Fetal and neonatal samples of a precursor surfactant protein B inversely related to gestational age

BMC Pediatrics

Hans Proquitté²  Christoph Bührer¹  Gerd Schmalisch¹  Christoph Czernik¹ 

[1] Department of Neonatology, Charité University Medical Center, Berlin, Germany;Department of Neonatology / Ped. Intensive Care, University Hospital, Jena, Germany

关键词: Preterm infants;    Immaturity;    Urine;    Amniotic fluid;    Blood;    C-proSP-B;   

Others  :  1144444
DOI  :  10.1186/1471-2431-13-164

 received in 2013-04-03, accepted in 2013-10-08,  发布年份 2013

【 摘 要 】

Background

Alveolar–capillary membrane leaks can increase the amount of surfactant protein B (SP-B) in the bloodstream. The purpose of this study was to measure the concentration of C-proSP-B, a SP-B precursor that includes C-terminal domains, in various body fluids of newborn infants and determine its dependence on gestational age.

Methods

C-pro-SPB was measured in amniotic fluid and umbilical cord blood at birth, and in peripheral blood and urine on postnatal day 3 in 137 newborn infants with a median birth weight of 2015 g (range, 550–4475 g) and gestational age of 34 weeks (range, 23–42 weeks).

Results

C-proSP-B levels differed more than 100-fold among samples. The levels (median; interquartile range) were highest in peripheral blood (655.6 ng/mL; 419.0-1467.0 ng/mL) and lowest in urine (3.08 ng/mL; 2.96-3.35 ng/mL). C-proSP-B levels in amniotic fluid (314.9 ng/mL; 192.7–603.6 ng/mL) were approximately half of those in peripheral blood. In cord blood C-proSP-B was slightly lower (589.1 ng/mL; 181.2-1129.0 ng/mL) compared with peripheral blood. C-proSP-B levels significantly increased in all the fluids sampled except urine with decreasing gestational age (p < 0.001).

Conclusions

This novel assay allows for the quantitative measurement of C-proSP-B in blood and amniotic fluid. The dependence of C-proSP-B on gestational age may hamper its use for the detection of alveolar leaks in preterm newborns.

