[1,25(OH)2D3] has been reported to stimulate lung maturity, alveolar type II cell differentiation, and pulmonary surfactant synthesis in rat lung. We hypothesized that 1,25(OH) 2D3 stimulates expression of surfactant protein-A (SP-A), SP-B, and SP-C in human fetal lung and type II cells. We found that immunoreactive vitamin D receptor was detectable in fetal lung tissue and type II cells only when incubated with 1,25(OH)2D3. 1,25(OH)2D3 significantly decreased SP-A mRNA in human fetal lung tissue but did not significantly decrease SP-A protein in the tissue. In type II cells, 1,25(OH)2D3 alone had no significant effect on SP-A mRNA or protein levels but reduced SP-A mRNA and protein in a dose-dependent manner when the cells were incubated with cAMP. SP-A mRNA levels in NCI-H441 cells, a nonciliated bronchiolar epithelial (Clara) cell line, were decreased in a dose-dependent manner in the absence or presence of cAMP. 1,25(OH)2D3 had no significant effect on SP-B mRNA levels in lung tissue but increased SP-B mRNA and protein levels in type II cells incubated in the absence or presence of cAMP. Expression of SP-C mRNA was unaffected by 1,25(OH)2D3 in lung tissue incubated Ϯ cAMP. These results suggest that regulation of surfactant protein gene expression in human lung and type II cells by 1,25(OH)2D3 is not coordinated; 1,25(OH)2D3 decreases SP-A mRNA and protein levels in both fetal lung tissue and type II cells, increases SP-B mRNA and protein levels only in type II cells, and has no effect on SP-C mRNA levels. alveolar type II cell; steroid hormone PULMONARY SURFACTANT IS a unique complex of phospholipids and proteins that maintains alveolar integrity by reducing surface tension at the alveolar air-liquid interface (15) and participates in host defense and the control of inflammation in the lung (16). Surfactant is composed of 90% lipids and 10% proteins by weight. Phosphatidylcholine, mostly dipalmitoyl phosphatidylcholine, constitutes 70 -80% of the lipid portion of surfactant. Several distinct lung-specific proteins make up the protein component of surfactant, surfactant protein-A (SP-A), SP-B, SP-C, and SP-D (23). Whereas the lipid portion of surfactant is largely responsible for its surface activity, the highly hydrophobic proteins SP-B and SP-C also play a direct role in influencing the surface tension-reducing properties of surfactant (54). On the other hand, SP-A and SP-D are hydrophilic members of the collectin family of proteins (25) that play important roles in the control of host defense and inflammation in the lung (16). Pulmonary alveolar type II epithelial cells that are positioned in the corners of the alveoli carry out the highly specialized functions of synthesizing, secreting, and reutilizing surfactant (36, 49). Surfactant synthesis is initiated in alveolar type II cells only after 75% of gestation is complete (43). Infants born before this period of gestation lack sufficient surfactant and are predisposed to develop respiratory distress syndrome, one of the leading causes of neonatal morbi...