血清SP-A、SP-D和KL-6在间质性肺疾病中的检测及其意义
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摘要
间质性肺疾病(ILD)是以弥漫性肺实质、肺泡炎症和间质纤维化为病理基本病变,以活动性呼吸困难、X线胸片弥漫性浸润阴影、限制性通气障碍、弥散功能降低和低氧血症为临床表现的不同种类疾病群构成的临床-病理实体的总称。相对于肺组织活检病理诊断,非侵入性的血清标志物检测更易操作。已有报道表面活性蛋白A(SP-A)、表面活性蛋白D(SP-D)和肿瘤分化抗原(KL-6)对ILD的诊断、判断疾病的活动性及预后等方面有一定的价值。近年来在对新增职业病——硬金属肺病的研究中,这类蛋白亦引起重视,现对其特点、检测及意义作一综述。
引文
[1]牟小芬.比较血清标记物KL-6、SP-A、SP-D和MCP-1对间质性肺疾病的诊断意义[J].国际老年医学杂志,2002,3(6):287-287.
[2]Takahashi H,Sano H,Chiba H,et al.Pulmonary surfactant proteins A and D:innate immune function and biomarkers for lung diseases.Current Pharmaceutical Design,2006,12:589-598.
[3]Lynch JPI,Saggar R,Weigt SS,et al.Usual interstitial pneumonia[C].Seminars in respiratory and critical care medicine,2006,27(6):634-651.
[4]Oberley R E,Ault K A,Neff T L,et al.Surfactant proteins A and D enhance the phagocytosis of Chlamydia into THP-1 cells[J].American Journal of Physiology-Lung Cellular and Molecular Physiology,2004,287(2):296-306.
[5]Khamri W,Moran A P,Worku M L,et al.Variations in Helicobacter pylori lipopolysaccharide to evade the innate immune component surfactant protein D[J].Infection and immunity,2005,73(11):7 677-7 686.
[6]Kishore U,Greenhough T J,Waters P,et al.Surfactant proteins SP-A and SP-D:structure,function and receptors[J].Molecular immunology,2006,43(9):1 293-1 315.
[7]Ohtsuki Y,Fujita J,Hachisuka Y,et al.Immunohistochemical and immunoelectron microscopic studies of the localization of KL-6and epithelial membrane antigen(EMA)in presumably normal pulmonary tissue and in interstitial pneumonia[J].Medical Molecular Morphology,2007,40(4):198-202.
[8]Inagaki Y,Tang W,Huanli X U,et al.Sustained Aberrant Localization of KL-6 Mucin andβ-Catenin at the Invasion Front of Human Gastric Cancer Cells[J].Anticancer Research,2011,31(2):535-542.
[9]King RJ,Klass DJ,Gikas EG,et al.Isolation of apoproteins from canine surface active material[J].Am J Physiol,1973,224:788-795.
[10]Reid K B M,Clark H,Palaniyar N.Surfactant and lung inflammation[J].Thorax,2005,60(8):620-622.
[11]Haczku A.Protective role of the lung collectins surfactant protein A and surfactant protein D in airway inflammation[J].Allergy Clin Immunol,2008,122:861-879.
[12]Kishore U,Greenhough TJ,Waters P,et al.Surfactant protein SP-A and SP-D:structure,function and receptors[J].M0lImmunol,2006,43:1 293-1 315.
[13]Crouch EC.Surfactant protein-D and pulmonary host defense[J].Respir Res,2001,1(2):93-108.
[14]Winkler C,Atochina-Vasserman EN,Holz O,et al.Comprehensive characterisation of pulmonary and serum surfactant protein D in COPD[J].Respir Res,2011,12:29.
[15]Greene KE,King TE Jr,Kuroki Y,et al.Serum surfactant proteins-A and D as biomarkeis in idiopathic pulmonary fibrosis[J].Eur Respir J,2002,19(3):439-446.
