Serum surfactant protein D (SP-D) is a prognostic marker of poor outcome in patients with A/H1N1 virus infection

Lung. 2015 Feb;193(1):25-30. doi: 10.1007/s00408-014-9669-3. Epub 2014 Dec 24.

Abstract

Introduction: Surfactant protein D (SP-D) plays an important role in the innate responses against pathogens and its production is altered in lung disorders.

Methods: We studied the circulating levels of SP-D in 37 patients with acute respiratory distress syndrome due to the A/H1N1 virus infection and in 40 healthy controls. Cox logistic regression models were constructed to explore the association of SP-D levels and risk of death.

Results: Mortality rate after a 28-day was 32.42 %. Significant higher levels of SP-D were detected in A/H1N1 patients with fatal outcome (p < 0.05). After adjusting for confounding variables, levels of SP-D ≥250 ng/mL were associated with increased the risk of death (HR = 8.27, 95 % CI 1.1-64.1, p = 0.043).

Conclusions: Our results revealed that higher circulating levels of SP-D are associated with higher mortality risk in critically ill A/H1N1 patients. SP-D might be a predictive factor of poor outcomes in viral pneumonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Case-Control Studies
  • Chi-Square Distribution
  • Critical Illness
  • Female
  • Hospital Mortality
  • Humans
  • Influenza A Virus, H1N1 Subtype / pathogenicity*
  • Influenza, Human / blood
  • Influenza, Human / diagnosis*
  • Influenza, Human / mortality
  • Influenza, Human / therapy
  • Influenza, Human / virology
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / therapy
  • Pneumonia, Viral / virology
  • Prognosis
  • Proportional Hazards Models
  • Pulmonary Surfactant-Associated Protein D / blood*
  • Respiratory Distress Syndrome / blood
  • Respiratory Distress Syndrome / diagnosis*
  • Respiratory Distress Syndrome / mortality
  • Respiratory Distress Syndrome / therapy
  • Respiratory Distress Syndrome / virology
  • Risk Factors
  • Time Factors
  • Up-Regulation

Substances

  • Biomarkers
  • Pulmonary Surfactant-Associated Protein D