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Multidisciplinary Respiratory Medicine

, 8:36

First Online: 01 June 2013Received: 15 September 2012Accepted: 31 March 2013


BackgroundSurfactant Protein D SP-D is an important marker in chronic obstructive pulmonary disease COPD. Serum SP-D levels increase while lung production of SP-D decreases in COPD. SP-D is a specific biomarker for monitoring COPD, assessment of exacerbation frequency and arrangement of treatment modalities. In the present study, we aimed to investigate the correlation between serum and induced sputum SP-D levels with severity and acute exacerbations of COPD.

Method20 healthy subjects, older than 40 years, with at least 10 pack-years smoking history group 1, 20 stage I-II COPD patients group 2 , and 20 stage III-IV COPD patients group 3 were enrolled in the study. All subjects performed pulmonary function tests. Venous blood samples were taken to determine complete blood count, C-reactive proteinCRP and serum SP-D levels. Induced sputum samples were obtained to determine SP-D level. COPD patients were followed up for acute exacerbations for 6 months.

ResultsSerum SP-D levels of group 3 were the highest and induced sputum SP-D levels of group 2 were the lowest among the three groups. SP-D levels of induced sputum decreased in patients with increasing number of cigarette pack-years p = 0.03, r = −0.115, whereas serum SP-D levels increased in these patients p = 0.0001, r = 0.6 . Induced sputum SP-D levels in COPD patients receiving inhaled corticosteroid treatment were significantly higher than in patients who were not receiving inhaler corticosteroid treatment p = 0.005. An inverse correlation between serum SP-D levels and FEV1 % was found and there was a positive correlation between the serum SP-D levels and exacerbations frequency in 6-month follow up period p = 0.049 ,r = −0.252; p = 0.0001, r = 0.598 respectively.

ConclusionOur study demonstrates the adverse effects of smoking on local SP-D levels since low levels of induced sputum SP-D were found in the group of current smokers, who were not receiving inhaled corticosteroid treatment. Relationship between serum SP-D and COPD exacerbations frequency suggests that serum SP-D level may be used as a lung-specific biomarker during the follow up and progression of COPD.

KeywordsChronic obstructive pulmonary disease Induced sputum Surfactant protein-D  Download fulltext PDF

Autor: Berna Akinci Ozyurek - Sevinc Sarinc Ulasli - Serife Savas Bozbas - Nilufer Bayraktar - Sule Akcay


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