[16]Hartl D,Griese M.Surfactant protein D in human lung diseases[J].Eur J Clin Invest,2006,36:423-435.
[17]Orgeig S,Hiemstra P S,Veldhuizen E J A,et al.Recent advances in alveolar biology:evolution and function of alveolar proteins[J].Respiratory Physiology&Neurobiology,2010,173(1):43-54.
[18]Stahel R A,Gilks W R,Lehmann H,et al.Third international workshop on lung tumor and differentiation antigens:Overview of the results of the central data analysis[J].International Journal of Cancer,1994,57(Supplement S8):6-26.
[19]Kuwano K,Maeyama T,Inoshima I,et al.Increased circulating levels of soluble Fas ligand are correlated with disease activity in patients with fibrosing lung diseases[J].Respirology,2002,7(1):15-21.
[20]Hattrup C L,Gendler S J.Structure and function of the cell surface(tethered)mucins[J].Annual Review of Physiology,2008,70:431-457.
[21]Hirasawa Y,Kohno N,Yokoyama A,et al.KL-6,a human MUC1mucin,is chemotactic for human fibroblasts[J].Am J Respir Cell Mol Biol,1997,17(4):501-507.
[22]陈玥.人类胚胎肺不同时期SP-A和SP-D的表达及其意义[D].第一军医大学,2005.
[23]Haczku A.Protective role of thelungcollectins surfactant protein Aand surfactantproteinD inairway inflammation[J].J Allergy Clin Immunol,2008,122:861-879.
[24]akahashi H,Sano H,Chiba H,et al.Pulmonary surfactant proteinsA and D:innate immune functions and biomarkers for lungdiseases[J].CurrPharm Des,2006,12:589-598.
[25]Gardai S J,Xiao Y M,Nick J A,et al.By binding SIRPalpha or calreticulin/CD91,lung collectins act as dual function surveillance molecules to suppress or enhance inflammation[J].Cell,2003,115(1):13-23.
[26]Kishore U,13ernai AL,Kamren MF,et al.Surfaccam proreins SP-A and SP-D in human heahh and disease[J].Arch Immunol T-her EKVW'araz),2005,53:399-417.
[27]Doi M,Yokoyama A,Kondo K,et al.Anti-tumor effect of the anti-KL-6/MUCl monoclonal antibody through exposure of surface molecules by MUCl capping[J].Cancer,2006,97(5):420-429.
[28]Xu H,Inagaki Y,Seyama Y,et al.Expression of KL-6/MUC1in pancreatic ductal carcinoma and its potential relationship withβ-catenin in tumor progression[J].Life Sciences,2011,88:1 063-1 069.
[29]McCormack F X,Whitsett J A.The puImonary coIIectins,SP-Aand SP-D,orchestrate innateimmunity in the lung[J].The JournaIof cIinicaI investigation,2002,109(6):707-712.
[30]Abe S,Honda Y,Ando M,et al.[Clinical significance of levels of lung surfactant protein A in serum,in various lung diseases][J].Nihon Kyōbu Shikkan Gakkai Zasshi,1995,33(11):1 219-1225.
[31]H Ishii,H Mukae,J Kadota,et al.High serum concentrations of surfactant protein A in usual interstitial pneumonia compared with non-specific interstitial pneumonia[J].Thorax,2003,58(1):52-57.
[32]Greene K E,Jr K T,Kuroki Y,et al.Serum surfactant proteins-A and-D as biomarkers in idiopathic pulmonary fibrosis[J].European Respiratory Journal,2002,19(3):439-446.
[33]Kuroki Y,Tsutahara S,Shijubo N,et al.Elevated levels of lung surfactant protein A in sera from patients with idiopathic pulmonary fibrosis and pulmonary alveolar proteinosis[J].American Review of Respiratory Disease,1993,147(3):723-729.
[34]Honda Y,Kuroki Y,Shijubo N,et al.Aberrant appearance of lung surfactant protein A in sera of patients with idiopathic pulmonary fibrosis and its clinical significance[J].Respiration,1995,62(2):64-69.
