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Increased recovery of surfactant protein A in AIDS-related pneumonia.


Am Rev Respir Dis. 1991 May;143(5 Pt 1):1072-5. Unique Identifier :

Respiratory infection with Pneumocystis carinii (PC) is the most frequent serious opportunistic infection in the clinical setting of acquired immunodeficiency syndrome (AIDS). The factors responsible for the predisposition of human immunodeficiency virus (HIV)-infected patients for PC infection are not fully understood. We postulated that changes in the alveolar lining material (ALM) could play a role in the pathogenesis of PC infection in AIDS. We have compared constituents of ALM in bronchoalveolar lavage fluid from normal, nonsmoking volunteers with that of HIV-infected patients with pneumonia. Using an ELISA, we found that surfactant protein A (SP-A) was markedly elevated in the pneumonia patients. Mean SP-A values for the normal nonsmoking individuals (n = 21) were 1.50 +/- 0.25 micrograms/ml (mean +/- SEM). SP-A levels in the HIV-infected patients (n = 22) were significantly elevated (p less than 0.01) with a mean of 5.23 +/- 0.54 micrograms/ml. This increase was greatest in the patients with more clinically severe pneumonia. The increase in SP-A did not appear to be pathogen-specific as it was also observed in cases of non-PC pneumonia. We also found that total protein levels were nearly five times higher in the HIV-infected pneumonia patients. These studies indicate that the protein component of the ALM is markedly different from normal in cases of HIV-associated PC and non-PC infection. Further investigation is needed to determine the mechanism of these alterations and their role, if any, in AIDS-related pneumonia.

Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Bronchoalveolar Lavage Fluid/*CHEMISTRY Comparative Study Enzyme-Linked Immunosorbent Assay Glycoproteins/*ANALYSIS Human Middle Age Pneumonia/*COMPLICATIONS/DIAGNOSIS Pneumonia, Pneumocystis carinii/*COMPLICATIONS/DIAGNOSIS Proteolipids/*ANALYSIS Pulmonary Alveoli/CHEMISTRY Pulmonary Surfactants/*ANALYSIS Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE


Information in this article was accurate in August 30, 1991. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.