【 授权许可】

   
2013 Czernik et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Cogo P, Baritussio A, Rosso F, Gucciardi A, Moretti V, Badon T, et al.: Surfactant-associated protein B kinetics in vivo in newborn infants by stable isotopes. Pediatr Res 2005, 57:519-522.
• [2]Merrill JD, Ballard RA, Cnaan A, Hibbs AM, Godinez RI, Godinez MH, et al.: Dysfunction of pulmonary surfactant in chronically ventilated premature infants. Pediatr Res 2004, 56:918-926.
• [3]Serrano AG, Cabre EJ, Perez-Gil J: Identification of a segment in the precursor of pulmonary surfactant protein SP-B, potentially involved in pH-dependent membrane assembly of the protein. Biochim Biophys Acta 2007, 1768:1059-1069.
• [4]Whitsett JA, Nogee LM, Weaver TE, Horowitz AD: Human surfactant protein B: structure, function, regulation, and genetic disease. Physiol Rev 1995, 75:749-757.
• [5]Tokieda K, Whitsett JA, Clark JC, Weaver TE, Ikeda K, McConnell KB, et al.: Pulmonary dysfunction in neonatal SP-B-deficient mice. Am J Physiol 1997, 273:L875-L882.
• [6]Walther FJ, Hernandez-Juviel JM, Gordon LM, Sherman MA, Waring AJ: Dimeric surfactant protein B peptide sp-b(1–25) in neonatal and acute respiratory distress syndrome. Exp Lung Res 2002, 28:623-640.
• [7]Dhar P, Eck E, Israelachvili JN, Lee DW, Min Y, Ramachandran A, et al.: Lipid-protein interactions alter line tensions and domain size distributions in lung surfactant monolayers. Biophys J 2012, 102:56-65.
• [8]Korimilli A, Gonzales LW, Guttentag SH: Intracellular localization of processing events in human surfactant protein B biosynthesis. J Biol Chem 2000, 275:8672-8679.
• [9]Robertson B, Curstedt T, Herting E, Sun B, Akino T, Schafer KP: Alveolar-to-vascular leakage of surfactant protein A in ventilated immature newborn rabbits. Biol Neonate 1995, 68:185-190.
• [10]Russo TA, Bartholomew LA, Davidson BA, Helinski JD, Carlino UB, Knight PR III, et al.: Total extracellular surfactant is increased but abnormal in a rat model of gram-negative bacterial pneumonia. Am J Physiol Lung Cell Mol Physiol 2002, 283:L655-L663.
• [11]Kuroki Y, Tsutahara S, Shijubo N, Takahashi H, Shiratori M, Hattori A, et al.: Elevated levels of lung surfactant protein A in sera from patients with idiopathic pulmonary fibrosis and pulmonary alveolar proteinosis. Am Rev Respir Dis 1993, 147:723-729.
• [12]Chida S, Phelps DS, Soll RF, Taeusch HW: Surfactant proteins and anti-surfactant antibodies in sera from infants with respiratory distress syndrome with and without surfactant treatment. Pediatrics 1991, 88:84-89.
• [13]Honda Y, Kuroki Y, Matsuura E, Nagae H, Takahashi H, Akino T, et al.: Pulmonary surfactant protein D in sera and bronchoalveolar lavage fluids. Am J Respir Crit Care Med 1995, 152:1860-1866.
• [14]Bersten AD, Hunt T, Nicholas TE, Doyle IR: Elevated plasma surfactant protein-B predicts development of acute respiratory distress syndrome in patients with acute respiratory failure. Am J Respir Crit Care Med 2001, 164:648-652.
• [15]Magri D, Brioschi M, Banfi C, Schmid JP, Palermo P, Contini M, et al.: Circulating plasma surfactant protein type B as biological marker of alveolar-capillary barrier damage in chronic heart failure. Circ Heart Fail 2009, 2:175-180.
• [16]Agostoni P, Banfi C, Brioschi M, Magri D, Sciomer S, Berna G, et al.: Surfactant protein B and RAGE increases in the plasma during cardiopulmonary bypass: a pilot study. Eur Respir J 2011, 37:841-847.
• [17]Pascual-Figal DA, Sanchez-Mas J, de la Morena G, Casas T, Garrido IP, Ruiperez JA, et al.: Pulmonary surfactant protein B in the peripheral circulation and functional impairment in patients with chronic heart failure. Rev Esp Cardiol 2009, 62:136-142.
• [18]De Pasquale CG, Arnolda LF, Doyle IR, Aylward PE, Russell AE, Bersten AD: Circulating surfactant protein-B levels increase acutely in response to exercise-induced left ventricular dysfunction. Clin Exp Pharmacol Physiol 2005, 32:622-627.
• [19]Eisner MD, Parsons P, Matthay MA, Ware L, Greene K: Plasma surfactant protein levels and clinical outcomes in patients with acute lung injury. Thorax 2003, 58:983-988.
• [20]Doyle IR, Bersten AD, Nicholas TE: Surfactant proteins-A and -B are elevated in plasma of patients with acute respiratory failure. Am J Respir Crit Care Med 1997, 156:1217-1229.
• [21]Jobe A, Jacobs H, Ikegami M, Berry D: Lung protein leaks in ventilated lambs: effects of gestational age. J Appl Physiol 1985, 58:1246-1251.
• [22]Cho K, Matsuda T, Okajima S, Matsumoto Y, Sagawa T, Fujimoto S, et al.: Prediction of respiratory distress syndrome by the level of pulmonary surfactant protein A in cord blood sera. Biol Neonate 2000, 77:83-87.
• [23]Kaneko K, Shimizu H, Arakawa H, Ogawa Y: Pulmonary surfactant protein A in sera for assessing neonatal lung maturation. Early Hum Dev 2001, 62:11-21.
• [24]Pison U, Seeger W, Buchhorn R, Joka T, Brand M, Obertacke U, et al.: Surfactant abnormalities in patients with respiratory failure after multiple trauma. Am Rev Respir Dis 1989, 140:1033-1039.
• [25]Takahashi H, Sano H, Chiba H, Kuroki Y: Pulmonary surfactant proteins A and D: innate immune functions and biomarkers for lung diseases. Curr Pharm Des 2006, 12:589-598.
• [26]Mahmoud RA, Roehr CC, Schmalisch G: Current methods of non-invasive ventilatory support for neonates. Paediatr Respir Rev 2011, 12:196-205.
• [27]Ramanathan R: Optimal ventilatory strategies and surfactant to protect the preterm lungs. Neonatology 2008, 93:302-308.
• [28]Awasthi S, Coalson JJ, Yoder BA, Crouch E, King RJ: Deficiencies in lung surfactant proteins A and D are associated with lung infection in very premature neonatal baboons. Am J Respir Crit Care Med 2001, 163:389-397.
• [29]Beresford MW, Shaw NJ: Bronchoalveolar lavage surfactant protein a, B, and d concentrations in preterm infants ventilated for respiratory distress syndrome receiving natural and synthetic surfactants. Pediatr Res 2003, 53:663-670.
• [30]Keller RL, Merrill JD, Black DM, Steinhorn RH, Eichenwald EC, Durand DJ, et al.: Late administration of surfactant replacement therapy increases surfactant protein-B content: a randomized pilot study. Pediatr Res 2012, 72:613-619.
• [31]Higuchi M, Hirano H, Gotoh K, Takahashi H, Maki M: Relationship of fetal breathing movement pattern to surfactant phospholipid levels in amniotic fluid and postnatal respiratory complications. Gynecol Obstet Invest 1991, 31:217-221.
• [32]Kalache KD, Chaoui R, Marks B, Wauer R, Bollmann R: Does fetal tracheal fluid flow during fetal breathing movements change before the onset of labour? BJOG 2002, 109:514-519.
• [33]Sonntag J, Prankel B, Waltz S: Serum creatinine concentration, urinary creatinine excretion and creatinine clearance during the first 9 weeks in preterm infants with a birth weight below 1500 g. Eur J Pediatr 1996, 155:815-819.