[35]Greene K E,Jr K T,Kuroki Y,et al.Serum surfactant proteins-A and-D as biomarkers in idiopathic pulmonary fibrosis[J].European Respiratory Journal,2002,19(3):439-446.
[36]Takahashi H,Kuroki Y H,Saito T,et al.Serum levels of surfactant proteins A and D are useful biomarkers for interstitial lung disease in patients with progressive systemic sclerosis[J].American Journal of Respiratory&Critical Care Medicine,2000,162(1):258-263.
[37]Takahashi H,Shiratori M,Kanai A,et al.Monitoring markers of disease activity for interstitial lung diseases with serum surfactant proteins A and D[J].Respirology,2006,11(1):51-54.
[38]Ohshimo S,Yokoyama A,Hattori N,et al.KL-6,a human MUC1 mucin,promotes proliferation and survival of lung fibroblasts[J].Biochem Biophys Res Commun,2005,338(4):1 845-1 852.
[39]Kobayashi M,Takeuchi T,Ohtsuki Y.Differences in the immunolocalization of surfactant protein(SP)-A,SP-D,and KL-6in pulmonary alveolar proteinosis[J].Pathology International,2008,58(3):203-207.
[40]Hiroshi O,Akihito Y,Keiichi K,et al.Comparative study of KL-6,surfactant protein-A,surfactant protein-D,and monocyte chemoattractant protein-1as serum markers for interstitial lung diseases[J].American Journal of Respiratory&Critical Care Medicine,2002,165(3):378-381.
[41]Kitaichi N,Kitamura M,Namba K,et al.Elevation of surfactant protein D,apulmonary disease biomarker,in the sera of uveitis patients with sarcoidosis[J].Japanese Journal of Ophthalmology,2010,54(1):81-84.
[42]陈芳,舒晓明,王冬雪,等.血清肺表面活性蛋白-A,D检测在多发性肌炎/皮肌炎合并间质性肺病中的意义[J].中华医学杂志,2012,92(31):2 182-2 185.
[43]Tzouvelekis A,Kouliatsis G,Anevlavis S,et al.Serum biomarkers in interstitial lung diseases[J].Respiratory Research,2005,6(1):289-298.
[44]Tzouvelekis A P I B D.Serum biomarkers in Acute Respiratory Distress Syndrome an ailing prognosticator[J].Respiratory Research,2005,6(4):259-267.
[45]Satoko A,Kazuhiro K,Reika M,et al.Marked increase in serum KL-6and surfactant protein D levels during the first 4weeks after treatment predicts poor prognos is in patients with active interstitial pneumonia associated with polymyositis/dermatomyositis[J].Modern Rheumatology,2013,23(5):872-883.
[46]宋以信,原信之.间质性肺疾病与血清KL-6关系的研究[J].中国综合临床,2002,18(9):806-807.
[47]Bonella F,Ohshimo S,Cai M,et al.Serum KL-6is a predictor of outcome in pulmonary alveolar proteinosis[J].Orphanet Journal of Rare Diseases,2013,8(4):238-254.
[48]Takahashi H,Fujishima T,Koba H,et al.Serum surfactant proteins A and D as prognostic factors in idiopathic pulmonary fibrosis and their relationship to disease extent[J].American Journal of Respiratory&Critical Care Medicine,2000,162(3):1 109-1 114.
[49]Asghar H.Naqvi,Hunt A.Pathologic spectrum and lung dust burden in giant cell interstitial pneumonia(hard metal disease/cobalt pneumonitis):review of 100cases[J].Arch Environ Occup Health,2008,63(2):51-70.
[50]Kaneko Y,Kikuchi N,Ishii Y,et al.Upper Lobe-Dominant Pulmonary Fibrosis Showing Deposits of HardMetal Component in the Fibrotic Lesions[J].Intern Med,2010,49(19):2143-2147.
