unipa.it