BRICHOS is a domain found in several proteins consisting of ف 100 amino acids with sequence and structural similarities. Mutations in BRICHOS domain have been associated with both degenerative and proliferative diseases in several nonpulmonary organs, although the pathogenic mechanisms are largely undefined. Recently, several mutations in surfactant protein C (SP-C) mapping to the BRICHOS domain located within the proprotein (proSP-C) have been linked to interstitial lung diseases. In vitro expression of one of these BRICHOS mutants, the exon 4 deletion (hSP-C Surfactant protein C (SP-C) is a small hydrophobic protein, found in pulmonary surfactant, initially identified upon isolation from bronchoalveolar lavage of a variety of mammalian species. SP-C is synthesized in alveolar type II cells as a 21-kD integral membrane precursor (proSP-C), which undergoes proteolytic C-and N-terminal cleavages as it is trafficked through the biosynthetic pathway from the Golgi complex, by way of small vesicles and multivesicular bodies, to the lumen of lamellar bodies, yielding a 3.7-kD mature peptide (1, 2). Together with other surfactant proteins and phospholipids contained in the lamellar body, SP-C is released into the alveolar space, via regulated secretion (1, 3), where it functions to modulate lung surface tension during the respiratory cycle.(Received in original form January 6, 2005 and in final form February 22, 2005) Correspondence and requests for reprints should be addressed to Surafel Mulugeta, Ph.D