[51]Nureki S,Miyazaki E,Nishio S,et al.Hard metal lung disease successfully treated with inhaled corticosteroids[J].Internal medicine(Tokyo,Japan),2012,52(17):1 957-1 961.
[52]Nakamura Y,Nishizaka Y,Ariyasu R,et al.Hard metal lung disease diagnosed on a transbronchial lung biopsyfollowing recurrent contact dermatitis[J].Internal medicine(Tokyo,Japan),2013,53(2):139-143.
[2]Takahashi H,Sano H,Chiba H,et al.Pulmonary surfactant proteins A and D:innate immune function and biomarkers for lung diseases.Current Pharmaceutical Design,2006,12:589-598.
[3]Lynch JPI,Saggar R,Weigt SS,et al.Usual interstitial pneumonia[C].Seminars in respiratory and critical care medicine,2006,27(6):634-651.
[4]Oberley R E,Ault K A,Neff T L,et al.Surfactant proteins A and D enhance the phagocytosis of Chlamydia into THP-1 cells[J].American Journal of Physiology-Lung Cellular and Molecular Physiology,2004,287(2):296-306.
[5]Khamri W,Moran A P,Worku M L,et al.Variations in Helicobacter pylori lipopolysaccharide to evade the innate immune component surfactant protein D[J].Infection and immunity,2005,73(11):7 677-7 686.
[6]Kishore U,Greenhough T J,Waters P,et al.Surfactant proteins SP-A and SP-D:structure,function and receptors[J].Molecular immunology,2006,43(9):1 293-1 315.
[7]Ohtsuki Y,Fujita J,Hachisuka Y,et al.Immunohistochemical and immunoelectron microscopic studies of the localization of KL-6and epithelial membrane antigen(EMA)in presumably normal pulmonary tissue and in interstitial pneumonia[J].Medical Molecular Morphology,2007,40(4):198-202.
[8]Inagaki Y,Tang W,Huanli X U,et al.Sustained Aberrant Localization of KL-6 Mucin andβ-Catenin at the Invasion Front of Human Gastric Cancer Cells[J].Anticancer Research,2011,31(2):535-542.
[9]King RJ,Klass DJ,Gikas EG,et al.Isolation of apoproteins from canine surface active material[J].Am J Physiol,1973,224:788-795.
[10]Reid K B M,Clark H,Palaniyar N.Surfactant and lung inflammation[J].Thorax,2005,60(8):620-622.
[11]Haczku A.Protective role of the lung collectins surfactant protein A and surfactant protein D in airway inflammation[J].Allergy Clin Immunol,2008,122:861-879.
[12]Kishore U,Greenhough TJ,Waters P,et al.Surfactant protein SP-A and SP-D:structure,function and receptors[J].M0lImmunol,2006,43:1 293-1 315.
[13]Crouch EC.Surfactant protein-D and pulmonary host defense[J].Respir Res,2001,1(2):93-108.
[14]Winkler C,Atochina-Vasserman EN,Holz O,et al.Comprehensive characterisation of pulmonary and serum surfactant protein D in COPD[J].Respir Res,2011,12:29.
[15]Greene KE,King TE Jr,Kuroki Y,et al.Serum surfactant proteins-A and D as biomarkeis in idiopathic pulmonary fibrosis[J].Eur Respir J,2002,19(3):439-446.
[16]Hartl D,Griese M.Surfactant protein D in human lung diseases[J].Eur J Clin Invest,2006,36:423-435.
[17]Orgeig S,Hiemstra P S,Veldhuizen E J A,et al.Recent advances in alveolar biology:evolution and function of alveolar proteins[J].Respiratory Physiology&Neurobiology,2010,173(1):43-54.
[18]Stahel R A,Gilks W R,Lehmann H,et al.Third international workshop on lung tumor and differentiation antigens:Overview of the results of the central data analysis[J].International Journal of Cancer,1994,57(Supplement S8):6-26.
[19]Kuwano K,Maeyama T,Inoshima I,et al.Increased circulating levels of soluble Fas ligand are correlated with disease activity in patients with fibrosing lung diseases[J].Respirology,2002,7(1):15-21.
[20]Hattrup C L,Gendler S J.Structure and function of the cell surface(tethered)mucins[J].Annual Review of Physiology,2008,70:431-457.
[21]Hirasawa Y,Kohno N,Yokoyama A,et al.KL-6,a human MUC1mucin,is chemotactic for human fibroblasts[J].Am J Respir Cell Mol Biol,1997,17(4):501-507.
[22]陈玥.人类胚胎肺不同时期SP-A和SP-D的表达及其意义[D].第一军医大学,2005.
[23]Haczku A.Protective role of thelungcollectins surfactant protein Aand surfactantproteinD inairway inflammation[J].J Allergy Clin Immunol,2008,122:861-879.
[24]akahashi H,Sano H,Chiba H,et al.Pulmonary surfactant proteinsA and D:innate immune functions and biomarkers for lungdiseases[J].CurrPharm Des,2006,12:589-598.
[25]Gardai S J,Xiao Y M,Nick J A,et al.By binding SIRPalpha or calreticulin/CD91,lung collectins act as dual function surveillance molecules to suppress or enhance inflammation[J].Cell,2003,115(1):13-23.
[26]Kishore U,13ernai AL,Kamren MF,et al.Surfaccam proreins SP-A and SP-D in human heahh and disease[J].Arch Immunol T-her EKVW'araz),2005,53:399-417.
[27]Doi M,Yokoyama A,Kondo K,et al.Anti-tumor effect of the anti-KL-6/MUCl monoclonal antibody through exposure of surface molecules by MUCl capping[J].Cancer,2006,97(5):420-429.
[28]Xu H,Inagaki Y,Seyama Y,et al.Expression of KL-6/MUC1in pancreatic ductal carcinoma and its potential relationship withβ-catenin in tumor progression[J].Life Sciences,2011,88:1 063-1 069.
[29]McCormack F X,Whitsett J A.The puImonary coIIectins,SP-Aand SP-D,orchestrate innateimmunity in the lung[J].The JournaIof cIinicaI investigation,2002,109(6):707-712.
[30]Abe S,Honda Y,Ando M,et al.[Clinical significance of levels of lung surfactant protein A in serum,in various lung diseases][J].Nihon Kyōbu Shikkan Gakkai Zasshi,1995,33(11):1 219-1225.
[31]H Ishii,H Mukae,J Kadota,et al.High serum concentrations of surfactant protein A in usual interstitial pneumonia compared with non-specific interstitial pneumonia[J].Thorax,2003,58(1):52-57.
[32]Greene K E,Jr K T,Kuroki Y,et al.Serum surfactant proteins-A and-D as biomarkers in idiopathic pulmonary fibrosis[J].European Respiratory Journal,2002,19(3):439-446.
[33]Kuroki Y,Tsutahara S,Shijubo N,et al.Elevated levels of lung surfactant protein A in sera from patients with idiopathic pulmonary fibrosis and pulmonary alveolar proteinosis[J].American Review of Respiratory Disease,1993,147(3):723-729.
[34]Honda Y,Kuroki Y,Shijubo N,et al.Aberrant appearance of lung surfactant protein A in sera of patients with idiopathic pulmonary fibrosis and its clinical significance[J].Respiration,1995,62(2):64-69.
[35]Greene K E,Jr K T,Kuroki Y,et al.Serum surfactant proteins-A and-D as biomarkers in idiopathic pulmonary fibrosis[J].European Respiratory Journal,2002,19(3):439-446.
[36]Takahashi H,Kuroki Y H,Saito T,et al.Serum levels of surfactant proteins A and D are useful biomarkers for interstitial lung disease in patients with progressive systemic sclerosis[J].American Journal of Respiratory&Critical Care Medicine,2000,162(1):258-263.
[37]Takahashi H,Shiratori M,Kanai A,et al.Monitoring markers of disease activity for interstitial lung diseases with serum surfactant proteins A and D[J].Respirology,2006,11(1):51-54.
[38]Ohshimo S,Yokoyama A,Hattori N,et al.KL-6,a human MUC1 mucin,promotes proliferation and survival of lung fibroblasts[J].Biochem Biophys Res Commun,2005,338(4):1 845-1 852.
[39]Kobayashi M,Takeuchi T,Ohtsuki Y.Differences in the immunolocalization of surfactant protein(SP)-A,SP-D,and KL-6in pulmonary alveolar proteinosis[J].Pathology International,2008,58(3):203-207.
[40]Hiroshi O,Akihito Y,Keiichi K,et al.Comparative study of KL-6,surfactant protein-A,surfactant protein-D,and monocyte chemoattractant protein-1as serum markers for interstitial lung diseases[J].American Journal of Respiratory&Critical Care Medicine,2002,165(3):378-381.
[41]Kitaichi N,Kitamura M,Namba K,et al.Elevation of surfactant protein D,apulmonary disease biomarker,in the sera of uveitis patients with sarcoidosis[J].Japanese Journal of Ophthalmology,2010,54(1):81-84.
[42]陈芳,舒晓明,王冬雪,等.血清肺表面活性蛋白-A,D检测在多发性肌炎/皮肌炎合并间质性肺病中的意义[J].中华医学杂志,2012,92(31):2 182-2 185.
[43]Tzouvelekis A,Kouliatsis G,Anevlavis S,et al.Serum biomarkers in interstitial lung diseases[J].Respiratory Research,2005,6(1):289-298.
[44]Tzouvelekis A P I B D.Serum biomarkers in Acute Respiratory Distress Syndrome an ailing prognosticator[J].Respiratory Research,2005,6(4):259-267.
[45]Satoko A,Kazuhiro K,Reika M,et al.Marked increase in serum KL-6and surfactant protein D levels during the first 4weeks after treatment predicts poor prognos is in patients with active interstitial pneumonia associated with polymyositis/dermatomyositis[J].Modern Rheumatology,2013,23(5):872-883.
[46]宋以信,原信之.间质性肺疾病与血清KL-6关系的研究[J].中国综合临床,2002,18(9):806-807.
[47]Bonella F,Ohshimo S,Cai M,et al.Serum KL-6is a predictor of outcome in pulmonary alveolar proteinosis[J].Orphanet Journal of Rare Diseases,2013,8(4):238-254.
[48]Takahashi H,Fujishima T,Koba H,et al.Serum surfactant proteins A and D as prognostic factors in idiopathic pulmonary fibrosis and their relationship to disease extent[J].American Journal of Respiratory&Critical Care Medicine,2000,162(3):1 109-1 114.
[49]Asghar H.Naqvi,Hunt A.Pathologic spectrum and lung dust burden in giant cell interstitial pneumonia(hard metal disease/cobalt pneumonitis):review of 100cases[J].Arch Environ Occup Health,2008,63(2):51-70.
[50]Kaneko Y,Kikuchi N,Ishii Y,et al.Upper Lobe-Dominant Pulmonary Fibrosis Showing Deposits of HardMetal Component in the Fibrotic Lesions[J].Intern Med,2010,49(19):2143-2147.
[51]Nureki S,Miyazaki E,Nishio S,et al.Hard metal lung disease successfully treated with inhaled corticosteroids[J].Internal medicine(Tokyo,Japan),2012,52(17):1 957-1 961.
[52]Nakamura Y,Nishizaka Y,Ariyasu R,et al.Hard metal lung disease diagnosed on a transbronchial lung biopsyfollowing recurrent contact dermatitis[J].Internal medicine(Tokyo,Japan),2013,53(2):139-143.